Erectile Dysfunction Research Articles

Testosterone deficiency

Testosterone deficiency, or hypogonadism, occurs when the body does not produce enough testosterone, the primary male sex hormone. This can lead to physical, emotional, and cognitive symptoms that affect quality of life, including decreased libido, erectile dysfunction, fatigue, depression, and reduced muscle mass. Causes include ageing, specific medical conditions such as diabetes, obesity, or systemic diseases, or damage to the testes. Numerous studies have indicated that testosterone levels start to decrease in men beginning in their 40s, with approximately 30% of men fitting the criteria for testosterone deficiency syndrome by the age of 70. These statistics highlight the need for awareness and management of this condition, especially among ageing males. GPs play a crucial role in diagnosing, managing, and referring cases of testosterone deficiency. This review helps GPs navigate the complexities of testosterone deficiency, ensuring patients receive appropriate care. It aligns with the GP curriculum, covering essential skills and knowledge areas, including history taking, physical examination, and screening tools, and includes a case scenario to discuss that illustrates application in general practice.

Evaluation of the Efficacy and Safety of On-Demand Tadalafil Alone or Combined With Lidocaine Spray for Treating Patients With Comorbid Erectile Dysfunction and Premature Ejaculation: A Randomized Controlled Trial

Background To evaluate the efficacy and safety of on-demand 20 mg tadalafil alone or combined with lidocaine spray for treating patients with comorbid erectile dysfunction (ED) and premature ejaculation (PE). Methods This randomized controlled trial included 98 patients with comorbid ED and PE, randomly assigned to the experimental group (n = 50, tadalafil alone) or the active control group (n = 48, tadalafil combined with lidocaine spray). Patients took tadalafil 30 min before sexual intercourse, while the combination therapy group also used lidocaine spray 5 min before intercourse. After 12 weeks of treatment, changes in the International Index of Erectile Function (IIEF-5), Chinese Index of Premature Ejaculation (CIPE-5), Intravaginal Ejaculatory Latency Time (IELT), and Sexual Satisfaction Score (SSS) were evaluated. Results Both groups showed significant improvement in IIEF-5 scores, but the difference between groups was not significant (F = 0.89, p = 0.45). The active control group showed significant improvement in CIPE-5 scores (p < 0.001), while the experimental group showed no significant change (p > 0.05). IELT in the active control group increased significantly from 25.7 s to 198.6 s (Z = 6.03, p < 0.001), while the experimental group showed no significant change (Z = 0.74, p = 0.46). SSS improved significantly in the active control group (p < 0.001) but not in the experimental group (p > 0.05). The incidence of adverse events was similar in both groups (14% vs 20.8%, p = 0.575). Conclusion Tadalafil combined with lidocaine spray is superior to tadalafil alone in improving symptoms, prolonging IELT, and enhancing sexual satisfaction in patients with comorbid ED and PE, with comparable safety. This combination therapy provides a new approach for improving treatment strategies for patients with comorbid ED and PE. Large-scale, multi-center randomized controlled trials are needed to further validate these findings.

Molecular docking and network pharmacology research on the Danggui Sini Decoction's mechanism of action for treating erectile dysfunction.

Utilizing network pharmacology and molecular docking, we evaluated the possible pharmacological mechanism of Danggui Sini Decoction (DGSND) for treating erectile dysfunction (ED). DGSND's chemical components and targets were found utilizing the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Disease-related genes associated with ED were identified through GeneCards, OMIM, TTD, DrugBank, and DisGeNET databases. These datasets intersected to identify possible DGSND targets for treating ED. We developed an interactive visual network that linked herbs, active components, diseases, and targets using Cytoscape 3.7.1. The protein-protein interactions (PPI) were analyzed using the STRING database. The DAVID database was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment studies to determine the mechanism of action of the discovered genes. The pathways most strongly associated with ED were analyzed through histograms and bubble maps. From the PPI network, the 6 promising targets were selected for molecular docking with the top ranked compounds in terms of degree value. DGSND contains 7 Chinese herbal medicines, 142 main components, and 73 latent targets for treating ED. GO and KEGG analyses suggest that DGSND may have the ability to modulate oxidative stress, apoptosis, and inflammatory responses. Through the PPI network and topology analysis, 6 core genes were pinpointed. Molecular docking revealed that beta-sitosterol exhibited the lowest binding energy with BCL2, indicating a more stable structure. This study demonstrates that DGSND's compounds stimulate NO synthesis and reduce inflammation and cell apoptosis to improve ED by acting on AKTI, ALB, IL6, TNF, TP53, and BCL2. The findings show that DGSND's compounds These findings offer a valuable scientific foundation for further understanding the mechanism of DGSND in treating ED.

