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N-acetylcysteine ameliorates erectile dysfunction in rats with hyperlipidemia by inhibiting oxidative stress and corpus cavernosum smooth muscle cells phenotypic modulation

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Asian Journal of Andrology 2024年第1期26卷 99-106页

作者： Wei Ding Jun-Hong Fan Li-Ren Zhong Nan-Xiong Wang Lu-Hao Liu Hai-Bo Zhang Li Wang Ming-Qiang Wang Bing-Lin He An-Yang Wei Department of Urology The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang 550002China Department of Urology Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhou 510000China Department of Urology Nanfang HospitalSouthern Medical UniversityGuangzhou 510000China Department of Urology Shenzhen Immigration Inspection General Station HospitalShenzhen 518000China Department of Organ Transplantation The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510000China Department of Endocrinology The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang 550002China

Hyperlipidemia is a major risk factor for erectile dysfunction(ED).Oxidative stress and phenotypic modulation of corpus cavernosum smooth muscle cells(CcSMCs)are the key pathological factors of ED.N-acetylcysteine(NAC)can inhibit oxidative stress;however,whether NAc can alleviate pathological variations in the corpus cavernosum and promote erectile function recovery in hyperlipidemic rats remains unclear.A hyperlipidemia model was established using 27 eight-week-old male Sprague-Dawley(SD)rats fed a high-fat and high-cholesterol diet(hyperlipidemic rats,HR).In addition,9 male SD rats were fed a normal diet to serve as controls(NC).HR rats were divided into three groups:HR,HR+normal saline(NS),and HR+NAC(n=9 for each group;NS or NAc intraperitoneal injections were administered daily for 16 weeks).Subsequently,the lipid profiles,erectile function,oxidative stress,phenotypic modulation markers of ccsMCs,and tissue histology were analyzed.The experimental results revealed that erectile function was significantly impaired in the HR and HR+NS groups,but enhanced in the HR+NAC group.Abnormal lipid levels,over-activated oxidative stress,and multi-organ lesions observed in the HR and HR+NS groups were improved in the HR+NAC group.Moreover,the HR group showed significant phenotypic modulation of CCSMCs,which was also inhibited by NAC treatment.This report focuses on the therapeutic effect of NAc in restoring erectile function using a hyperlipidemic rat model by preventing CcSMC phenotypic modulationand attenuating oxidativestress.

关键词： erectile dysfunction hyperlipidemia N-acetylcysteine oxidative stress henotypic modulation

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Association between MTHFR c.677C>T variant and erectile dysfunction among males attending fertility clinic

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Asian Journal of Andrology 2024年第1期26卷 41-45页

作者： Shun Bai Ming-Zhen Li Yang-Yang Wan Xue-Chun Hu Yi-Xun Liu Xian-Hong Tong Tong-Hang Guo Lu Zong Ran Liu Yuan-Qi Zhao Ping Xiang Bo Xu Xiao-Hua Jiang Department of Gynecology and Obstetrics Reproductive and Genetic HospitalThe First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China NHC Key Laboratory of Male Reproduction and Genetics Guangdong Provincial Reproductive Science Institute(Guangdong Provincial Fertility Hospital)Guangzhou 510600China Department of Urology The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Wannan Medical College Wuhu 241002China

Genetic risk factors have been shown to contribute to the development of sexual dysfunction.However,the role of methylenetetrahydrofolate reductase(MTHFR)gene variants in the risk of erectile dysfunction(ED)remains unclear.In this study,we recruited 1254 participants who underwent ED assessed by the International Index of erectile Function-5.The MTHFR c.677C>T variant was also measured by fluorescence polymerase chain reaction(PCR).No significant difference in the genotypic frequency of the MTHFR C677T polymorphism(CC,CT,and TT)was observed between men from the ED and non-ED groups.In addition,on binary logistic regression analysis,both crude and adjusted models showed that the risk of ED was not significantly associated with the C677T polymorphism.Interestingly,a significantly higher frequency of the 677TT polymorphism was found in severe and moderate ED(P=O.02).The positive correlation between the MTHFR 677TT polymorphism and severe ED was confirmed by logistic regression analysis,even after adjusting for potential confounders(odds ratio[OR]=2.46,95%confidence interval[CI]:1.15-5.50,P=0.02).These findings suggest a positive correlation between the MTHFR 677TT polymorphism and the risk of severe ED.Identification of MTHFR gene polymorphisms may provide complementary information for ED patients during routineclinicaldiagnosis.

