Induced Penile Erection Research Articles

A novel strategy to induce penile erection during penile doppler ultrasound: oral sildenafil administration plus alprostadil injection

Objectives To evaluate the efficacy of a novel approach to achieve the optimal penile erection during the penile doppler ultrasound (PDU) examination, which was oral sildenafil combined alprostadil injection. Materials and Methods A total of 60 ED patients were enrolled in our prospective study, and they were randomly assigned to two group with different PDU order. The approaches assisted the PDU included two models, mode A meaning injection of 15 μg alprostadil and model B meaning oral sildenafil 100 mg plus injection of 15 μg alprostadil. The PDU parameters were measured continuously before induced erection, and 5, 10, 15, 20, 25 min. Results Each group included 30 ED patients with similar clinical characteristics. After pooling the results together, the PSV, EDV, and RI were all improved significantly, when adding the oral sildenafil administration to assist PDU. Also, the clinical response of oral sildenafil administration plus alprostadil injection was better than that in alprostadil injection alone (p = 0.016). The arterial ED were decreased from 31.67% to 15.00% with the P value 0.031, and the mixed ED was also decreased statistically (23.33% vs 8.33%, p = 0.024). Conclusion Oral sildenafil administration plus alprostadil injection could improve the diagnostic accuracy of PDU.

Oxytocinergic neurons, but not oxytocin, are crucial for male penile erection

The cumulative evidence suggests that oxytocin is involved in the male sexual behaviors. However, no significant sexual impairments were observed in oxytocin gene knock-out (KO) mice, suggesting that oxytocin is not necessary for sexual behavior in male mice. To better understand the role of oxytocin in male erection, two types of oxytocin gene KO mice were created. In the first type, the oxytocin gene was deleted in the zygote, while in the second type, the oxytocin gene was mutated in adulthood by injecting the CRISPR/Cas9 AAVs. The results showed that disrupting the oxytocin gene at either the embryonic or adult stage did not affect erection, indicating that oxytocin is not necessary for penile erection. Pharmacologically, injecting oxytocin receptor agonist Carbetocin into the VTA of the oxytocin gene KO mice still evoked penile erection. By employing the Oxt-Ires-Cre mice, we found that specifically activating oxytocinergic neurons through chemogenetics strongly induced penile erection, while inhibiting these neurons blocked the erection responses. Furthermore, ablating PVN oxytocinergic neurons abolished the male erection response. In conclusion, although the neuropeptide oxytocin is not essential for male erection, the activity of oxytocinergic neurons is required. Our results might reflect the redundancy in the central nerve system in the sense that many signals contribute to the activation of oxytocinergic neurons to evoke penile erection during sexual behaviors.

MP27-12 FUNCTIONAL ERECTOGENIC NERVE MAPPING OF THE ENTIRE RAT PROSTATE WITH OPTICAL CLEARING

You have accessJournal of UrologyCME1 Apr 2023MP27-12 FUNCTIONAL ERECTOGENIC NERVE MAPPING OF THE ENTIRE RAT PROSTATE WITH OPTICAL CLEARING Selman Unal, Biljana Musicki, Ahmet Hoke, and Arthur Burnett Selman UnalSelman Unal More articles by this author , Biljana MusickiBiljana Musicki More articles by this author , Ahmet HokeAhmet Hoke More articles by this author , and Arthur BurnettArthur Burnett More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003255.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Erectile dysfunction is an important complication of radical prostatectomy (RP) due to cavernous nerve (CN) injury, which is in part a result of the unknown exact distribution of the CN branches (CNBs) on the prostate. We hypothesized that preserving functional pro-erectile CNBs promotes the success of retaining erectile function after RP. The aim of this study was to determine the functional erectogenic nerve distribution surrounding the entire prostate using a rat model. METHODS: Submaximal electrical stimulation of the CN was performed in male rats to induce penile erection by stimulating nNOS phosphorylation on Ser-1412 (functional nNOS). For localization of the P-nNOS (Ser-1412)-containing and nNOS-containing nerves, whole mount immunofluorescence staining was performed on the prostate, using ß-III-tubulin, a non-specific nerve marker, as control. Furthermore, the staining was combined with optical clearing with benzylalcohol/benzylbenzoate (BABB), which removes lipids and minimizes light scattering, allowing imaging of the tissue in situ. Because the BABB clearing technique has not been used previously for the CN or the whole prostate, we first modified it by optimizing stringency of lipid removal. RESULTS: We achieved optimum staining signal and prostate transparency by modification of BABB clearing technique to include shortening dehydration to prevent fluorescence quenching, followed by incubation with tert-butanol and BABB (1:2) at decreased acidity for 1.5 hour (Figure 1a). Microscopic examination localized nNOS and P-nNOS (Ser-1412)-containing cell bodies in the major pelvic ganglia, CN, and CNBs on the prostate. All nerves stained with nNOS/P-nNOS were also stained with ß-III-tubulin (Figure 1b, c). While there was no background noise in ß-III-tubulin staining, a minor signal of the nNOS and P-nNOS (Ser-1412) staining was observed in other tissues such as vascular smooth muscles. CONCLUSIONS: This study presents the first mapping of the pro-erectile nerves, in contrast to all nerves, surrounding the anatomically preserved whole rat prostate. This approach allows a dimensional shift from 2D to 3D histology of the whole intact prostate, providing further information about the distribution of pro-erectile CNBs in penile erection. Source of Funding: This study was supported by the Patrick C. Walsh Prostate Cancer Research Grant. Selman Unal was supported by The Scientific and Technological Research Council of Turkey (TÜBİTAK) for this study © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e366 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Selman Unal More articles by this author Biljana Musicki More articles by this author Ahmet Hoke More articles by this author Arthur Burnett More articles by this author Expand All Advertisement PDF downloadLoading ...

