An Unappreciated Correlation : Surgical Treatment of Lumbosacral Disc Disease and Erectile Dysfunction

Kulaksizoglu, Haluk,Kaptan, Hulagu The Korean Neurosurgical Society 2010 Journal of Korean neurosurgical society Vol.47 No.4

Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.

발기부전 환자에서 홍삼농축분말의 유효성 및 안전성: 다기관, 무작위배정, 이중맹검, 위약 대조 임상연구

함원식,김원태,이진선,주희정,강신정,오진환,허율,정재용,박광성,최영득 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.2

Purpose: To evaluate the safety and efficacy of red ginseng extract powder (OKBT) for treating erectile dysfunction. Materials and Methods: Sixty-nine adult patients with mild to moderate erectile dysfunction of various etiologies were randomized to receive placebo or red ginseng extract powder. The red ginseng extract powder used in the present study was named OKBT. The primary efficacy parameter was response to the International Index of Erectile Function (IIEF) erectile function domain at baseline and week 8. Other IIEF domain scores were evaluated as secondary parameters. For safety evaluation, we performed history taking, physical examination, clinical laboratory tests, and hormonal tests at baseline and week 8. Results: There were no significant differences in the patients’ characteristics between the 2 groups. After 8 weeks of administration, primary efficacy (erectile function domain) and all secondary efficacy domains were significantly improved in the OKBT group compared with the placebo group (p<0.05). Notably, even the domain related to sexual desire, frequency and degree of sexual desire, was also improved in the OKBT group (p<0.001). There were no significant adverse reactions with OKBT administration, and there were also no significant differences in the results of laboratory tests between the 2 groups after administration. Conclusions: Our data show that red ginseng extract powder can be used as an alternative remedy for Korean men suffering from mild to moderate erectile dysfunction. Purpose: To evaluate the safety and efficacy of red ginseng extract powder (OKBT) for treating erectile dysfunction. Materials and Methods: Sixty-nine adult patients with mild to moderate erectile dysfunction of various etiologies were randomized to receive placebo or red ginseng extract powder. The red ginseng extract powder used in the present study was named OKBT. The primary efficacy parameter was response to the International Index of Erectile Function (IIEF) erectile function domain at baseline and week 8. Other IIEF domain scores were evaluated as secondary parameters. For safety evaluation, we performed history taking, physical examination, clinical laboratory tests, and hormonal tests at baseline and week 8. Results: There were no significant differences in the patients’ characteristics between the 2 groups. After 8 weeks of administration, primary efficacy (erectile function domain) and all secondary efficacy domains were significantly improved in the OKBT group compared with the placebo group (p<0.05). Notably, even the domain related to sexual desire, frequency and degree of sexual desire, was also improved in the OKBT group (p<0.001). There were no significant adverse reactions with OKBT administration, and there were also no significant differences in the results of laboratory tests between the 2 groups after administration. Conclusions: Our data show that red ginseng extract powder can be used as an alternative remedy for Korean men suffering from mild to moderate erectile dysfunction.