关键词： erectile dysfunction gene variant genetic risk factors methylenetetrahydrofolate reductase sexual function

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Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19:A randomized placebo-controlled trial

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Asian Journal of Urology 2024年第1期11卷 128-133页

作者： Iman Shamohammadi Seyedmohammad Kazemeyni Mohammadali Sadighi Tara Hasanzadeh Alireza Dizavi Department of Urology Nemazee HospitalShiraz University of Medical ScienceShirazIran Department of Urology Shariati HospitalTehran University of Medical ScienceTehranIran

Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (perectile dysfunction caused by COVID-19.

关键词： Tadalafil erectile dysfunction COVID-19 Sexual function

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Shaping the future of men's sexual health:How artificial intelligence can assist in the management and treatment of erectile dysfunction

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UroPrecision 2024年第1期2卷 1-8,I0013页

作者： Darren Sanchez Hannah Slovacek Run Wang Department of Surgery Division of UrologyThe University of Texas McGovern Medical SchoolThe University of Texas Health Science CenterHoustonTexasUSA

Artificial intelligence(AI)is a complex combination of multidisciplinary machines and systems that can replicate human-like cognitive tasks to execute capabilities such as pattern recognition,decision-making,and problem-solving.Dating back to the 2000s,AI has been utilized in the medical field,however the interest in this subject has sharply increased over the past several years.erectile dysfunction(ED)is an increasingly pervasive issue as men age,affecting up to 150 million men worldwide.In the field of men's health,AI has been employed to assist physicians in the evaluation and management of ED.This article aims to summarize the ways in which AI has been utilized in the management of ED,as well as the considerations that must be made when implementing this technology.AI can be utilized for virtual health assistance to protect patient privacy and increase access to care.Augmented reality can aid surgeons in real-time during operations,as well as be utilized to prepare physicians for situations that they may encounter in the operating room.Pharmaceutical companies can benefit from AI in the interpretation of data,analysis of chemical compounds and in drug development.Additionally,AI can be used to assist patients in post-procedure recovery in the form of rehabilitation and post-treatment monitoring.While the utilization of AI in men's health is an exciting venture,there are tremendous ethical and practical considerations that have limited its use in the management of ED.

关键词： artificial intelligence erectile dysfunction male sexual dysfunction

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Value of phosphodiesterase 5 inhibitors as a combination therapy for treating erectile dysfunction:A literature review

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UroPrecision 2024年第1期2卷 9-15页

作者： Christopher K.Owen Kareim Khalafalla Run Wang Department of Surgery Division of UrologyMcGovern Medical SchoolHoustonTexasUSA Department of Urology MD Anderson Cancer CenterHoustonTexasUSA

erectile dysfunction(ED)is increasing in prevalence,with estimates that 50%of men between 40 and 70 years of age suffer from the disease.Due to a wide array of available medical interventions,significant focus has been put on combination therapies that can treat ED refractory to first-line treatments such as phosphodiesterase 5 inhibitors(PDE5is).However,reviews evaluating monotherapy noninferiority and patient satisfaction of monotherapy versus combination therapy are lacking.A thorough PubMed search was performed to evaluate combination therapy in ED treatment.Articles published between January 2008 and June 2023 were reviewed,including randomized control trials,retrospective analyses,and cohort studies.Combination therapies included PDE5i plus another PDE5i,testosterone supplementation,α-blockers,vacuum erectile devices,intracavernosal injections,and low-intensity shockwave therapy.Based on this review,PDE5i monotherapy is not inferior to combination therapy and has increased satisfaction,convenience,and ease of use for patients with ED.Limitations of current literature on combination therapy include small sample size,limited data on patient satisfaction,possible biases,and limited follow-up time.Further studies will need larger randomized control trials with follow-up times greater than 1 year.