The Effect of Bio-Electromagnetic Energy Regulation Therapy on Erectile Dysfunction in Patients with Multiple Sclerosis: A Triple-Blind Randomized Clinical Trial.

Objectives: To evaluate the effect of bio-electromagnetic energy regulation (BEMER) therapy on erectile dysfunction (ED) in patients with multiple sclerosis (MS). Methods: A triple-blind randomized clinical trial was conducted in two different centers. Fifty-two male participants with MS were randomly allocated into two groups. Patients received either three weeks of BEMER with pelvic floor exercises or sham BEMER with pelvic floor exercises. The primary measure was the International Index of Erectile Function-Erectile Function (IIEF-EF). Secondary measures included the Sexual Health Inventory for Men (SHIM), Erection Hardness Scale (EHS), Arizona Sexual Experience Scale (AXES), Modified Fatigue Impact Scale (MFIS), and Multiple Sclerosis, Intimacy, and Sexuality Questionnaire (MSISQ-19). Results: Compared to the sham BEMER group, the BEMER group showed better improvements in the IIEF-EF (mean difference [MD]: -6.9, p < 0.001), SHIM (MD: -6.1, p < 0.001), EHS (MD: -0.4, p = 0.022), AXES (MD: 2.9, p = 0.030), MSISQ-19 (MD: 15.0, p < 0.001), and MFIS (MD: 31.0, p < 0.001). Conclusions: BEMER therapy improved erectile function and sexual satisfaction and reduced fatigue in patients with MS after three weeks of intervention. Long-term follow-up studies are warranted to ascertain the sustained benefits of BEMER therapy for MS-related ED.

Use of Platelet Rich Plasma in Urological Conditions

Introduction: Platelet-rich plasma (PRP) has become an increasingly popular therapeutic tool across various medical specialties since its introduction in 1958. Defined as a concentrated solution of platelets and growth factors derived from autologous blood, PRP supports tissue repair and regeneration processes. PRP’s composition includes high concentrations of platelets and growth factors that facilitate angiogenesis, connective tissue remodeling, and cellular repair, making PRP a promising treatment option for complex urological conditions and beyond. Purpose of the study: This review aims to summarize the applications and efficacy of PRP in treating specific urological conditions such as erectile dysfunction, Peyronie's disease, urethral stricture, hypospadias, interstitial cystitis and urinary incontinence. Materials and Methods: To provide a comprehensive summary of current knowledge on this topic, a literature review of English-language articles, with an emphasis on recent publications, was conducted. The review utilized the PubMed database and included 51 studies accessed prior to October 2024. Conclusions: PRP therapy appears to be a promising, safe, and minimally invasive treatment option for several urological conditions. Studies suggest that PRP may benefit erectile function, reduce symptoms in Peyronie's disease, and improve outcomes in conditions related to the urethra and bladder, with minimal reported adverse effects. However, the lack of standardized PRP preparation protocols and large placebo-controlled trials poses a challenge to fully establishing its efficacy. Further research is necessary to confirm PRP’s effectiveness, optimize preparation and administration methods, and develop guidelines for its clinical application in urology.