산수유를 포함한 복합추출물이 cimetidine으로 발기부전을 유도한동물모델에서 성기능 개선 효과

장지훈,김태묵,심미옥,노종현,정호경,이무진,이기호,안병관,조현우 한국자원식물학회 2018 한국자원식물학회지 Vol.31 No.2

Erectile dysfunction (ED), also known as impotence, is the inability to attain and sustain an erection firm enough to have sexual intercourse. Frequent ED may be a symptom of health problems including heart disease, obesity, alcoholism, stress, smoking, and depression, that need treatment. This study aimed to effect of complex extract (CPL) including Cornus officinalis on sexual function factor in the erectile dysfunction rat model. The erectile dysfuction rat model was induced by cimetidine (500 ㎎/㎏ in 5% ethanol, oral injection 2 weeks). Rats were oral administered with different concentration of CPL in rat erectile dysfunction model. As a results, sexual function factors (NO, cGMP) significantly improved in CPL treated groups (CPL-300, 600, 900 ㎎/㎏) compared to CON group. Serum testosterone was increased in a dose-dependent manner after CPL treatment. Furthermore, administrations of CPL restored lumen areas of the prostate in the erectile dysfunction rat model. These results indicated that CPL alleviated erectile dysfunction by increasing sexual function factor and testosterone in rat model. CPL could be used to natural treatement for erectile dysfunction. However, further study is required to identify active ingredient and its mechanism of erectile dysfunction. Key words – cGMP, Cimetidine, Cornus officinalis, Erectile dysfunction, Nitric oxide, Testosterone 발기부전(erectile dysfunction, impotence)은 성교과정을위한 음경이 딱딱하게 발기되지 않거나 유지하지 못하는 것을말한다. 잦은 발기 부전은 심장 질환, 비만, 알코올 중독, 스트레스, 흡연 및 우울증을 비롯하여 치료가 필요한 건강상의 문제가원인이 된다. 본 연구는 산수유(Cornus officinalis)를 포함한복합 추출물이 발기부전 랫드모델에서 성기능과 관련된 인자에미치는 영향을 알아보고자 하였다. 발기부전 랫드모델은Cimetidine/5% EtOH를 2주 동안 경구투여하여 유도한 후, 산수유 등 복합추출물을 각각 다른 농도로 경구투여하였다. 그 결과, 산수유 등 복합추출물 처리군(CPL-300, 600, 900 ㎎/㎏)에서 성 기능 인자(NO, cGMP)가 대조군에 비해 유의성 있게 향상되었다. 또한 혈청 테스토스테론은 산수유 등 복합추출물 처리후 용량 의존적으로 증가하였다. 더욱이, 산수유 등 복합추출물의 투여는 발기부전 랫드모델에서 전립선의 크기를 회복시키는것을 확인하였다. 결과를 종합하자면 산수유 등 복합추출물이랫드모델에서 성기능 인자와 테스토스테론을 증가시킴으로써발기부전을 완화시킨다는 것을 보여 주었고, 이는 산수유 등 복합추출물이 천연 추출물로 향 후 발기부전 치료에 사용될 수 있음을 시사한다. 하지만 산수유 복합추출물의 남성 성기능의 직접적인 연관관계, 유효성분과 그 메커니즘을 자세히 밝히기 위해서는 추가적인 연구가 필요하다고 사료된다.

음경복합초음파검사의 발기유발제로서 복용약이 주사제를 대체할 수 있는가?