Effect of Aqueous Extract of Carpolobia Lutea Stem on Some Reproductive Parameters in Adult Male Wistar

Background: The use of medicinal plants as fertility enhancer in human is now on the increase because of the shifting of attention from synthetic drug to natural plants. Carpolobia lutea (CL) is a popular aphrodisiac herbal medicine, known for curing male sterility; increasing libido; induction of penile erection; enhancement of aphrodisiac prowess; enhancement of virility and male fertility; and augmentation of male sexual functions. The present study was therefore designed to investigate the fertility enhancement ability and possible side effect(s) of CL in male rats and also to provide insight and added to the existing knowledge available in the society on the usage of CL. Methods: A total of 20 Wistar rats with average weight of 162g were randomly grouped into 4 groups (A, B, C and D) of 5 rats per group, with group A served as the control and was administered normal saline. The remaining 3 groups (B-D) were orally administered 47mg/kgbw, 94mg/kgbw and 141mg/kgbw of Carpolobia lutea (CL) respectively for 60 days before sacrifice by cervical dislocation method. Results: The results obtained show ed that the blood testosterone of the treated rats reduced significantly. The morphometric result was good with significant increase in cross sectional area and luminal diameters in rats exposed to 141mg/kgbw and germinal epithelial diameter in rats exposed to 47mg/kgbw and 141mg/kgbw. Semen parameters showed that the sperm count was significantly increased at the high doses of 94mg/kgbw and 141mg/kgbw. The percentage of motile sperm also increased significantly while the morphological grading showed no changes at all. The experimental rats testes showed no visible lesions or the lesion was very mild (20%), seminiferous tubules were normal and concentric with intact basal membrane and lumen containing matured sperm cells together with the interstitial spaces which are well delineated and defined. Conclusion: It was concluded that the consumption of CL stem in any form can enhance the normal anatomy and physiology of testes at moderate dose and may account in part for the rationale behind its use in the management of sexual dysfunction.

Novel Concept Enabling an Old Idea: A Flexible Electrode Array to Treat Neurogenic Erectile Dysfunction

