Comprehensive Laboratory Evaluation of Impotent Men

Blaivas, Jerry G.; O’Donnell, Thomas F.; Gottlieb, Philip M.; Labib, Kamal B.

doi:10.1016/s0022-5347(17)55372-0

Cited by 36 publications

(15 citation statements)

References 9 publications

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“…After exam ining both BCR and pudendal SSEPs in 300 unselected men with erectile dysfunction, we feel that the latter often may be due to multiple factors such as psychogenic, vas cular and neurologic abnormalities in one and the same patient. This is in accordance with previous results [9]. However, as illustrated by the present case, the electro diagnostic tests prove to be a valid supplement to the clin ical examination for the diagnosis of 'neurogenic' impo tence.…”

supporting

confidence: 93%

Lipoma of the Cauda equina Selectively Involving Lower Sacral Roots

1992

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A 44-year-old male patient suffering from sexual and voiding dysfunction did not exhibit any sensorimotor deficit except for a lax anal sphincter with loss of the bulbocavernosus reflex (BCR). The absence of both the electrically induced BCR and cortical evoked responses to stimulation of the dorsal penile nerve as well as partial denervation of the pelvic floor musculature suggested damage to the lower sacral roots. The site of the lesion as indicated by electrophysiological findings was confirmed by computerized tomography and magnetic resonance imaging. The operation revealed a lipoma involving a few cauda fibers which produced a distension in the region of the conus medullaris.

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supporting

confidence: 93%

Lipoma of the Cauda equina Selectively Involving Lower Sacral Roots

1992

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“…The physiological significance of an ICP-to-BP ratio Ն0.6 in the rat model of penile erection has been previously noted (32) and is further supported by data summarized in Table 4. Similar measurements have been made in humans and reported as the penile-to-brachial index (PBI) (1,8,18,21,23,25,35). In clinical studies, a PBI value of Ͻ0.6 has been used as the cut off below which BP in the penis is considered insufficient to permit penile rigidity.…”

Section: Discussionmentioning

confidence: 87%

Intracorporal injection ofhSlocDNA restores erectile capacity in STZ-diabetic F-344 rats in vivo

Christ¹,

Day²,

Santizo³

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

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The ability of gene transfer with the pore-forming subunit of the human maxi-K channel ( hSlo) to ameliorate the decline in erectile capacity commensurate with 12–24 wk of streptozotocin (STZ)-diabetes was examined in 181 Fischer-344 rats. A 2-mo period of STZ-diabetes was induced before gene transfer, and erectile capacity was evaluated by measuring the intracavernous pressure response (ICP) to cavernous nerve (CN) stimulation (ranging from 0.5 to 10 mA). In the first series of experiments, ANOVA revealed increased CN-stimulated ICP responses at 1 and 2 mo postinjection of 100 μg pcDNA- hSlo compared with control values. A second series of experiments further examined the dose dependence and duration of gene transfer. The ICP response to submaximal (0.5 mA) and maximal (10 mA) nerve stimulation was evaluated 3 or 4 mo postinjection of a single dose of pcDNA- hSlo ranging from 10 to 1,000 μg. ANOVA again revealed that hSlo overexpression was associated with increased CN-stimulated ICP responses compared with responses in corresponding control animals. Histological studies revealed no immune response to the presence of hSlo. PCR analysis documented that expression of both plasmid and transcript were largely confined to the corporal tissue. In the third series of pharmacological experiments, hSlo gene transfer in vivo was associated with iberiotoxin-sensitive relaxation responses to sodium nitroprusside in corporal tissue strips in vitro. The latter data indicate that gene transfer produces functional maxi-K channels that participate in the modulation of corporal smooth muscle cell tone. Taken together, these observations suggest a fundamental diabetes-related change in corporal myocyte maxi-K channel regulation, expression, or function that may be corrected by expression of recombinant hSlo.

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“…A PBI < 0.6 is regarded as a diagnostic criterion of erectile dysfunction of arterial origin [4,[16][17][18]. However, corhparative studies of PBI and arteriography of the internal iliac artery showed that the PBI is not reliable in indicating the presence of a proximal stenosis in the area of the internal lilac or internal pudendal arteries [11,12,19]. Moreover, it is not very reliable in the identification of vascular anomalies [12].…”

Section: Discussionmentioning

confidence: 99%

“…Doppler ultrasound of the penile vessels after intracavernosal injection of vasoactive drugs is a minimally invasive and accurate method to define the arterial inflow, and is therefore an important diagnostic step in the multidisciplinary evaluation program of erectile dysfunction [3,4,6,12,19,22]. The high diagnostic effectiveness of Doppler ultrasound reduces the need for invasive angiography of the internal pudendal artery.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Doppler ultrasound technique of the penile arteries in correlation to selective arteriography

Gall¹,

Bähren²,

Scherb³

et al. 1988

Cardiovasc Intervent Radiol

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Abstract. In 63% of 265 patients with erectile dysfunction a relevant arterial inflow disturbance was found by Doppler ultrasound examination. Correlation between Doppler and arteriography in 58 patients showed an accuracy of 95% in detecting penile arteries and an accuracy of 91% in discovering a pathological arterial pattern (arterial anomaly or arteriosclerotic obstruction). In 15 patients the arterial inflow was measured additionally by Doppler ultrasound technique after intracavernosal injection of vasoactive drugs (IIVD) (7.5 mg .papaverine and 0.25 mg phentolamine). This technique proved to be more reliable than in the flaccid state and markedly facilitated localization and assessment of pathological changes of the cavernosal arteries.

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Comprehensive Laboratory Evaluation of Impotent Men

Cited by 36 publications

References 9 publications

Lipoma of the Cauda equina Selectively Involving Lower Sacral Roots

Lipoma of the Cauda equina Selectively Involving Lower Sacral Roots

Intracorporal injection ofhSlocDNA restores erectile capacity in STZ-diabetic F-344 rats in vivo

Diagnostic accuracy of Doppler ultrasound technique of the penile arteries in correlation to selective arteriography

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