류인욱,윤하나,심봉석,박영요,정우식 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.7

Purpose: To clarify whether vardenafil can be used as a substitute for intracavernosal injection as a method of induction of penile erection, we compared the outcome of penile duplex Doppler ultrasonography using both methods in the same patient with erectile dysfunction. Materials and Methods: A total of 23 patients underwent penile duplex ultrasonography twice with a one week interval between procedures. Twelve were randomly selected for intracavernosal injection first with prostaglandin E1(PGE1) 20μg and the remaining 11 were initially treated with oral vardenafil 20mg 1 hour before the Doppler study and in addition had visual sexual stimulation using a head-mounted display during the study. The peak systolic velocity(PSV), end diastolic velocity(EDV) and the degree of maximum erectile response were measured and compared between the two groups. Results: Measurements from the PGE1 treatment were not significantly different from those with the vardenafil treatment. The percentage of compatibility between the two methods with regard to hemodynamic diagnosis and pharmaceutical erectile response was as high as 83%(19 of 23) and 91%(21 of 23), respectively. Both methods were tolerable and safe without severe complications. However, in 4 patients where the diagnosis was uncertain, the injection method provided a more accurate interpretation of the penile vascular status with duplex ultrasonography. Conclusions: These results suggest that oral vardenafil can be used as an initial method for inducing penile erection when assessing erectile dysfunction with penile duplex Doppler ultrasonography in selected patients with erectile dysfunction. Purpose: To clarify whether vardenafil can be used as a substitute for intracavernosal injection as a method of induction of penile erection, we compared the outcome of penile duplex Doppler ultrasonography using both methods in the same patient with erectile dysfunction. Materials and Methods: A total of 23 patients underwent penile duplex ultrasonography twice with a one week interval between procedures. Twelve were randomly selected for intracavernosal injection first with prostaglandin E1(PGE1) 20μg and the remaining 11 were initially treated with oral vardenafil 20mg 1 hour before the Doppler study and in addition had visual sexual stimulation using a head-mounted display during the study. The peak systolic velocity(PSV), end diastolic velocity(EDV) and the degree of maximum erectile response were measured and compared between the two groups. Results: Measurements from the PGE1 treatment were not significantly different from those with the vardenafil treatment. The percentage of compatibility between the two methods with regard to hemodynamic diagnosis and pharmaceutical erectile response was as high as 83%(19 of 23) and 91%(21 of 23), respectively. Both methods were tolerable and safe without severe complications. However, in 4 patients where the diagnosis was uncertain, the injection method provided a more accurate interpretation of the penile vascular status with duplex ultrasonography. Conclusions: These results suggest that oral vardenafil can be used as an initial method for inducing penile erection when assessing erectile dysfunction with penile duplex Doppler ultrasonography in selected patients with erectile dysfunction.

발기부전의 원인에 따른 야간수면발기검사의 진단적 의의

양원재,이웅희,최형기 大韓泌尿器科學會 1999 Korean Journal of Urology Vol.40 No.10

발기 부전에서 유산소성 운동의 역할: 무작위 통제 연구의 고찰

김광래 ( Kwang Lae Kim ) 한국운동생리학회(구 한국운동과학회) 2021 운동과학 Vol.30 No.2

PURPOSE: This study aimed to determine the role or applicability of aerobic exercise in erectile dysfunction. METHODS: This narrative review was conducted by searching terms such as ‘impotence,’ ‘erectile dysfunction,’ ‘erection dysfunction,’ ‘sexual dysfunction,’ ‘aerobic exercise,’ ‘aerobic training,’ ‘cardiovascular exercise,’ ‘cardiovascular training,’ ‘human,’ ‘randomized controlled trials,’ and ‘randomized clinical trials’ in the titles or abstracts in PubMed, Google Scholar, Scopus, Wiley Online Library, and Science Direct databases. RESULTS: Nine articles met the inclusion criteria. Aerobic exercise of light (low)-vigorous (high) intensity was found to be effective in erectile dysfunction in seven articles. CONCLUSIONS: In case of mild-moderate erectile dysfunction accompanied by high blood pressure, obesity, physical inactivity, metabolic syndrome, acute myocardial infarction, and ischemic heart disease, it is suggested that following an aerobic exercise program has potential advantages. Further clinical research is required to compare nonlinear aerobic exercise with linear aerobic exercise in the population with erectile dysfunction.