IntroductionMany studies have shown that electrostimulation of the cavernosal nerve can induce and maintain penile erection. Based on these discoveries, neurostimulation to activate the erectile response has been considered a potential solution to treat erectile dysfunction (ED). However, despite recognized potential, this technology has not been further developed. The barrier is the complex anatomy of the human cavernous nerve, which challenges the intraoperative identification of the cavernosal nerves for electrode placement. AimTo overcome this major barrier, we proposed a practical solution: a 2-dimensional flexible electrode array that can cover the entire plexus area, ensuring that at least 1 of the electrodes will be in optimal contact with the cavernosal nerve, without the need of intraoperative identification. The present study aims to evaluate this concept intraoperatively. Methods24 patients enrolled for open radical prostatectomy were recruited. During the surgical procedures, the electrode array was positioned on the pelvic plexus (on the prostatic apex or pelvic wall) and electrical stimulation was applied to induce penile erection. Penile erectile response was assessed by (i) visual change of penile tumescence and (ii) by a penile plethysmograph system. Main Outcome MeasureAbility and success rate of evoking penile response were measured by applying electrical stimulation using the developed electrode array. ResultsElectrical stimulation produced immediate penile response in all cases when tested before (on prostatic apex) or after prostate removal (on pelvic wall). Clear visual penile engorgement was observed in 75% of the cases, whereas 25% showed minimal to moderate penile tumescence. As expected, patients with lower International Index of Erectile Function-5 score presented a reduced response, whereas stimulation before prostate removal showed greater response than following removal. Interestingly, erectile response was potentiated by bilateral stimulation (circumference increase [mm]: 2.7 ± 1.02 vs. 8.2 ± 1.9, P = .01). Clinical ImplicationsThese data bring sufficient proof of concept of a conceivable novel medical implant for the treatment of ED caused by mechanical nerve injury, such as prostatectomy and spinal cord injury. Strength & LimitationsThis is the first approach that can ensure the optimal site stimulation of the erectogenic neuronal path within the lower pelvic area and overcome the major barrier of individual anatomic variability. However, because this study was performed intraoperatively in an acute scenario, further studies are needed to evaluate its chronic efficacy for clinical practice. ConclusionThe flexible electrode array concept can ensure the electrostimulation of erectogenic neuronal path when positioned on the prostate apex or pelvic floor.Skoufias S, Sturny M, Fraga-Silva R, et al. Novel concept enabling an old idea: A flexible electrode array to treat neurogenic erectile dysfunction. J Sex Med 2018;15:1558–1569.

Pattern of presentation and surgical management of penile fractures in a semi-urban African teaching hospital: Case reports and literature review

IntroductionPenile fracture is relatively rare and also under-reported in our environment. There seem to be a gradual change in this pattern however, as we managed six patients over a two-year period. ObjectiveTo present the peculiarities of penile fracture presentation and surgical management in our semi-urban African setting; while also reviewing the available literature on the subject to possibly validate our practice. Patients and methodsAll patients with penile fracture managed in our university teaching hospital between January 2014 and December 2015 were prospectively studied in order to identify any peculiarities of clinical presentation, surgical reconstruction technique and management outcome. ResultsSix male patients were studied. Their ages ranged from 23 to 41 years (mean 31 years) while interval between penile fracture occurrence and clinical presentation in our emergency unit ranged from 45min to 30h (mean about 10h). The aetiologic mechanism was penile self manipulation (2, 33.2%), masturbation (1, 16.7%), sexual intercourse with the female in the dominant position (1, 16.7%), turning in bed (1, 16.7%) and motorcycle road traffic accident in a man with local aphrodisiac induced penile erection who was rushing home to his female partner (1, 16.7%). The rupture of the tunica albuginea was located on the right side in majority of cases (4, 66.7%) while none of the patients had coexisting urethral injury. All of them had surgical repair between 3 and 9h of presentation with good cosmetic and functional outcome. ConclusionThe trend of penile fracture seems to be changing in our semi-urban African community. Surgical reconstruction results in good outcome.

VACUUM THERAPY – PREVENTION OF HYPOXIA OF CAVERNOUS TISSUE PATIENTS AFTER RADICAL PROSTATECTOMY

Patients, after radical prostatectomy with the use of nerve-sparing techniques, without carrying out penile rehabilitation, are at risk of forming cavernous fibrosis with the emergence of subsequent persistent erectile dysfunction. In order to minimize damage to cavernous tissue and early restoration of erectile function during the period of neuropraxia, it is necessary to ensure a sufficient level of oxygenation. The role of applying vacuum in penile rehabilitation for the prevention of hypoxia of cavernous tissue is not fully understood, due to the lack of data on the gaseous composition of the blood at the time of reaching the vacuum of erection. The purpose of this work was to review the scientific studies devoted to the study of vacuum induced penile erection in animals or humans, which indicates high results due to increased oxygenation of cavernous tissue.

Oxytocin induces penile erection and yawning when injected into the bed nucleus of the stria terminalis: Involvement of glutamic acid, dopamine, and nitric oxide

