The devil is in the details: an analysis of the subtleties between phosphodiesterase

Smith‐Harrison, Luriel I.; Patel, Abhishek; Smith, Ryan P.

doi:10.21037/tau.2016.03.01

Cited by 9 publications

(4 citation statements)

References 38 publications

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“…PDE5 inhibitors like sildenafil, tadalafil or vardenafil are used in the treatment of erectile dysfunction (Smith-Harrison et al 2016), but also to treat pulmonary hypertension (Ghofrani et al 2006) thereby exposing more and younger patients. Interestingly, long-term treatment with sildenafil did not change spontaneous contractility of the epididymis in a rat model (Mietens et al 2014).…”

Section: Pde Inhibitorsmentioning

confidence: 99%

Contractility of the epididymal duct - function, regulation and potential drug effects

et al. 2018

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During their transit through the epididymis, spermatozoa mature and acquire motility and fertilizing capacity. The smooth muscle cells (SMCs) of the epididymal duct are thought to be responsible for the adequate transport of spermatozoa. Thus, precise regulation of SMC function also represents a prerequisite for sperm maturation thereby contributing to male fertility. In this review we would like to highlight various aspects of epididymal SMC function and discuss several angles with respect to regulation of contraction and relaxation. Different to the vas deferens, where disturbed SMC pathways resulting in male infertility could be defined, comparable information is missing in the epididymis. We therefore include some vas deferens data which could also be useful for a better understanding of epididymal SMC function. Furthermore, we would like to draw attention to drugs used in clinical practice and their potential (side) effects on contractions in the epididymis.

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Section: Pde Inhibitorsmentioning

confidence: 99%

Contractility of the epididymal duct - function, regulation and potential drug effects

et al. 2018

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“… 11 , 28 , 29 , 30 Controlled trials and systematic reviews have shown that the response rates to that medication are almost 90%. 31 , 32 Because there is sound evidence in the literature demonstrating the efficacy and safety of PDE-5 inhibitors and other types of non-surgical treatment in men with SCI, we found it surprising that only a few patients had access to any sort of ED treatment. This fact might indicate that more attention should be addressed to this population of men with SCI and medical care providers.…”

Section: Discussionmentioning

confidence: 97%

Erectile Function Predicts Sexual Satisfaction in Men With Spinal Cord Injury

et al. 2017

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IntroductionSpinal cord injury (SCI) is usually a sudden traumatic event and has a negative effect on sexual function.AimTo evaluate the characteristics of sexual activity in men with SCI and identify predictors of being sexually active and having a satisfactory sex life.MethodsWe assessed sexual activity profiles of men with SCI from a Brazilian tertiary rehabilitation center from February to August 2012. All patients older than 18 years with SCI for longer than 1 year were invited to participate. We analyzed age, time since SCI, patient age at SCI, employment status, partner status, completeness of lesion, functional independence, urinary continence, and Sexual Health Inventory for Men (SHIM) score.Main Outcome MeasuresThe SHIM was used to assess erectile function (EF). Satisfaction with sex life was analyzed as a dichotomous variable. Predictors of an active and satisfactory sex life were identified using univariable and multivariable analyses.ResultsWe evaluated 295 men with mean age of 40.7 ± 14.5 years. Most patients had a complete SCI (65.1%) and 159 (53.9%) were incontinent. The median SHIM score was 5 (interquartile range = 0–16) and only 71 men (24.1%) had a SHIM score of at least 17. Of these men, 159 (53.9%) were sexually active. Only 63 men (39.6%) were satisfied with their sex life after SCI. In univariable analysis, all variables were associated with an active sex life. Those with a SHIM score of at least 17 had a greater likelihood of being sexually active (odds ratio = 116, 95% confidence interval = 14–432). EF was the only parameter associated with a satisfactory sex life (odds ratio = 1.3, 95% confidence interval = 1.2–1.4).ConclusionsMost men with SCI were sexually inactive and/or dissatisfied with their sex life. Age, duration of SCI, completeness of SCI, continence, having a partner, and good EF were identified as predictors of an active sex life. However, only EF was a predictor of a satisfactory sex life.Gomes CM, Miranda EP, de Bessa J, et al. Erectile Function Predicts Sexual Satisfaction in Men With Spinal Cord Injury. Sex Med 2017;5:e148–e155.

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“…The clinical efficacy and safety profile of PDE5i has been reported by numerous high-quality, well-designed, blinded, randomized controlled trials comparing PDE5i both to placebo and to other PDE5i drugs [3,4,5,6]. Overall, oral PDE5i in recommended doses is an effective medical therapy for ED with an excellent safety profile and is generally well tolerated.…”

Section: Current Standard Erectile Dysfunction Therapymentioning

confidence: 99%

A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction

Chung

2019

Medical Sciences

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Contemporary treatment algorithms for erectile dysfunction (ED) involve the use of medical therapies such as phosphodiesterase type 5 (PDE5) inhibitors and intracavernosal injection therapy of vasoactive agents, as well as vacuum erection devices and penile prosthesis implants in medically refractory cases. However, the current therapeutic options only address the symptoms of ED and not the underlying pathogenesis that results in ED. Newer and novel ED therapies aspire to reverse ED conditions by preventing cavernosal fibrosis, promoting endothelial revascularization and modulating various neuro-hormonal pathways. Regenerative therapeutic strategies such as low-intensity shock wave, gene and cellular-based therapies, and penile transplants are designed to improve penile hemodynamics and revitalize the cavernosal smooth muscle to mitigate and/or reverse underlying ED. This state-of-art article evaluates current and emerging therapeutic options for ED.

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The devil is in the details: an analysis of the subtleties between phosphodiesterase

Cited by 9 publications

References 38 publications

Contractility of the epididymal duct - function, regulation and potential drug effects

Contractility of the epididymal duct - function, regulation and potential drug effects

Erectile Function Predicts Sexual Satisfaction in Men With Spinal Cord Injury

A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction

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