关键词： combination therapy erectile dysfunction intracavernosal injection low-intensity shockwave therapy phosphodiesterase 5 inhibitor vacuum erectile device to 150 million men affected

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erectile dysfunction in nonmuscle-invasive bladder cancer patients before and after transurethral resection(TUR)of bladder tumor in China

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Asian Journal of Andrology 2022年第5期24卷 509-512页

作者： Peng Guo Yu Wang Yun-Feng Xie Tian-Bing Lv Department of Urology Neijiang First People’s HospitalNeijiang 641000China Department of Pathology Neijiang First People’s HospitalNeijiang 641000China

The aim of this study was to investigate the incidence of erectile dysfunction(ED)in nonmuscle-invasive bladder cancer(NMIBC)patients before and after transurethral resection(TUR)in China.Clinical data from 165 male patients with NMIBC who received adjuvant intravesical chemotherapy after TUR in Neijiang First People’s Hospital(Neijiang,China)between January 2010 and June 2019 were retrospectively reviewed.The sexual function of these patients was evaluated before and 1.5 years after initial TUR by the International Index of erectile Function-5(IIEF-5).An age-specific subanalysis was performed among the patients:<45 years old(Group 1,n=19)and≥45 years old(Group 2,n=146).Before and 1.5 years after TUR,the incidence rates of ED in Group 1 were 15.8%and 52.6%,and those in Group 2 were 54.1%and 61.0%,respectively.The difference between groups was statistically significant at the preoperative stage(15.8%vs 54.1%,P=0.002)but not at the postoperative stage(52.6%vs 61.0%,P=0.562).Compared with the preoperative stage,the incidence of ED at the postoperative stage was increased significantly in Group 1(15.8%vs 52.6%,P=0.017)but not in Group 2(54.1%vs 61.0%,P=0.345).In conclusion,the incidence of ED increased in male NMIBC patients under the age of 45 years after TUR in China.These patients should be offered professional counseling during the follow-up period.

关键词： erectile dysfunction male sexual dysfunction nonmuscle-invasive bladder cancer transurethral resection

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Long-term tadalafil once daily in Chinese men witherectile dysfunction:a 2-year final analysis of apost-marketing,multicenter,randomized,open-labeltrial

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Asian Journal of Andrology 2024年第3期26卷 282-287页

作者： Hui Jiang Lian-Ming Zhao Su Yan Ji-Hong Liu Zhao-Hui Zhu Jin-Dan Luo Yu-Tian Dai Fu-Biao Li Hao-Cheng Lin Zhi-Chao Zhang Department of Urology Peking University First HospitalBeijing 100000China Department of Urology Peking University Third HospitalBeijing 100191China Department of Urology Peking Union Medical College HospitalBeijing 100730China Department of Urology Tongji HospitalTongji Medical CollegeHuazhongUniversity of Science and TechnologyWuhan 430030China Department of Urology Union Hospital of Tongji Medical CollegeHuazhong University of Science andTechnologyWuhan 430022China Department of Urology The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Departmentof Andrology Nanjing Drum Tower HospitalNanjing 210008China Department of Andrology The First Hospital of Jilin UniversityChangchun 130021China Andrology Center Department of UrologyPeking University First HospitalBeijing 100034China.