Oxytocin (5–100ng), but not Arg8-vasopressin (100ng), injected unilaterally into the bed nucleus of the stria terminalis (BNST) induces penile erection and yawning in a dose-dependent manner in male rats. The minimal effective dose was 20ng for penile erection and 5ng for yawning. Oxytocin responses were abolished not only by the oxytocin receptor antagonist d(CH2)5Tyr(Me)2-Orn8-vasotocin (1μg), but also by (+) MK-801 (1μg), an excitatory amino acid receptor antagonist of the N-methyl-d-aspartic acid (NMDA) subtype, SCH 23390 (1μg), a D1 receptor antagonist, but not haloperidol (1μg), a D2 receptor antagonist, and SMTC (40μg), an inhibitor of neuronal nitric oxide synthase, injected into the BNST 15min before oxytocin. Oxytocin-induced penile erection, but not yawning, was also abolished by CNQX (1μg), an excitatory amino acid receptor antagonist of the AMPA subtype. In contrast, oxytocin responses were not reduced by bicuculline (20ng), a GABAA receptor antagonist, phaclofen (5μg), a GABAB receptor antagonist, CP 376395, a CRF receptor-1 antagonist (5μg), or astressin 2B, a CRF receptor-2 antagonist (150ng). Considering the ability of NMDA (100ng) to induce penile erection and yawning when injected into the BNST and the available evidence showing possible interaction among oxytocin, glutamic acid, and dopamine in the BNST, oxytocin possibly activates glutamatergic neurotransmission in the BNST. This in turn leads to the activation of neural pathways projecting back to the paraventricular nucleus, medial preoptic area, ventral tegmental area, and/or ventral subiculum/amygdala, thereby inducing penile erection and yawning.

Diagnostic value of four-dimensional CT angiography in arterial erectile dysfunction using 320-detector row dynamic volume CT

The present study aims to evaluate the diagnostic value of four-dimensional CT angiography (4D-CTA) in the diagnosis of arterial erectile dysfunction (ED) using 320-detector row dynamic volume CT. Arterial ED patients attributed to arterial insufficiency were enrolled. To induce penile erection, an intracavernous injection (ICI) of corpus cavernosum with a vasoactive drug was administered. Patients were assigned into the erection hardness score (EHS) 1/2 group or EHS 3/4 group. Color duplex Doppler ultrasound (CDDU) was used to analyze blood flow spectrum. Each patient was examined using 4D-CTA. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of 4D-CTA in arterial ED. According to Irwin Goldstein, the EHS 3/4 group (n=38) had a shorter course of ED and low proportion with history of hypertension, hyperlipidemia, and diabetes than the EHS 1/2 group (n=35). The peak systolic velocity (PSV), end diastolic velocity (EDV), and resistant index (RI) in the EHS 3/4 group were lower than those of the EHS 1/2 group. 4D-CTA showed there were a total of 35 cases in the EHS 1/2 group (two cases missed) and 38 cases in the EHS 3/4 group (seven cases misdiagnosed). Using 4D-CTA to diagnose arterial ED, the area under the ROC curve yielded a value of 0.879, with a specificity of 93.9% and a sensitivity of 82.5%. These findings indicated that 4D-CTA using 320-detector row dynamic volume CT is a promising and reliable utility in diagnosing arterial ED.

MP84-15 A NEW METHOD OF QUANTITATIVELY MEASURING PENILE ERECTION HARDNESS IN ERECTILE DYSFUNCTION PATIENTS: REAL-TIME ULTRASONIC SHEAR WAVE ELASTOGRAPHY

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II1 Apr 2017MP84-15 A NEW METHOD OF QUANTITATIVELY MEASURING PENILE ERECTION HARDNESS IN ERECTILE DYSFUNCTION PATIENTS: REAL-TIME ULTRASONIC SHEAR WAVE ELASTOGRAPHY Lin Yang, Hao Cheng, and Litao Ruan Lin YangLin Yang More articles by this author , Hao ChengHao Cheng More articles by this author , and Litao RuanLitao Ruan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2656AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Penile erection hardness (EH), according to the Erectile Hardness Grading Scale (EHS), is an important indicator for evaluating penile erectile function. In this study, we provided a new method of real-time quantitative measurement of penile EH for erectile dysfunction (ED) patients using ultrasonic shear wave elastography (SWE). METHODS Sixty ED patients diagnosed using the IIEF-5 questionnaire and the presence of nocturnal penile tumescence underwent real-time SWE to measure Young's modulus of the penile corpus cavernosum and albuginea while resting and at various grades of EH. Prostaglandin injection into the corpus cavernosum was used to induce penile erection. RESULTS Young's modulus for the corpus cavernosum (resting) and EH grades 1, 2, 3, and 4 were, (12.16±1.97)kPa,(10.97±1.98)kPa,(9.06±1.71)kPa,(9.38±1.68)kPa,(9.36±1.34)kPa respectively; Corresponding Young's modulus values for the albuginea (resting) and EH grades 1, 2, 3, and 4 were(21.97±4.68)kPa,(32.71±3.71)kPa,(54.12±10.09)kPa ,(127.81±18.10)kPa ,(223.99±26.73)kPa respectively. These Young's modulus values were grouped respectively to draw the receiver operating characteristics curve. The area under the albuginea curve was significantly better than that of the cavernosum (?2 = 61.10). Cutoff point of albuginea at grade 3 hardness was 81.60kPa. CONCLUSIONS Quantitatively measuring Young's modulus of penile albuginea using SWE is a novel, noninvasive, objective technique for quantitatively assessing the EH of ED patients. We proved that albuginea hardness, not cavernous tissue hardness, was a good clinical imaging index for penile EH evaluating. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1145 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Lin Yang More articles by this author Hao Cheng More articles by this author Litao Ruan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Penile erection induces angiogenic, survival, and antifibrotic signals: molecular events associated with penile erection induced by cavernous nerve stimulation in mice.