Development and Validation of a Sexual Quality of Life Score for Youths with Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD) are known to impact patients 'sexual lives. The aim of this study is to create and validate a sexual QoL designed for youth with IBD. This study was conducted in two phases: development of the score and validation of the items. A multidisciplinary team created a score called BLOOMI, based on two validated scores: the International Index of Erectile Function (IIEF) and the Sexual Function Questionnaire 28 (SFQ28). It was validated through a French multicentric cross-sectional study among patients aged 15-25 years with IBD by comparison with IIEF and SFQ28 gold standard scores. BLOOMI is a sexual QoL designed with 10 items and formatted as a disk. The score was validated through the participation of 104 patients with a median age of 23.2 years. BLOOMI was well correlated with both goldstandards and had a strong internal consistency. 19.1% of IIEF-responders have erectile dysfunction and median scores for the SFQ domains Desire, Arousal sensation and cognition, and orgasm are below the threshold for the absence of sexual dysfunction. Fatigue, abdominal pain, body image concerns or fear of anal leakages are correlated to a poorer sexual QoL. BLOOMI score is a new validated score to assess the sexual QoL in 15-25 years with IBD. This tool may improve the screening for sexual challenges encountered by youths with IBD and may support future research into the impact of IBD on young patients' lives.

BMSCs transplantation combined with LIPUS treatment improves erectile function through downregulation of IGFBP3 in rats with cavernosa injury.

Erectile dysfunction (ED) is the most common type of sexual dysfunction, which seriously affects male reproductive health. Recently, stem cell therapy and low-intensity pulsed ultrasound (LIPUS) have been applied in the treatment of ED, but the specific mechanism is still unclear. The study aims to investigate the effect and underlying mechanism of further LIPUS treatment on the basis of bone marrow mesenchymal stem cells (BMSCs) transplantation in the treatment of ED rats. We established a cavernosa injury-induced ED rat model and injected BMSCs into the penile corpus cavernosum with or without LIPUS treatment every other day for three times. The survival rate of BMSCs, value of ICP/MAP, blood flow, the endothelial content, and expression of CD31 and ɑ-SMA in the rat penis were investigated. Transcriptome analyses and in vitro assays of cell proliferation, migration, and tube formation were also performed. The results showed that LIPUS treatment significantly promoted the survival rate of BMSCs in the rat penis after 1, 7, and 14 days of final treatment. The values of ICP/MAP and blood flow in rats treated with BMSCs were significantly increased compared to the control group, and the values were further enhanced in rats treated with BMSCs plus LIPUS. The endothelial content and CD31 and ɑ-SMA mRNA and protein expression in the BMSCs plus LIPUS group were remarkably higher than in other groups, indicating improved endothelial vascular function. Transcriptome analyses found that insulin-like growth factor binding protein-3 (IGFBP3) was remarkably downregulated in the BMSCs plus LIPUS group compared to the other two groups. In in vitro assays, LIPUS intervention significantly increased BMSCs proliferation and HUVECs migration, and HUVECs angiogenesis was improved after IGFBP3 siRNA transfection. BMSCs transplantation combined with LIPUS treatment could improve erectile function in ED rats via downregulation of IGFBP3, which might be a proposed optimized strategy for the ED treatment.

Exploring the bidirectional link between erectile dysfunction and 10-year cardiovascular risk in men with diabetes and hypertension

Erectile dysfunction (ED) shares common risk factors with cardiovascular (CV) disease, such as a sedentary lifestyle, obesity, and metabolic syndrome. However, the relationship between ED and CV risk in Vietnam remains unknown. To investigate this, we conducted a multi-center observational study, randomly selecting 2,936 men aged 40 to 69 years in Vietnam, with 385 participants included after exclusions. The study evaluated the 10-year CV risk using the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) score and assessed ED using the International Index of Erectile Function (IIEF-5) score. Results showed that men with diabetes mellitus and hypertension had significantly lower IIEF-5 scores compared to healthy individuals (18 [15–22] vs. 23 [20–24], p < 0.001). Additionally, the IIEF-5 score proved effective in identifying patients at very high CV risk, with an area under the curve (AUC) of 0.747, a cutoff point of 18.5, sensitivity of 69.6%, and specificity of 69.9%. Furthermore, we found a significant inverse correlation between SCORE2-Diabetes and IIEF-5 (ρ = -0.45 and p < 0.001). These findings establish a significant connection between ED and CV risk in men with diabetes, underscoring the need for integrated screening and management strategies to address both conditions concurrently.

Patients' perceptions of nocturnal erectile function assessment with the RigiScan®.

