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Etiology and treatment of erectile failure in diabetes mellitus.
Men with diabetes are especially prone to neuronal and endothelial disease and are afflicted with erectile dysfunction (ED) at a much higher incidence and prevalence than normal men, with a consequent reduction in quality of life. ED in diabetes results from combinations of impairments from nearly every step in the production of a penile ( penis enlargement pills for big penis) erection. These include the failed transmission of neural signals to and from the spinal cord due to neuropathy resulting in reduced neural nitric oxide (NO) delivery to cavernosal smooth muscle, impaired sinusoidal endothelial cell NO release because of endothelial dysfunction, reduced arterial and arteriolar inflow due to peripheral vascular disease, and failure of relaxation of the corpora from glycation of the elastic fibers. The evaluation of men with diabetes and ED is similar to that in nondiabetic men. It includes assessment of gonadal, neural, arterial, and on occasion, venous function, along with marital and psychological status. Although treatment options for diabetic men with ED have fortunately expanded, the risk factors for ED are the same as those for cardiovascular disease; a flagging male organ ( penis enlargement pills for enhancement) should raise a red flag of warning to evaluate and treat the risk factors for coronary, cerebral, and peripheral vascular disease, which are common in persons, of either sex, afflicted by diabetes.
Application of Yao medicine in andrology
Yao medicine, with its long history and peculiar characteristics, has developed in the long practice of the Yao peoples fight against diseases. The past decade has seen frequent reports on the unique theories and techniques of Yao medicine in the diagnosis and treatment of andrological diseases. This paper reviews the original experiences of Yao medicine in the treatment of prostatitis, male infertility, male erectile dysfunction, and so on.
Regenerative medicine in andrology: Tissue engineering and gene therapy as potential treatment options for penile ( penis enlargement pills for big penis) deformations and erectile dysfunction.
Tissue engineering and gene therapy are currently investigated in animal studies for reconstructing penile ( penis enlargement pills for big penis) tissue or treating erectile dysfunction. This review aims to examine these experimental efforts from the last years and tries to give a brief introduction to the basic methodology of these new techniques from the field of regenerative medicine.
Disorders of ejaculation.
The physiology of ejaculation includes emission of sperm with the accessory gland fluid into the urethra, simultaneous closure of the urethral sphincters, and forceful ejaculation of semen through the urethra. Emission and closure of the bladder neck are primarily alpha-adrenergically mediated thoracolumbar sympathetic reflex events with supraspinal modulation. Ejaculation is a sacralspinal reflex mediated by the pudendal nerve. The most common ejaculation disorder is premature ejaculation, but there is little agreement regarding the definition of this disorder or its etiology, diagnosis, and treatment options. Premature ejaculation is in fact classically considered psychogenic in nature. However, recent data have demonstrated that prostatic inflammation/infection has been found with high frequency in premature ejaculation, suggesting a role of prostatic pathologies in the pathogenesis of some cases of failure of ejaculatory control. Rarer disorders are emission and ejaculation failure and urine contamination of semen. The new use of diagnostic procedures and the availability of pharmacological aids place this topic in the mainframe of medical sexology.
Quality of life after treatment for prostate cancer.
Quality of life is a major concern of patients when they are choosing treatment for prostate cancer. Health-related quality of life is a patient-centered variable from the field of health services research that can be measured in a valid and reliable manner. Using standardized questionnaires specifically developed to capture health-related quality of life data in men with prostate cancer, the effect of treatments on patients' quality of life can be studied. Patients with localized disease who are undergoing radical prostatectomy tend to have more sexual and urinary dysfunction than men undergoing external beam radiation therapy, although both groups have more impairment in these areas than age-matched controls. Men undergoing external beam radiation therapy have worse bowel function and more urinary distress from irritative voiding symptoms than men undergoing radical prostatectomy or age-matched controls. Recent studies of men undergoing interstitial brachytherapy indicate that these patients have less urinary leakage than those who undergo radical prostatectomy, but experience considerably more irritating voiding symptoms, which often profoundly affect their quality of life. Better information regarding the potential impact of prostate cancer treatment on quality of life will improve medical decision-making.
Management of the neuropathic bladder.
Neurological injury and disease are common, and intimately related to abnormalities of the urinary system. The prevention and treatment of urological sequelae in patients with neurological injury or disease requires a clear multidisciplinary management strategy.
Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: sexual function.
Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH), and sexual dysfunction, are common, highly bothersome conditions in older men, and the prevalence of both disorders increases with age. Sexual dysfunction manifests mainly as erectile dysfunction (ED), ejaculatory disorders, or decreased libido/hypoactive sexual desire (HSD). Whereas both reduced rigidity and reduced ejaculate volume are highly prevalent in ageing men, reduced rigidity and pain on ejaculation are considered to be most bothersome. Sexual dysfunction is much more prevalent in patients with LUTS/BPH than in men with no LUTS/BPH, even after controlling for confounding variables such as age or comorbidities. Hence LUTS/BPH is considered an independent risk factor for sexual dysfunction. Whether this is because of a common underlying pathology, or whether the considerable bother associated with LUTS/BPH leads to reduced sexual functioning, remains to be elucidated. Despite a decline in the frequency of sexual intercourse, as well as in overall sexual functioning, most ageing men report regular sexual activity and consider their sex life as an important dimension of their quality of life (QoL). However, most patients with LUTS/BPH experience a negative effect of their LUTS on their sex life. Hence, treatment of LUTS/BPH should aim to at least maintain or, if possible, improve sexual function. Current medical treatment of LUTS/BPH consists of monotherapy with alpha1-adrenoceptor (AR) antagonists, 5alpha-reductase inhibitors (RIs) or a combination of these. Whereas 5alpha-RIs increase the risk of ED, ejaculatory disorders and HSD, alpha1-AR antagonists can induce ejaculatory disorders, but do not provoke HSD or ED. Combined therapy carries the cumulative risk for sexual dysfunction associated with either type of drug. As already indicated, ED is generally perceived as more bothersome than ejaculatory disorders. In addition, alpha1-AR antagonists slightly improve overall sexual function, possibly by increasing blood flow in the male organ ( penis enlargement pills for enhancement) through alpha1-AR blockade and/or to an increased overall QoL from the relief of LUTS. It can be concluded that alpha1-AR antagonists constitute a first-line therapy for LUTS/BPH because they combine good treatment efficacy with very few adverse effects on sexual function.
Clinical presentations of Peyronie's disease.
Patients with Peyronie's disease usually present soon after the onset of the disease with penile ( penis enlargement pills for big penis) pain and deformity when they develop an erection. They are middle-aged men and a palpable plaque is usually present. A good clinical history and examination are all that are necessary to manage most patients with Peyronie's disease. Further investigation is only required in those men with erectile dysfunction or where surgery is indicated.
Urological manifestations of vascular disease.
We have detailed several of the urological manifestations of vascular disease. With the aging of the North American population, urologists will encounter the urological complications of vascular disease with ever-increasing frequency.
The etiology, diagnosis, and treatment of priapism: review of the American Foundation for Urologic Disease Consensus Panel Report.
Priapism is an important medical condition that requires immediate evaluation, and depending on etiology, may require emergency management. Based on the classification scheme offerednbsp;
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