To determine the molecular events related to penile erection in the corpus cavernosum tissue of mice after electrical stimulation of the cavernous nerve. Twelve-week-old male C57BL/6 mice were used in this study. Electrical stimulation of the cavernous nerve was carried out to induce penile erection. Corpus cavernosum tissues were then harvested to determine the effect of nerve-induced penile erection on signaling pathway involved in angiogenesis (vascular endothelial growth factor, hepatocyte growth factor, angiopoietin-1, matrix metalloproteinase2, and matrix metalloproteinase9), cell survival and proliferation (phosphatidylinositol 3-kinase, phospho-Akt/Akt, and phospho-ERK/ERK), and tissue fibrosis (phospho-Smad2/Smad2, phospho-Smad3/Smad3, and plasminogen activator inhibitor-1). Cavernous nerve stimulation enhanced the expression of factors involved in angiogenesis (vascular endothelial growth factor, hepatocyte growth factor, angiopoietin-1, matrix metalloproteinase2, and metalloproteinase9), and activated intracellular signaling mediators related to cell survival and proliferation (phosphatidylinositol 3-kinase, phospho-Akt/Akt, and phospho-ERK/ERK), while suppressing the pathways involved in tissue fibrosis (phospho-Smad2/Smad2, phospho-Smad3/Smad3, and plasminogen activator inhibitor-1). Penile erection in mice is accompanied by the activation of a cascade of signaling pathways involved in angiogenesis, cell survival and proliferation, and antifibrosis. The present results might provide a theoretical and molecular basis for understanding the importance of penile rehabilitation and subsequent restoration of nocturnal or sexually-mediated penile erections.

AB029. The clinical significance of RigiScan plus detection

Erectile dysfunction (ED) is a common disease in male outpatient service, the penis hardness testing of ED in the clinical diagnosis has important significance, past some detection methods, such as nocturnal penile tumescence monitoring (NPT) due to time-consuming is not easy in outpatient service and a vasodilator agent intervention tests such as color Doppler detection due to the injection of drugs in the penis is difficult for patients to accept. In 1965 night rapid eye movement sleep phase 3–5 times of penile erection phenomenon was first reported by Fisher, in 1970 the night monitoring instrument of penis erectile hardness is used for evaluation of male erectile function. In 1985 researchers reported the RigiScan plus software was used to record of nocturnal erection, 1994 this method was gradually improved and used in clinical application by Levine. Sol reported that after taking sildenafil the patient was given audio-visual stimulation to induce the penis erects, then the RigiScan plus was used to record erection hardness in 2006. Due to the complexity of the etiology of ED, for the evaluation of penile erectile function should also be in many ways any single check has its limitations, the drug combined with audio-visual sense stimulation induced penile erection hardness monitoring (AVSS + RigiScan plus) in newly diagnosed patients with erectile function has a certain significance. Compared with AVSS + RigiScan examination, NPT is more expensive, time-consuming, and cumbersome, and patients feel unwell. And AVSS + RigiScan is simple, effective, easy, cheap, and the diagnostic accuracy rate matching to NPT, it is suitable for routine examination of patients with newly diagnosed ED.