In recent decades, the assessment of male sexual function has been a subject of enduring interest. The use of the RigiScan®, a conventional diagnostic tool designed to differentiate between psychological and organic causes of erectile dysfunction (ED), has decreased due to several disadvantages. In this study, patient perspectives on the merits and drawbacks of the RigiScan®, as well as preferences for a future diagnostic device, were explored. Patients at St. Antonius Hospital and Leiden University Medical Center who underwent RigiScan® examinations were surveyed. A pretested questionnaire was used to gather data on their experiences, satisfaction levels, and suggestions for improvement. Among the 120 distributed questionnaires, a 39.2% response rate was achieved. The process of applying the RigiScan® around the penis was reported to have an average difficulty rating of 4.6 ± 2.5 (range: 1-9) points. While 74.5% of the participants were able to keep the device on all night, 25.5% of the participants experienced difficulties. Sleep quality was assessed at 5.5 ± 2.6 (range: 0-9) points. The participants reported an average pain rating of 4.7 ± 2.8 (range: 0-9) points. Despite these challenges, 69.6% of the participants reported that the device met their expectations, while 30.4% of the participants were dissatisfied. The key areas for improvement included device size (33.7%), user-friendliness (25.5%), sound (9.2%), hygiene (7.1%), and pain (6.1%). This study revealed that patients who underwent a nocturnal erectile function assessment with the RigiScan® device preferred a more patient-friendly and less intrusive diagnostic device. Further research is needed to determine whether a new sensor possessing these improved characteristics can increase patient satisfaction.

Association of relative fat mass with prevalence of erectile dysfunction in US men: an analysis of NHANES 2001-2004.

The high prevalence of erectile dysfunction (ED) underscores the critical importance of interventions and preventive measures targeting potential risk factors, among which obesity stands out. Relative fat mass (RFM) emerges as a superior indicator for quantifying body fat compared to traditional metrics like body mass index (BMI) or waist circumference (WC). However, research on the relationship between RFM and ED is extremely limited. A total of 3627 participants from the National Health and Nutrition Examination Survey 2001-2004 were eligible for analysis. The RFM is calculated using the following formula: RFM = 64-(20×height/WC). Weighted multivariable logistic regression models were utilized to assess the correlation between RFM and ED, supplemented by smooth curve fitting to further explore the linear association. When all potential covariates adjusted, continuous RFM demonstrated a positive association with ED prevalence (odds ratio (OR): 1.11, 95% confidence interval (CI): 1.05-1.18, P = 0.002). When RFM was categorized into tertiles (T1-T3), participants in T3 group exhibited a significantly higher likelihood of ED (OR: 2.19, 95% CI: 1.19, 4.05, P = 0.020) compared to those in T1. Subgroup analyses revealed a stronger correlation among participants aged over 60 years, obese individuals, and those with hypertension, while weaker correlations were observed among those with diabetes and cardiovascular disease (CVD). After sensitivity analysis for severe ED, the aforementioned regression analysis results remained statistically significant. The final ROC analysis demonstrated that the predictive ability of RFM was superior to that of BMI and WC, with an AUC (95% CI) of 0.639 (0.619-0.659). Elevated RFM demonstrated a linear correlation with increased incidence of ED and exhibited strong predictive capability for ED, underscoring the importance of obesity intervention for ED. Future studies with larger clinical samples are necessary to confirm our findings and expand the application value of RFM in assessing ED risk.

Erectile dysfunction is an underdiagnosed consequence of low anterior resection and abdominoperineal resection for colorectal cancer.

