Contemporary therapies for erectile dysfunction are generally targeted towards older men and universally engage pharmacological and/ or device related treatment options. Penile revascularization, using microvascular a...Contemporary therapies for erectile dysfunction are generally targeted towards older men and universally engage pharmacological and/ or device related treatment options. Penile revascularization, using microvascular arterial bypass surgical techniques, is a non-pharmacological, non-device-related, and reconstructive surgical strategy for men with erectile dysfunction that was first described by Dr Vaclav Michal in 1973.展开更多
The authors conducted an analytical cross-sectional study over a period of 3 months among hypertensive patients, in order to determine the frequency of the erectile dysfunction (ED), and to identify the predictive fac...The authors conducted an analytical cross-sectional study over a period of 3 months among hypertensive patients, in order to determine the frequency of the erectile dysfunction (ED), and to identify the predictive factors. It included treated hypertensive patients, presenting an ED, defined as the incapacity to obtain or maintain an erection sufficient for satisfactory sexual activity. On 265 hypertensive patients, 172 (65%) presented an ED. The average age was 58.2 ± 9.7 years. The associated cardiovascular risk factors were overweight/obesity in 99 cases (37.4%), sedentariness in 90 cases (34%), diabetes mellitus in 50 cases (19%), dyslipidemia in 12 cases (4.5%), and tobacco addiction in 6 cases (2.3%). Arterial hypertension (HTN), old of 6.7 ± 5.8 years, was treated by bitherapy in 129 cases (48.7%), and tritherapy in 102 cases (38.5%). The principal therapeutic classes used were ACE inhibitors/ARBs in 213 cases (81%), calcium antagonists in 205 cases (78%), thiazides in 137 cases (52.1%), and beta-blockers in 82 cases (31%). ED, severe in 124 cases (72%), and moderate in 48 cases (28%), consisted of a difficulty to maintain the erection in 78 cases (45.3%), to obtain the erection in 30 cases (17.4%), and the two partners in 64 cases (37.2%). In multivariate analysis, only the age, seniority of HTN, and the existence of diabetes mellitus were the predictive factors of ED. The early and effective assumption of responsibility of the AHT, as well as other cardiovascular risk factors whose diabetes, would make it possible to reduce the frequency of it, thus improving quality of life of the hypertensive patients.展开更多
Aim： To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction （ED） was related to their peak systolic velocity （PSV）, peripheral atherosclerosis, cardiovascular...Aim： To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction （ED） was related to their peak systolic velocity （PSV）, peripheral atherosclerosis, cardiovascular risk factors （RF） and/or comorbidities at low cardiovascular risk. Methods： We enrolled 97 patients with 1-2 RF and comorbidities, combined with arterial ED alone （group A, n = 27）, ED plus atherosclerotic carotid artery （group B, n = 23）, ED plus lower limb artery abnormalities （group C, n = 25）, and ED plus carotid and lower limb artery abnormalities （group D, n = 22）. Sildenafil efficacy （100 mg twice a week for 12 weeks） was also examined in patients with ≥ 3 RF, peripheral a（herosclerosis and no cardiovascular comorbidities （group E, n = 20）. Results： Median PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and E, respectively. Sildenafil response was higher in group A patients （77.8%）, intermediate in groups B and C （65.2% and 56%） and lowest in groups D （45.4%） and E （50%）, and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was nega- tively influenced by： 〉 3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidifies was positively related to atherosclerosis localization or extension （25, 35, 38 and 47 in groups A, B, C and D, respectively）. Conclusion： Low sildenafil efficacy in patients with arterial ED was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.展开更多
The landmark Massachusetts Male Ageing Study shed new light on the prevalence of erectile dysfunction （ED） and drew attention to ED as a disease of ageing. Over the years, ED has been linked to the development of ca...The landmark Massachusetts Male Ageing Study shed new light on the prevalence of erectile dysfunction （ED） and drew attention to ED as a disease of ageing. Over the years, ED has been linked to the development of cardiovascular disease （CVD） in some patients. There is clear evidence that ED and CVD share and have a similar risk factor profile. CVD is one of the most recognizable causes of mortality and early detection coupled with prevention of mortality from CVD has been the prime interest of many researchers. Consequently, there has been a multidisciplinary curiosity regarding the proposal to use ED as a marker for future CVD. I n fact, there have been several proposals to use ED as a screening tool for future CVD. We performed a comprehensive Search of two main databases--PubMed and Cochrane Library using a combination of keywords such as acute myocardial infarction, coronary artery disease （CAD） and ED. Journal articles from January 2000 to June 2011 were reviewed. We included all articles discussing the relationship between ED and CVD in the English language. All the relevant randomized controlled trials, cohort and retrospective studies, and review articles were included in our overall analysis in an attempt to answer the question whether all patients with ED should be clinically evaluated for CVD. The results showed a link between ED and the development of future CVD in some patients, but ED was not shown to be an independent risk predictor that is any better than the traditional Framingham risk factors. Screening for CVD may, however, be rewarding in younger patients with severe ED and in patients with concurrent CVD risk factors.展开更多
文摘Contemporary therapies for erectile dysfunction are generally targeted towards older men and universally engage pharmacological and/ or device related treatment options. Penile revascularization, using microvascular arterial bypass surgical techniques, is a non-pharmacological, non-device-related, and reconstructive surgical strategy for men with erectile dysfunction that was first described by Dr Vaclav Michal in 1973.