The long-term safety and effectiveness of once-daily tadalafil is crucial,but limited data are available in Chinese patients witherectile dysfunction(ED).In this post-marketing,multicenter,randomized,open-label trial with 2-year follow-up,635 ED caseswere randomized to receive daily oral tadalafil 2.5 mg or 5 mg for 3 months,of whom 580 continued once-daily tadalafil 5 mg for21 months.Treatment-emergent adverse events in the 12-month and 24-month period were similar,with the most common beingviral upper respiratory tract infection,upper respiratory tract infection,and headache.Significant improvement from baseline inthe International Index of erectile Function-erectile Function(IIEF-EF)score was detected at month 12(least squares mean[LSM]change:7.9,95%confidence interval[CI]:7.5–8.4,Perectile function(IIEF-EF score≥26)were 43.7%and 48.0%at months 12 and 24,respectively.Global Assessment Questionnaire results showed improved erection function in 97.5%ofpatients and improved ability to engage in sexual activity in 95.9%of patients at month 12;these values were 96.1%and 95.0%at month 24,respectively.The quality of sexual life score based on the Sexual Life Quality Questionnaire(SLQQ)was increased by52.2%at month 12 and by 55.3%at month 24(both P<0.001).The treatment satisfaction score determined by SLQQ(mean±standard deviation)was 62.4±21.0 at month 12 versus 65.9±20.2 at month 24.Two-year daily application of tadalafil 5mg in Chinese men with ED showed a favorable safety profile and durable improvement in sexual performance and satisfaction.

关键词： clinical trial erectile dysfunction long-term safety once-daily dosing tadalafil

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The association between heavy metal exposure and erectile dysfunction in the United States

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Asian Journal of Andrology 2023年第2期25卷 271-276页

作者： Wei Wang Li-Yuan Xiang Yu-Cheng Ma Jia-Wei Chen Liao Peng Xiao-Shuai Gao Fu-Xun Zhang Yang Xiong Feng Qin Jiu-Hong Yuan Andrology Laboratory West China HospitalSichuan UniversityChengdu 610041China Department of Urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China Department of Clinical Research Management West China HospitalSichuan UniversityChengdu 610041China

Literature regarding the impacts of heavy metal exposure on erectile dysfunction(ED)is scarce.We aimed to evaluate the correlation between 10 urinary metals and ED in a large,nationally representative adult male sample.The dataset was extracted from the National Health and Nutrition Examination Survey(NHANES)during the period of 2001–2002 and 2003–2004.Weighted proportions and multivariable logistic regression analysis adjusted for confounding variables were utilized to determine the relationship between metal exposure and ED.Weighted quantile sum(WQS)regression was utilized to evaluate the impact of a mixture of urinary metals on ED.A total of 1328 participants were included in our study.In multivariable logistic regression analysis,cobalt(Co)and antimony(Sb)were positively associated with ED(odds ratio[OR]:1.36,95%confidence interval[CI]:1.10–1.73,P=0.020;and OR:1.41,95%CI:1.12–1.77,P=0.018,respectively)after full adjustment.Men in tertile 4 for Co(OR:1.49,95%CI:1.02–2.41,P for trend=0.012)and Sb(OR:1.53,95%CI:1.08–2.40,P for trend=0.041)had significantly higher odds of ED than those in tertile 1.Furthermore,the WQS index was significantly linked with increased odds of ED after full adjustment(OR:1.31,95%CI:1.04–1.72,P<0.05).Our study expanded on previous literature indicating the possible role of heavy metal exposure in the etiology of ED.The evaluation of heavy metal exposure should be included in the risk assessment of ED.