To explore the frequency and predictive factors of erectile dysfunction diagnosis after colorectal cancer surgery. The Surveillance, Epidemiology, and End Results-Medicare database was used to identify a national sample of men undergoing surgery for colorectal cancer from 2004 to 2015. Men aged > 65years with any index surgery within 1year of diagnosis of colorectal cancer were included. Men with a history of prior erectile dysfunction, metastatic cancer, or genitourinary cancer prior to their index procedure were excluded. The primary outcome was a new diagnosis of erectile dysfunction within 2years of the index procedure. A total of 28,248 men aged > 65 years who underwent colorectal cancer surgery were identified. The rates of erectile dysfunction diagnosis 2years after surgery were 3.6% for hemicolectomy, 5.3% for low anterior resection, and 6.4% for abdominoperineal resection. On multivariable analysis, low anterior resection (HR: 1.27, 95%CI 1.08 to 1.51, p < 0.01) and abdominoperineal resection (HR: 1.49, 95%CI 1.14 -1.93, p < 0.01) were independently associated with increased risk of erectile dysfunction compared to hemicolectomy. Minimally invasive surgery was independently associated with an increased risk of erectile dysfunction compared to open surgery (HR: 1.44, 95% CI 1.25-1.65, p < 0.001). Compared to hemicolectomy, men treated with low anterior resection and abdominoperineal resection have a higher risk of being diagnosed with erectile dysfunction within 2years of treatment. The absolute rate of erectile dysfunction diagnosis was low compared to rates reported in prior controlled trials, suggesting that patients are underdiagnosed in real-world settings.

Nerve graft for erectile dysfunction after radical prostatectomy: animal study and clinical data-a narrative review.

Introduced in the late 1990s, nerve grafting, particularly with sural and genitofemoral nerves, aims to enhance erectile function recovery when neurovascular bundles cannot be preserved following radical prostatectomy. Over the past three decades, researchers have conducted numerous animal and clinical studies to explore the application and clinical effectiveness of this method, with the hope of benefiting patients suffering from erectile dysfunction after radical prostatectomy. Animal studies have demonstrated the potential of various grafting materials, including autologous nerve and vein grafts, and bioengineered grafts, in promoting nerve regeneration and erectile function recovery. Clinical studies, especially those focusing on sural and genitofemoral nerve grafts, have shown mixed results with varied success rates due to methodological weaknesses and small sample sizes. This review thoroughly incorporates current data, explores emerging nerve grafting methods, demonstrates the complexity of nerve grafting outcomes, and emphasizes the necessity for continuous research, including multi-institutional randomized controlled trials, to establish standardized protocols and optimize patient selection for nerve grafting in the management of erectile dysfunction after radical prostatectomy.

Association between a novel inflammation-lipid composite marker CRP/HDL and erectile dysfunction: evidence from a large national cross-sectional study.

Erectile dysfunction (ED) is one of the most common male sexual disorders, closely associated with both inflammation and lipid dysregulation. Recently, a novel inflammation-lipid composite marker, CRP/HDL, has been proposed to integrate the impact of both pathways on health, yet its relationship with ED remains unexplored. Therefore, our study aimed to investigate the potential association between the CRP/HDL ratio and ED. We utilized data from the NHANES database, known for its comprehensive and high-quality information. A total of 3,633 eligible participants from the 2001-2004 cycles were included. ED was assessed using a single-item questionnaire, while CRP and HDL were measured from blood samples. Multivariable regression analyses were performed to evaluate the association between CRP/HDL and ED after adjusting for potential confounders. Additionally, subgroup and sensitivity analyses were conducted to test the robustness of the results, and the linear trend between CRP/HDL and ED was visualized through smooth curve fitting. Among the 3,633 participants, 1,027 had a history of ED. The CRP/HDL ratio was significantly higher in participants with ED compared to those without (10.53 ± 0.69 vs. 7.43 ± 0.35, P<0.001). In the regression analysis, a higher continuous CRP/HDL ratio was significantly associated with increased ED risk even after full adjustment (OR: 1.17, 95% CI: 1.05, 1.30; P = 0.01). Compared to Q1 of the CRP/HDL ratio, participants in Q2, Q3, and Q4 had progressively higher ED risks: Q2 (OR: 1.40, 95% CI: 1.01, 1.95; P = 0.05), Q3 (OR: 1.58, 95% CI: 1.10, 2.27; P = 0.02), and Q4 (OR: 1.85, 95% CI: 1.31, 2.60; P = 0.005), showing a clear linear trend. Subgroup analyses indicated consistent results across various populations with no significant interactions, and sensitivity analysis revealed that the CRP/HDL ratio also increased the risk of severe ED (OR: 1.14, 95% CI: 1.03, 1.26; P = 0.02). This is the first study to establish a significant positive association between an elevated CRP/HDL ratio and ED risk, suggesting its potential role in screening for ED risk and guiding timely interventions. However, further large-scale studies are needed to confirm our findings and explore the underlying mechanisms.