당뇨성과 비당뇨성 발기부전 환자의 음경해면체 내 발기 유발제 주사에 의한 발기반응 비교

장옥룡,김재일,박석산 大韓泌尿器科學會 2000 Korean Journal of Urology Vol.41 No.3

노인 남성의 성기능장애 진단과 치료

박현준 대한의사협회 2019 대한의사협회지 Vol.62 No.6

Male sexual dysfunction refers to a phenomenon in which a man experiences difficulty at any stage during the process of sexual intercourse. In general, erectile dysfunction is regarded as the most representative form of sexual dysfunction, but various other diseases can also be categorized as male sexual dysfunction, including sexual arousal disorder, decreased libido, ejaculation disorder, and Peyronie’s disease. Causes of sexual dysfunction include chronic diseases, such as diabetes, hypertension, dyslipidemia, and obesity. In addition, some medications, surgical procedures, and traumas can cause sexual dysfunction. However, aging is the most important cause of male sexual dysfunction. To diagnose and treat elderly patients who complain of male sexual dysfunction, it is first necessary to become familiar with the characteristics of sexual dysfunction in elderly men. The prevalence rates of metabolic syndrome, hypertension, diabetes, dyslipidemia, coronary artery disease, stroke, and depression are higher among elderly men than among younger men; furthermore, the elderly are at a higher risk for the development of kidney, hepatic, spinal cord, and neurological diseases. Notably, anti-hypertensive agents can affect erectile function in elderly men: sexual dysfunction may be severe or the response to treatment may be poor. For satisfactory treatment, spousal factors should also be considered.

전립샘비대증 환자에서 전립샘용적와 발기부전과의 관계

김민석(Min Seok Kim),조원진(Won Jin Cho),임동훈(Dong Hoon Lim),김철성(Chul-Sung Kim),이철갑(Chul-Gab Lee),노준(Joon Rho) 조선대학교 의학연구원 2020 The Medical Journal of Chosun University Vol.45 No.2

Common symptoms of aging include degradation of male sexual function and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). There is no systematic report that prostatic hyperplasia causes sexual dysfunction. In addition, since both prostatic hyperplasia and erectile dysfunction are related to age, it is difficult to directly link prostate hyperplasia and erectile dysfunction. The relationship between prostate volum and erectile dysfunction due to prostate hyperplasia is controversial, but the exact mechanism of integration is still being considered. Age and age-adjusted LUTS severity are decreasing factors of erectile function. With BPH therapy, increase of urinary symptoms and quality of life are well-known, but there are controversies over the sexual function according to the treatment method. The purpose of this study is to evaluate the correlation between prostate volume and erectile dysfunction in patients with symptoms of urinary tract depression caused by benign prostatic hyperplasia. 50 subjects with BPH, and before initiating BPH treatment that may affect erectile function, quantification of erectile function is conducted in 5 questions to all respondents using the International Index of Erectile Function (IIEF-5). The Pearson correlation coefficient between prostate volume and IIEF-5 score was -0.039 (p-value-0.784). Therefore, as the volume of the prostate increases, erectile dysfunction is not related to evil. The results of IIEF-5 appear to be unregulated in the case of the prostate volume or the rate of increase in the prostate volume, and there is no change in the IIEF score.

Ginseng for Erectile Dysfunction: A Cochrane Systematic Review

Lee Hye Won,Lee Myeong Soo,Kim Tae-Hun,Alraek Terje,Zaslawski Chris,Kim Jong Wook,Moon Du Geon 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.2

The objectives of this study were to assess the effects of ginseng on erectile dysfunction. We searched multiple electronic databases from their inceptions to 30 January 2021 without restrictions by language. We included randomized or quasi-randomized controlled trials that evaluated the use of any type of ginseng as a treatment for erectile dysfunction compared to placebo or conventional treatment. The authors independently screened the literature, extracted data, assessed risk of bias, and rated the certainty of evidence (CoE) according to the GRADE approach. We included nine studies, and all compared ginseng to placebo. Ginseng appears to have a trivial effect on erectile dysfunction when compared to placebo based on the Erectile Function Domain of the International Index of Erectile Function (IIEF)-15 instrument (mean difference [MD] 3.52, 95% confidence interval [CI] 1.79 to 5.25; I²=0%; 3 studies; low CoE). Ginseng may have little to no effect on adverse events compared to placebo (risk ratio [RR] 1.45, 95% CI 0.69 to 3.03; I²=0%; 7 studies; low CoE). While ginseng may improve men's self-reported ability to have intercourse (RR 2.55, 95% CI 1.76 to 3.69; I²=23%; 6 studies; low CoE), it may have a triv-ial effect on men's satisfaction with intercourse based on the Intercourse Satisfaction Domain of the IIEF-15 (MD 1.19, 95% CI 0.41 to 1.97; I²=0%; 3 studies; low CoE). No study reported quality of life as an outcome.