Effects of sildenafil on human penile blood vessels

Medina, Pascual; Segarra, Gloria; Vila, José M.; Domènech, Cristina Benlloch; Martínez-León, Juan; Lluch, Salvador

doi:10.1016/s0090-4295(00)00622-1

Cited by 39 publications

(19 citation statements)

References 19 publications

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“…[8][9][10] However, the SV is a highly contractile tubular organ composed of circular and longitudinal smooth muscle layers similar to blood vessels and the trachea. In contrast to studies on the SV, the experiments for hollow organs usually use a ring preparation, for example, studies investigating the effects of sildenafil on human penile blood vessels 12 and testosterone-induced vasodilatory effects of the rat aorta. 17 Similarly, In vitro bath studies could provide more accurate and physiologic results with the ring technique which preserves the natural tubular structure of the SV.…”

Section: Discussionmentioning

confidence: 99%

“…These tissues are generally cut into ring or spiral shapes to record the response of both the circular and longitudinal muscle layers, preserving the physiology of the intact circular structures. 11,12 In addition, the ring preparation technique makes it easier to manipulate the tissues and therefore saves time thereby reducing the tissue destruction and hypoxic damage associated with tissue manipulation. The SV is a thick-walled muscular organ with a tubular structure similar to other hollow organs.…”

Section: Aimsmentioning

confidence: 99%

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A novel method of seminal vesicle preparation in isolated seminal vesicle experiments in the rat: ring preparation

et al. 2008

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In this study, we evaluated the efficacy of a novel method of seminal vesicle (SV) preparation-ring preparation method-in isolated SV experiments in the rat. Rat SVs were prepared as strips and rings and applied to organ baths. The relaxation responses by sodium nitroprusside or doxazosin and contractile responses by electrical field stimulation (EFS) were recorded in both groups. We compared the proportion of tissues that showed consistent responses to the stimuli-drug or EFSin both groups. And magnitudes of the contractile or relaxation responses were also evaluated in the two groups. In strip preparations (n ¼ 20), six tissues (30%) showed stable responses to drugs and were regarded to be useful. However, in ring preparations (n ¼ 20), 13 tissues (65%) showed stable responses (Po0.001). Similarly, consistent contractile responses to the EFS were recorded in eight strips (40%) and 13 rings (65%) (n ¼ 20 in each group; Po0.05). The magnitudes of the relaxations by drugs were not different between the two methods (P ¼ 0.42) and the contractions by EFS were higher in ring preparations (Po0.05). The ring preparation seems to be better for responses to drugs and EFS compared with the strip preparations and, therefore, might be an alternative technique for in vitro SV experiments.

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Section: Discussionmentioning

confidence: 99%

Section: Aimsmentioning

confidence: 99%

A novel method of seminal vesicle preparation in isolated seminal vesicle experiments in the rat: ring preparation

et al. 2008

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“…Mc Auley et al 23 demonstrated experimentally that IC sildenafil has an erectogenic effect independent of the classical NO/cGMP pathway. Furthermore, Medina et al 24 found that the relaxant effect of sildenafil on penile vessels involves in addition to the NO-mediated relaxation an inhibitory effect on the noradrenergic contractions and on the smooth muscle contractions.…”

Section: Discussionmentioning

confidence: 99%

Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function

et al. 2005

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To assess the efficacy of vacuum constriction devices (VCD) following radical prostatectomy (RP) and determine whether early use of VCD facilitates early sexual activity and potentially earlier return of erectile function. This prospective study consisted of 109 patients who underwent nervesparing (NS) or non-nerve-sparing (NNS) RP between August 1999 and October 2001 and developed erectile dysfunction following surgery. The patients were randomized to VCD use daily for 9 months (Group 1, N ¼ 74) or observation without any erectogenic treatment (Group 2, N ¼ 35). Treatment efficacy was analyzed by responses to the Sexual Health Inventory of Men (SHIM) (abridged 5-item International Index of Erectile Function (IIEF-5)), which were stratified by the NS status. Patient outcome regarding compliance, change in penile length, return of natural erection, and ability for vaginal intercourse were also assessed. The mean patient age was 58.2 years, and the minimum follow-up was 9 months. Use of VCD began at an average of 3.9 weeks after RP. In Group 1, 80% (60/ 74) successfully used their VCD with a constriction ring for vaginal intercourse at a frequency of twice/week with an overall spousal satisfaction rate of 55% (33/60). In all, 19 of these 60 patients (32%) reported return of natural erections at 9 months, with 10/60 (17%) having erections sufficient for vaginal intercourse. The abridged IIEF-5 score significantly increased after VCD use in both the NS and NNS groups. After a mean use of 3 months, 14/74 (18%) discontinued treatment. In Group 2, 37% (13/35) of patients regained spontaneous erections at a minimum follow-up of 9 months after surgery. However, only four of these patients (29%) had erections sufficient for successful vaginal intercourse and rest of patients (71%) sought adjuvant treatment. Of the 60 successful users, 14 (23%) reported a decrease in penile length and circumference at 9 months (range, 4-8 months) compared to 12/14 (85%) among the nonresponders. However, in control group 22/35 reported decrease in penile length and circumference. Early use of VCD following RP facilitates early sexual intercourse, early patient/spousal sexual satisfaction, and potentially an earlier return of natural erections sufficient for vaginal penetration.

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“…20 Studies in vitro have shown that sildenafil is preferentially selective for PDE-5, but not exclusive of other phosphodiesterase enzymes. 1,21 The concomitant use of potent cytochrome P450 3A4 inhibitors (e.g., erythromycin, ketoconazole, itraconazole among several others) as well as the nonspecific CYP inhibitor cimetidine can be associated with increased plasma levels of PDE5i. [22][23][24][25][26] Whether this is clinically relevant is controversial.…”

Section: Mechanism Of Action Of Pde-5imentioning

confidence: 99%

The effects of chronic phosphodiesterase-5 inhibitor use on different organ systems

et al. 2006

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Phosphodiesterase-5 (PDE-5) inhibitors selectively inhibit PDE-5 enzymes that are present in various tissues like penile tissue, platelets, vascular, and smooth muscle tissue. The drug's actions on these tissues have lead to the successful therapeutic use in patients suffering from conditions such as erectile dysfunction (ED) and pulmonary hypertension. PDE-5 inhibitors (PDE-5i) act on the erectile tissue causing penile smooth muscle relaxation and vasodilatation leading to penile erection. In addition, in particular when used in conjunction with prostaglandin inhibitors, PDE-5i cause vasodilatation in pulmonary vasculature hence decreasing both the pulmonary arterial pressure and resistance. PDE-5i have also shown to mildly decrease blood pressure, increase cardiac index, and increase coronary blood flow in experimental animals as well as in human studies. The Food and Drug Administration (FDA) has approved three PDE-5i for the treatment of ED: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) and one for pulmonary hypertension: sildenafil (Revatio). These agents are highly selective for PDE-5 enzymes as compared to other subclasses of PDE enzymes and have the almost identical pharmacological action but slightly different pharmacokinetics. Only little data exist about long-term use of PDE-5i and their effects on different organ system. This paper reviews the current information available on chronic PDE-5 inhibitor use.

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Effects of sildenafil on human penile blood vessels

Cited by 39 publications

References 19 publications

A novel method of seminal vesicle preparation in isolated seminal vesicle experiments in the rat: ring preparation

A novel method of seminal vesicle preparation in isolated seminal vesicle experiments in the rat: ring preparation

Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function

The effects of chronic phosphodiesterase-5 inhibitor use on different organ systems

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