关键词： erectile dysfunction heavy metals National Health and Nutrition Examination Survey

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Ten-year experience with penile prosthetic surgery for the treatment of erectile dysfunction:outcomes of a tertiary referral center and predictors of early prosthetic infection

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Asian Journal of Andrology 2022年第1期24卷 32-39页

作者： Franco Palmisano Luca Boeri Riccardo Ievoli Josvany Sánchez-Curbelo Matteo Giulio Spinelli Andrea Gregori Antonio Maria Granata Eduard Ruiz-Castane Emanuele Montanari Joaquim Sarquella-Geli ASST Fatebenefratelli-Sacco Department of UrologyLuigi Sacco University HospitalMilan 20157Italy IRCCS Foundation Ca’Granda Ospedale Maggiore Policlinico Department of UrologyUniversity of MilanMilan 20122Italy Department of Economics and Management University of FerraraFerrara 44121Italy FundacióPuigvert Department of AndrologyUniversity of BarcelonaBarcelona 08025Spain

We aimed to evaluate ten-year outcomes of penile prosthesis(PP)implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection(EPI).We identified 549 men who underwent 576 PP placements between 2008 and 2018.Univariate and multivariate analyses were used to identify potential predictors of EPI.An EPI predictive nomogram was developed.Thirty-five(6.1%)cases of EPI were recorded with an explant rate of 3.1%.In terms of satisfaction,82.0%of the patients defined themselves as“satisfied,”while partner’s satisfaction was 88.3%.Diabetes(P=0.012),longer operative time(P=0.032),and reinterventions(P=0.048)were associated with EPI risk,while postoperative ciprofloxacin was inversely associated with EPI(P=0.014).Rifampin/gentamicin-coated 3-piece inflatable PP(r/g-c 3IPP)showed a higher EPI risk(P=0.019).Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients,redo surgeries,or when a r/g-c 3IPP was used(all P<0.03).We showed that diabetes,longer operative time,and secondary surgeries were the risk factors for EPI.Postoperative ciprofloxacin was associated with a reduced risk of EPI,while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant.After further validation,the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.

关键词： Boston Coloplast Titan three-piece penile prosthesis erectile dysfunction impotence Inhibizone patient satisfaction penile prosthesis prosthesis infection rifampin soaking

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A prospective randomized controlled study on scheduled PDE5i and vacuum erectile devices in the treatment of erectile dysfunction after nerve sparing prostatectomy

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Asian Journal of Andrology 2022年第5期24卷 473-477页

作者： Ming Zhang Ji-Zhong Che Yi-Dong Liu Hong-Xiang Wang Yan-Ping Huang Xiang-Guo Lv Wei Liu Mu-Jun Lu Department of Urology and Andrology Shanghai Institute of AndrologyRenji HospitalShanghai Jiao Tong University School of MedicineShanghai 200001China Department of Urology Yantai Affiliated Hospital of Binzhou Medical UniversityYantai 264100China

Cavernous nerve injury is an important cause of erectile dysfunction(ED).Although protective nerve technology has been widely used in nerve-sparing radical prostatectomy(nsRP),the incidence of ED is still very high after surgery.The purpose of our study was to evaluate erectile function(EF)and penile length in the non-erectile state(PLNES)following scheduled phosphodiesterase 5 inhibitor(PDE5i),vacuum erectile device(VED)treatment,and combination therapy after nsRP.One hundred patients with localized prostate cancer and normal EF were randomized to scheduled PDE5i group,VED treatment group,a combined treatment group,and the control group without any intervention.The International Index of erectile Function-5(IIEF-5)scores and PLNES were evaluated after 6 months and 12 months of treatment.Sexual Encounter Profile(SEP-Question 2 and SEP-Question 3)were evaluated after 12 months of treatment.Ninety-one of the 100 randomized patients completed the study.We found that the 5 mg tadalafil once a day(OaD)combined with VED can help improve IIEF-5 scores in nsRP patients after both 6 months and 12 months.VED alone or combined with tadalafil OaD can help patients maintain PLNES.VED combined with tadalafil OaD can improve the rate of successful penetration(SEP-Question 2)after 12 months.There were no significant differences in the return to target EF after 12 months among the groups.No significant correlation was noted between the variables and return to target EF(IIEF≥17),and between the variables and effective shortening of the patient’s penis(shortening≥1 cm)after 12 months of intervention.

关键词： erectile dysfunction nerve-sparing radical prostatectomy penile length tadalafil vacuum erectile devices

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