AB044. Initial analysis of PDE5i and visual-auditory sexual stimulation Rigiscan plus detection results of 1,896 cases in outpatients

ObjectiveTotal of 1,896 cases of drugs combined with audio-visual stimulation induced penile erection hardness monitoring were summarized, the results of cases with no correlation accompaniment diseases and associated with diseases were compared.MethodsTotal of 1,896 cases Rigiscan exam were underwent in our center, the patients were aged 18-72 years old (average 41.3 years), courses of disease were 2 months to 23 years, 21 cases had no sex life history, those who no correlated accompaniment disease were 1,067 cases (I group), those who with correlated accompaniment disease were 829 cases (II group). Methods of operation as below: oral sidinafil 100 mg, 60 min later, by means of Rigiscan to detect the baseline value of the glans penis and the base penis in peace and quiet state, utilizing spectacles visual-auditory sexual stimulation appearance to detect the erection condition of the penis for 1 hour, the hardness of the glans penis and the base penis ≥70%, expansion diameter >20 mm, persistence time >15 min would be considered effective erection, the hardness of the glans penis and the base penis ≥40% and <70%, expansion diameter >10 mm, persistence time >10 min would be considered apart erection, rest was no erection.ResultsAll the subjects were collected effective erection 1,131 cases, the constituent ratio was 1,131/1,896 (59.6%), part effective erection took place in 495 cases, the constituent ratio was 495/1,896 (26.1%), no erection took place in 270 cases, the constituent ratio was 270/1,896 (14.3%). Among I group effective erection was collected in 786 cases, the constituent ratio was 786/1,067 (73.7%), part effective erection took place in 198 cases, the constituent ratio was 198/1,067 (18.6%), no erection took place in 83 cases, the constituent ratio was 83/1,067 (7.7%). Among II group effective erection was collected in 345 cases, the constituent ratio was 345/829 (41.6%), part effective erection took place in 297 cases, the constituent ratio was 297/829 (35.8%), no erection 187 cases, the constituent ratio was 187/829 (22.6%). Chi-square criterion eventuate: effective erection in I group was significantly higher than that of II group, opposite, part effective and no erection in II group was significantly higher than that of I group.ConclusionsThe effective erection of cases with no correlation accompaniment diseases was significantly higher than that of related with the diseases, suggesting a correlation with diseases and erectile dysfunction (ED) occurred more easily than previous health.

The aphrodisiac herb Carpolobia: A biopharmacological and phytochemical review.

Any agent with the ability to provoke sexual desire in an individual is referred to as an aphrodisiac. Aphrodisiac plants are used in the management of erectile dysfunction (ED) in men. One such plant popular in West and Central Africa among the Pygmies of Cameroon, Ipassa of Garbon, and the Yoruba, Ibo, Efik and Ijaw peoples of Nigeria is Carpolobia. It is an accepted and commonly utilized herbal booster of libido. It is used to cure male infertility and to boosts libido thereby augmenting male sexual functions or it is used to induce penile erection, and enhance male virility. The chewing stick prepared from the stem and root of either Carpolobia alba (CA) or Carpolobia lutea (CL) is patronized because it boosts male sexual performance. The genus Carpolobia has over 14 species. The leaf essential oil contains a variety of terpenoids, while polyphenols and triterpenoid saponins have been isolated from the root and leaf extracts respectively. Other ethnomedicinal uses include curing of stomach ailments, rheumatism, fever, pains, insanity, dermal infection, venereal diseases; to promote child birth; and as a taeniafuge and vermifuge. In spite of its popularity, no scientific data reviewing the biopharmacological and phytochemical activities of Carpolobia exist to our knowledge. The aim of this work is to collate all available published scientific reports in the literature on Carpolobia in a review paper. In this review, an overview of the morphology, taxonomy, ethnomedicinal claims, geographical distribution, and structurally elucidated compounds that are secondary metabolites isolated and characterized from Carpolobia species is established. The pharmacological assays, phytochemical screenings, and toxicological reports are also reviewed.

Physicochemistry of dinitrosyl iron complexes with thiolate ligands underlying their beneficial effect in endometriosis

Exogenous dinitrosyl iron complexes (DNIC) with thiolate ligands as NO and NO+ donors are capable of exerting both regulatory and cytotoxic effects on diverse biological processes similarly to those characteristic of endogenous nitric oxide. Regulatory activity of DNIC (vasodilatory, hypotensive, suppressing thrombosis, increasing erythrocyte elasticity, accelerating skin wound healing, inducing penile erection, etc.) is determined by their capacity of NO and NO+ transfer to biological targets of the latter (heme- and thiol-containing proteins, respectively) due to higher affinity of the proteins for NO and NO+ than that of DNIC. Cytotoxic activity of DNIC is provided by rapid DNIC decomposition under action of iron-chelating compounds, resulting in appearance of NO and NO+ in cells and tissues in high amounts. The latter mechanism is suggested to cause the blocking effect of DNIC as cytotoxic effectors on the development of benign endometrial tumors in rats with experimental endometriosis. It is also proposed that a similar mechanism can operate to cause at least a delay of malignant tumor proliferation under action of DNIC.