文摘The authors conducted an analytical cross-sectional study over a period of 3 months among hypertensive patients, in order to determine the frequency of the erectile dysfunction (ED), and to identify the predictive factors. It included treated hypertensive patients, presenting an ED, defined as the incapacity to obtain or maintain an erection sufficient for satisfactory sexual activity. On 265 hypertensive patients, 172 (65%) presented an ED. The average age was 58.2 ± 9.7 years. The associated cardiovascular risk factors were overweight/obesity in 99 cases (37.4%), sedentariness in 90 cases (34%), diabetes mellitus in 50 cases (19%), dyslipidemia in 12 cases (4.5%), and tobacco addiction in 6 cases (2.3%). Arterial hypertension (HTN), old of 6.7 ± 5.8 years, was treated by bitherapy in 129 cases (48.7%), and tritherapy in 102 cases (38.5%). The principal therapeutic classes used were ACE inhibitors/ARBs in 213 cases (81%), calcium antagonists in 205 cases (78%), thiazides in 137 cases (52.1%), and beta-blockers in 82 cases (31%). ED, severe in 124 cases (72%), and moderate in 48 cases (28%), consisted of a difficulty to maintain the erection in 78 cases (45.3%), to obtain the erection in 30 cases (17.4%), and the two partners in 64 cases (37.2%). In multivariate analysis, only the age, seniority of HTN, and the existence of diabetes mellitus were the predictive factors of ED. The early and effective assumption of responsibility of the AHT, as well as other cardiovascular risk factors whose diabetes, would make it possible to reduce the frequency of it, thus improving quality of life of the hypertensive patients.
文摘Aim： To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction （ED） was related to their peak systolic velocity （PSV）, peripheral atherosclerosis, cardiovascular risk factors （RF） and/or comorbidities at low cardiovascular risk. Methods： We enrolled 97 patients with 1-2 RF and comorbidities, combined with arterial ED alone （group A, n = 27）, ED plus atherosclerotic carotid artery （group B, n = 23）, ED plus lower limb artery abnormalities （group C, n = 25）, and ED plus carotid and lower limb artery abnormalities （group D, n = 22）. Sildenafil efficacy （100 mg twice a week for 12 weeks） was also examined in patients with ≥ 3 RF, peripheral a（herosclerosis and no cardiovascular comorbidities （group E, n = 20）. Results： Median PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and E, respectively. Sildenafil response was higher in group A patients （77.8%）, intermediate in groups B and C （65.2% and 56%） and lowest in groups D （45.4%） and E （50%）, and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was nega- tively influenced by： 〉 3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidifies was positively related to atherosclerosis localization or extension （25, 35, 38 and 47 in groups A, B, C and D, respectively）. Conclusion： Low sildenafil efficacy in patients with arterial ED was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.
文摘The landmark Massachusetts Male Ageing Study shed new light on the prevalence of erectile dysfunction （ED） and drew attention to ED as a disease of ageing. Over the years, ED has been linked to the development of cardiovascular disease （CVD） in some patients. There is clear evidence that ED and CVD share and have a similar risk factor profile. CVD is one of the most recognizable causes of mortality and early detection coupled with prevention of mortality from CVD has been the prime interest of many researchers. Consequently, there has been a multidisciplinary curiosity regarding the proposal to use ED as a marker for future CVD. I n fact, there have been several proposals to use ED as a screening tool for future CVD. We performed a comprehensive Search of two main databases--PubMed and Cochrane Library using a combination of keywords such as acute myocardial infarction, coronary artery disease （CAD） and ED. Journal articles from January 2000 to June 2011 were reviewed. We included all articles discussing the relationship between ED and CVD in the English language. All the relevant randomized controlled trials, cohort and retrospective studies, and review articles were included in our overall analysis in an attempt to answer the question whether all patients with ED should be clinically evaluated for CVD. The results showed a link between ED and the development of future CVD in some patients, but ED was not shown to be an independent risk predictor that is any better than the traditional Framingham risk factors. Screening for CVD may, however, be rewarding in younger patients with severe ED and in patients with concurrent CVD risk factors.
