Introduction Recent studies suggest a direct relationship between free testosterone and cavernous vasodilatation. Some men with erectile dysfunction (ED) associated with PADAM (partial androgen deficiency in aging men) might possibly benefit from testosterone undecanoate therapy (TRT). Objectives To determine the efficacy of testosterone undecanoate in facilitating the erectile response and patient satisfaction with sildenafil in men 40–70 years old with PADAM symptoms. Design and Methods Prospective study including 40 patients recruited after a sildenafil therapeutic trial. Total testosterone and sex hormone binding globulin (SHBG) were measured to calculate the free androgen index. Prostate specific antigen (PSA) was measured and repeated 2 months after treatment. A rating score was used for PADAM symptoms, and the 5-point abbreviated version of the International Index of Erectile Function (IIEF-5) to assess erectile function. Men failing to respond to sildenafil were randomized into two groups receiving sildenafil plus continuous TRT (group 1ST), and TRT (group 1T) alone. Men partially responding to sildenafil were randomized into two groups receiving sildenafil plus continuous TRT for 2 months (group 2ST), or sildenafil alone (group 2S). Treatment efficacy was assessed by analysis of between-group differences. Results Groups 1T, 2S, and 2ST showed significant improvement in PADAM scores (P < 0.05, Wilcoxon matched pairs test). Patients receiving both sildenafil plus continuous TRT (groups 1ST and 2ST) showed significant improvement in IIEF-5 scores (P < 0.5, paired t-test). No significant changes in serum levels of PSA were detected (paired t-test). Conclusions We conclude that TRT appears to be beneficial and safe in facilitating the erectile response and patient satisfaction with sildenafil in men with PADAM symptoms. Androgen supplementation should be carried out cautiously with careful monitoring to avoid possible adverse effects.
To evaluate the efficacy, safety and patients' preference of different treatment modalities of ED in men with SCI. Sixty SCI men with ED were included in the study. They were divided into three groups. Group A received sildenafil, group B received intracorporal injection (ICI) and were then shifted to sildenafil and group C used vacuum constriction devices (VCD) and were then shifted to sildenafil. Erection was evaluated before and after each treatment. Ninety percent of patients reported improvement of erection after sildenafil and ICI treatment according to IIEF-EF and only 70% of patients reported improvement in erection with VCD. However, 14 patients reported that they preferred sildenafil due to the easier route of administration. In men with SCI, sildenafil is the most effective treatment and is widely accepted. ICI, VCD therapy in SCI patients should be used according to patient's preference and choice.
Introduction With the increase in penile augmentation procedures it becomes important to assess what is the normal erect penile size in both potent men and men with erectile dysfunction (ED). Aim The aim of this work is to define the average stretched penile size in normal men and ED patients. Main Outcome Measures Penile length and girth. Methods This study included 1,027 adult men presenting to a university hospital outpatient clinic. Two groups of patients were included in this research work. Group I comprises normal adult men (949) and Group II, ED patients (78). There were no differences of race, age, height, and weight. Penile length and girth were measured using a tape measure and rigid ruler in the fully stretched states in both groups. All penile measurements were performed by the same physician. Results In normal men (Group I) the mean of the fully stretched length was 12.9 ± 1.9 cm and the mean of the fully stretched girth was 8.9 ± 0.9 cm. In ED patients (Group II), the mean of the fully stretched length was 11.2 ± 1.5 cm and the mean of fully stretched girth was 8.8 ± 0.8 cm. Comparing the mean of fully stretched penile lengths in both groups revealed statistical significant difference (P < 0.001) between them, whereas comparing the mean of fully stretched penile girths in both groups revealed statistical nonsignificant difference (P = 0.474) between them. There were significant positive correlations between fully stretched penile lengths and fully stretched penile girths in both groups. Conclusion The average of fully stretched penile length in normal potent men is 12.9 cm, whereas the patients with ED tend to have significantly shorter penises (11.2 ± 1.5 cm).
Introduction Common complications of intracavernous injection therapy include pain, hematoma formation, syncope, prolonged erections, and penile fibrosis. Rare reported complications include postinjection cavernositis, intracorporeal needle breakage. Aim We report a case of postinjection intracavernous needle breakage with successful ultrasound-guided retrieval. Methods A 32-year-old patient complaining of a 6-month penile pain following intracavernous papaverine injection presented to our department. Clinical examination and penile ultrasound revealed a broken intracavernous needle at the left mid-dorsum aspect of the penis with surrounding fibrosis. A decision was made to remove the broken needle. Results The needle was dislodged effortlessly under local anesthesia. Conclusion A deeply seated intracavernous broken needle should be immediately retrieved. Patients must be carefully instructed on the proper injection technique with emphasis on the delicacy of the needle and the possibility of needle breakage during injection.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.