Clavulanic acid induces penile erection and yawning in male rats: Comparison with apomorphine

The beta-lactamase inhibitor clavulanic acid induced penile erection and yawning in a dose dependent manner when given intraperitoneally (IP, 0.05–5mg/kg), perorally (OS, 0.1–5mg/kg) and intracereboventricularly (ICV, 0.01–5μg/rat) to male rats. The effect resembles that of the dopamine receptor agonist apomorphine given subcutaneously (SC) (0.02–0.25mg/kg), although the responses of the latter followed a U inverted dose–response curve, disappearing at doses higher than 0.1mg/kg. Clavulanic acid responses were reduced by about 55% by haloperidol, a dopamine D2 receptor antagonist (0.1mg/kg IP), and by d(CH2)5Tyr(Me)2-Orn8-vasotocin, an oxytocin receptor antagonist (2μg/rat ICV), both given 15min before clavulanic acid. A higher reduction of clavulanic acid responses (more than 80%) was also found with morphine, an opioid receptor agonist (5mg/kg IP), and with mianserin, a serotonin 5HT2c receptor antagonist (0.2mg/kg SC). In contrast, no reduction was found with naloxone, an opioid receptor antagonist (1mg/kg IP). The ability of haloperidol, d(CH2)5Tyr(Me)2-Orn8-vasotocin and morphine to reduce clavulanic acid induced penile erection and yawning suggests that clavulanic acid induces these responses, at least in part, by increasing central dopaminergic neurotransmission. Dopamine in turn activates oxytocinergic neurotransmission and centrally released oxytocin induces penile erection and yawning. However, since both penile erection and yawning episodes were reduced not only by the blockade of central dopamine and oxytocin receptors and by the stimulation of opioid receptors, which inhibits oxytocinergic neurotransmission, but also by mianserin, an increase of central serotonin neurotransmission is also likely to participate in these clavulanic acid responses.

Neuroendocrine regulatory peptide-1 and neuroendocrine regulatory peptide-2 influence differentially feeding and penile erection in male rats: Sites of action in the brain

The effect of NERP-1 and NERP-2, two recently discovered VGF-derived peptides, on feeding and penile erection was studied after injection into the lateral ventricles, the lateral hypothalamus, the arcuate nucleus or the paraventricular nucleus of the hypothalamus. NERP-2 (1–5nmol), but not NERP-1 (2–4nmol), increased feeding in a dose-dependent manner when injected into the lateral ventricles or bilaterally into the lateral hypothalamus but not into the arcuate or the paraventricular nucleus. The effect of NERP-2 given into the lateral ventricles was found in the first, but not in the second 60min after treatment, and was antagonized by SB-408124, an orexin-1 receptor antagonist given into the lateral ventricles or the arcuate nucleus, but not into the paraventricular nucleus. However, SB-408124 was unable to reduce NERP-2-induced feeding when injected bilaterally into the lateral hypothalamus before NERP-2 given also bilaterally into the lateral hypothalamus. In contrast, NERP-1, but not NERP-2, induced penile erection in a dose-dependent manner when injected into the lateral ventricles or the arcuate nucleus, but not into the paraventricular nucleus or the lateral hypothalamus. The pro-erectile effect of NERP-1 was not prevented by the prior injection of d(CH2)5Tyr (Me)2-Orn8-oxytocin or SB-408124 into the lateral ventricles. The present results suggest that while NERP-2 facilitates feeding by acting in the lateral hypothalamus, possibly by increasing orexin activity in the arcuate nucleus, NERP-1 facilitates penile erection by acting in the arcuate nucleus with a mechanism not related to orexin or oxytocin.

Arctium lappa improve Penile Erection in Penile Smooth Muscle

The aim of the present study was to investigate whether an ethanol extract of Arctium lappa (EAL) augments penile erection in vitro. Isolated rabbit endothelium‐intact corpus cavernosum was preconstricted with phenylephrine (PE). EAL relaxed penile smooth muscle in a dose‐dependent manner, which was significantly inhibited by pretreatment with NG‐nitro‐L‐arginine methyl ester (L‐NAME), a nitric oxide synthase inhibitor, and 1H‐[1,2,4]‐oxadiazole‐[4,3‐¥á]‐quinoxalin‐1‐one (ODQ), a soluble guanylyl cyclase (sGC) inhibitor. EAL‐induced relaxation was also significantly attenuated by pertreatment with verapamil and diltiazem, respectively. On the other hand, relaxation of penile smooth muscle induced by EAL was not blocked by several inhibitors including tetraethylammonium (TEA), glibenclamide, indomethacin, atropine and propranolol, respectively. In the perfusion model of penile tissue, EAL also relaxed PE‐precontracted penile tissue tension in a dose‐dependent manner. Moreover, perfusion of penile tissues with EAL significantly increased the levels of cGMP and cAMP. Taken together, these results suggest that EAL may be induced penile erection through the activation of penile tissue NO/cGMP system and/or Ca2+channels in corpus cavernosum.