Association of insulin resistance surrogate indices and erectile dysfunction: a systematic review and meta-analysis.

Erectile dysfunction (ED) has been linked to insulin resistance (IR), with various surrogate indices being used to assess this association. This systematic review and meta-analysis aimed to evaluate the relationship between IR indices and the incidence and severity of ED. A comprehensive search across PubMed, Embase, Web of Science, and Scopus was carried out. Required data were extracted and meta-analyzed. The Newcastle-Ottawa Scale (NOS) was employed to evaluate the studies' risk of bias. Sensitivity analyses and meta-regressions were conducted to explore heterogeneity and the impact of confounding variables. Seventeen studies with a total of 3810 patients with ED and 8252 without ED were included. Meta-analysis revealed that males with ED had significantly higher levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (SMD = 0.59, 95% CI [0.15, 1.03], I2 = 82%, P < 0.01), Triglyceride-Glucose Index (TyG) (SMD = 0.53, 95% CI [0.31, 0.75], I2 = 69%, P < 0.01), and Visceral Adiposity Index (VAI) (SMD = 0.45, 95% CI [0.25, 0.64], I2 = 76%, P < 0.01) compared to those without ED. However, there was no significant correlation between a one-unit increase in HOMA-IR (OR = 0.63, 95% CI [0.03, 13.69], I2 = 91%, P = 0.77) or TyG (OR = 0.53, 95% CI [0.02, 11.53], I2 = 88%, P = 0.68) and the odds of ED. Additionally, a one-unit increase in VAI was associated with more severe ED (SMD = 0.34, 95% CI [0.03, 0.64], I2 = 16%, P = 0.03). The diagnostic accuracy of these indices varied. The results indicate a significant connection between insulin resistance and erectile dysfunction, as shown by HOMA-IR, TyG, and VAI. Yet, their usefulness in predicting ED is restricted because of significant differences and inconsistencies in diagnostic precision. More research is required to determine the clinical importance of these indices in treating ED.

Magnetic soft microrobots for erectile dysfunction therapy

Erectile dysfunction (ED) is a major threat to male fertility and quality of life, and mesenchymal stromal cells (MSCs) are a promising therapeutic option. However, therapeutic outcomes are compromised by low MSC retention and survival rates in corpus cavernosum tissue. Here, we developed an innovative magnetic soft microrobot comprising an ultrasoft hydrogel microsphere embedded with a magnetic nanoparticle chain for MSC delivery. This design also features phenylboronic acid groups for scavenging reactive oxygen species (ROS). With a Young's modulus of less than 1 kPa, the ultrasoft microrobot adapts its shape within narrow blood vessels, ensuring a uniform distribution of MSCs within the corpus cavernosum. Our findings showed that compared with traditional MSC injections, the MSC delivery microrobot (MSC-Rob) significantly enhanced MSC retention and survival. In both rat and beagle ED models, MSC-Rob treatment accelerated the repair of corpus cavernosum tissue and restored erectile function. Single-cell RNA sequencing (scRNA-seq) revealed that MSC-Rob treatment facilitates nerve and blood vessel regeneration in the corpus cavernosum by increasing the presence of regenerative macrophages. Overall, our MSC-Rob not only advances the clinical application of MSCs for ED therapy but also broadens the scope of microrobots for other cell therapies.

Computational Investigation of the Therapeutic Potential of Detarium senegalense in the Management of Erectile Dysfunction.

Erectile dysfunction (ED) is a multifactorial social problem affecting men worldwide. While phosphodiesterase type 5 inhibitors (PDE5) like sildenafil are commonly used, they often present side effects, underscoring the need for alternative therapies. Therefore, this study investigated the potential of phytochemicals from Detarium senegalense in the management of ED. A library of phytochemicals from Detarium senegalense was generated, prepared, and interacted with six key enzymes implicated in ED, including PDE5, using the Schrödinger Maestro suite. The results identified catechin, epicatechin, and gallic acid as the leading compounds with significant binding affinities for the targeted enzymes. Catechin and epicatechin (-9.877 and -11.408 kcal/mol, respectively) exhibited comparable binding affinities to sildenafil (-11.926 kcal/mol) on PDE5. The MD simulation results also revealed superior stability and ability to maintain interaction with key amino acids at the active site of PDE5 over the entire simulation period for these compounds. These compounds also demonstrated favorable ADMET profiles over sildenafil, including high gastrointestinal absorption and no violation of Lipinski's rule, indicating good bioavailability and drug likeness. These findings suggest that flavonoids from Detarium senegalense, especially catechin and epicatechin, have potential in the management of ED by interacting with multiple targets involved in its pathogenesis.

ИССЛЕДОВАНИЕ ЭРЕКТИЛЬНОЙ ДИСФУНКЦИИ У МУЖЧИН С БЕСПЛОДИЕМ: РАСПРОСТРАНЕННОСТЬ И ФАКТОРЫ

The aim of this study is to investigate the relationship between erectile dysfunction (ED), psychoemotional disorders and sexual activity in men with primary and secondary infertility. Materials and methods. The study was conducted from May 2023 to March 2024 at the Republican Urology Center in Makhachkala and included 57 eligible men divided into primary (n = 38) and secondary (n = 19) infertility groups. Participants completed anonymous questionnaires that included a fertility score, the International Erectile Function Index (IIEF-5), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7). Results. It was found that men with secondary infertility were more likely to show erectile dysfunction and had lower sexual satisfaction compared to men in the primary group, although no significant differences in the frequency of sexual acts were observed. The PHQ-9 and GAD-7 scores also showed comparable results for both groups. Conclusions. The study identified a need for a comprehensive approach in the treatment of men with infertility that takes into account both physical and psychological aspects. This may include medication and emotional support to improve quality of life and successful conception in couples facing this problem.

Artificial Intelligence as a Tool for Creating Patient Visit Summary: A Scoping Review and Guide to Implementation in an Erectile Dysfunction Clinic.

In modern healthcare, the integration of artificial intelligence (AI) has revolutionized clinical practices, particularly in data management and patient visit summary creation. Manual creation of patient summary is repetitive, time-consuming, prone to errors, and increases clinicians' workload. AI, through voice recognition and Natural Language Processing (NLP), can automate this task more accurately and efficiently. Erectile dysfunction (ED) clinics, which deal with specific pattern of conditions together with an involvement of broader systemic issues, can greatly benefit from AI-driven patient summary. This scoping review examined the evidence on AI-generated patient summary and evaluated their implementation in ED clinics. A total of 381 articles were initially identified, 11 studies were included for the analysis. These studies showcased various methodologies, such as AI-assisted clinical notes and NLP algorithms. Most studies have demonstrated the ability of AI to be used in real life clinical scenarios. Major electronic health record platforms are also integrating AI to their system. However, to date, no studies have specifically addressed AI for patient summary creation in ED clinics.

From Hypoxia to Oxidative Stress: Antioxidants' Role to Reduce Male Reproductive Damage.

Hypoxia is one of the main reasons causing male reproductive damage for people living in high altitude. Pathological evidences have been presented both in humans and animal models. Spermatogenesis disruption, worse sperm parameters, hormone disorder and erectile dysfunction are emblematic of male reproductive impairments brought by hypoxia. Among many mechanisms impairing male reproductive systems, oxidative stress is always a field of interest to explore. Although previous reviews have discussed about hypoxia or oxidative stress and antioxidants on male fertility respectively, no one has elucidated the concrete role of oxidative stress in hypoxia and correlating antioxidants that can ameliorate the negative effects. In this review, we firstly introduce hypoxia etiology and describe specific damage of hypoxia on male reproductive functions. Then, we emphasized interplays between hypoxia and oxidative stress as well as negative influences brought by oxidative stress. Finally, we listed antioxidants for oxidative stress and hypoxia-induced reproductive damage and discussed their controversial experimental effects for male infertility.

Can artificial intelligence evaluate the quality of YouTube videos on erectile dysfunction?

Can artificial intelligence evaluate the quality of YouTube videos on erectile dysfunction?