Erectile properties of the Rho-kinase inhibitor SAR407899 in diabetic animals and human isolated corpora cavernosa

BackgroundRhoA-Rho kinase complex contributes to keep the cavernosus smooth muscle contracted and its inhibition is considered a potential strategy for the therapy of erectile dysfunction (ED).MethodsWe compared the effects of SAR407899, the Rho-kinase inhibitor Y-27632 and the PDE5 inhibitor sildenafil for their ability to relax corpus cavernosum strips contracted with phenylephrine in healthy and diabetic animals. Strips were obtained from WKY, spontaneous hypertensive (SHR), control CD, and diabetic CD rats, humans, control and diabetic rabbits. Diabetes was induced by streptozotocin or alloxan injection. In vivo penile erection (length) induced by drugs was measured in conscious rabbits.ResultsSAR407899 dose-dependently relaxed the pre-contracted corpora cavernosa in all species, with similar potency and efficacy in healthy vs diabetic rats, WKY vs SHR rats, healthy vs diabetic rabbits (IC50 range from 0.05 to 0.29 μM, Emax range 89 to 97%). In the presence of the NO-synthase (NOS) inhibitor, L-NAME, the SAR407899 response did not decrease in any of the species or experimental conditions. The effect was confirmed in human strips where sildenafil was significantly less potent and effective, with IC50 respectively 0.13 and 0.51 μM; Emax 92 and 43%. Unlike SAR407899, the potency and efficacy of sildenafil and Y27632 were significantly reduced by diabetes and L-NAME. In vivo, SAR407899 dose-dependently induced rabbit penile erection, with greater potency and longer duration of action than sildenafil. Sildenafil, but not SAR407899, was less effective in alloxan-induced diabetes.ConclusionThe induction of penile erection by SAR407899, unlike that by sildenafil, is largely independent of e-NO activity. This suggests its use in erectile dysfunction for diabetic and hypertensive patients where e-NO activity is impaired.

Dopamine agonist-induced penile erection and yawning: Differential role of D2-like receptor subtypes and correlation with nitric oxide production in the paraventricular nucleus of the hypothalamus of male rats

The dopamine D3 preferring agonist pramipexole (50ng) induced penile erection and yawning when injected into the paraventricular nucleus of the hypothalamus of male rats, like the mixed D1/D2-like agonist apomorphine (50ng), while the D4 agonist PD 168,077 (100ng), induced penile erection only. These responses lasted for 45–60min and occurred with an increase of NO2− and NO3− concentrations in the dialysate obtained from the paraventricular nucleus by intracerebral microdialysis. Pramipexole and apomorphine responses were reduced by the D2 preferring antagonist L-741,626 (5μg), but not by the D3 preferring antagonist SB-277011A (10μg), or the D4 preferring antagonist L-745,870 (5μg), injected into the PVN before the dopamine agonist. In contrast, PD 168,077 responses were reduced by L-745,870, but not by L-741,626 or SB-277011A. Pramipexole, apomorphine and PD 168,077 effects were also reduced by the nitric oxide synthase inhibitor S-methyl-l-thiocitrulline (20μg) and the N-type voltage-dependent Ca2+ channels blocker ω-conotoxin (5ng), given into the paraventricular nucleus, and by the oxytocin antagonist d(CH2)5Tyr(Me)2-Orn8-vasotocin (2μg), given intracerebroventricularly but not into the paraventricular nucleus before dopamine agonists. These results suggest that stimulation of D2, but not D3 or D4 receptors, by pramipexole or apomorphine increases Ca2+ influx in cell bodies of oxytocinergic neurons. This increases the production of nitric oxide, which activates oxytocinergic neurotransmission in extra-hypothalamic brain areas and spinal cord, leading to penile erection and yawning. However, the stimulation of D4 receptors by PD 168,077 also increases Ca2+ influx/nitric oxide production leading to penile erection, but not yawning.