Nocturnal Penile Tumescence And Rigidity Research Articles

Association between testosterone levels and RigiScan parameters of patients with erectile dysfunction.

It is difficult to diagnose hypogonadism because of the lack of objective assessments of erectile dysfunction (ED), which is caused by hypogonadism. To provide a new approach for diagnosing hypogonadism, this study evaluated the efficacy of nocturnal penile tumescence and rigidity (NPTR) testing with RigiScan for patients with ED with and without hypogonadism. From June 2021 to February 2023, 133 patients with ED (62 with hypogonadism and 71 without) underwent NPTR testing at the Department of Andrology. A detailed history of all participants was obtained. All participants also underwent a physical examination, sex hormone testing, and ultrasound examination of the cavernous vessels of the penis. Patient characteristics, sex hormone serum levels, and RigiScan Plus data of NPTR testing of patients with ED were obtained and evaluated. Between the groups, there were no significant differences in age, body mass index, or erectile function score or in the prevalence of smoking, drinking, diabetes, hypertension, and hyperlipidemia. RigiScan data revealed differences in erection episodes per night, average event rigidity, erection durations, and percentage of tumescence greater than baseline, which were significantly lower in the testosterone-deficient group than in the normal testosterone group. The average event rigidity of the tip displayed the largest area under the curve value, with a sensitivity of 67.6%, a specificity of 85.5%, and a cutoff value of 52.50. Our findings may allow appropriate patients to receive testosterone replacement therapy, which has been shown to be an effective treatment for hypogonadism. This is the first study of its kind to perform a comprehensive review of the association between hypogonadism and RigiScan parameters. This study was limited by its small sample size. RigiScan parameters of patients with ED and testosterone deficiency were significantly lower than those of patients with normal testosterone; therefore, RigiScan is useful for the differential diagnosis of patients with ED caused by hypogonadism.

More Efficient Approach: Independent Diagnostic Value of Audiovisual Sexual Stimulation for Psychogenic Erectile Dysfunction

The diagnostic value of audiovisual sexual stimulation (AVSS) for psychogenic erectile dysfunction (ED) is still unclear. We investigated the independent diagnostic value and optimal cut-off parameter of AVSS for psychogenic ED. All participants had received the AVSS test and nocturnal penile tumescence and rigidity (NPTR) monitoring at least twice. ED patients were divided into psychogenic ED and organic ED according to NPTR examination. The diagnostic accuracy of AVSS parameters was evaluated with the receiver operating characteristic (ROC) curve, and the Youden index was employed to determine the optimal diagnostic cut-off values. A total of 346 patients with ED and 60 healthy men were included in this study, among which 162 and 184 cases of psychogenic and organic ED were identified based on NPTR, respectively. When comparing the two ED groups, the area under the curve (AUC) of AVSS parameters was 0.85–0.89. Six-selected AVSS parameters could precisely diagnose psychogenic ED, exhibiting increased diagnostic specificity compared with corresponding sensitivity. When comparing psychogenic ED with the control group, the AUC of the tumescence of the tip was superior to the AUC other parameters (0.81 vs. 0.58, 0.66, 0.59, 0.53, 0.68), and the best determined diagnostic cut-off value was the tumescence of the tip < 29.87%. Independent AVSS could diagnose psychogenic ED objectively and effectively, and its diagnostic value was highest when 1.50% ≤ tumescence of the tip < 29.87%.

Association between sleep quality and nocturnal erection monitor by RigiScan in erectile dysfunction patients: a prospective study using fitbit charge 2

Background Few studies were conducted to explore the association between sleep quality and nocturnal erection. Here, we intended to explore the association between sleep quality and nocturnal erection monitor when conducting nocturnal erection monitor. All erectile dysfunction (ED) patients underwent sleep monitors using Fitbit Charge 2™ (Fitbit Inc.) and nocturnal penile tumescence and rigidity (NPTR) monitors using RigiScan® (GOTOP medical, Inc., USA) for two nights. Subsequently, the patients were divided into two groups: Group A included patients who experienced effective erections only on the second night, while Group B included patients who had effective erections on both nights. To explore the associations between NPTR parameters and sleep parameters, a comparative analysis was performed between Group A and Group B for both nights.ResultsFinally, our study included 103 participants, with 47 patients in Group A and 56 patients in Group B. Notably, the Group A patients showed significant improvements in NPTR parameters on the second night compared to the first night. Conversely, the NPTR parameters on Group B of the second night did not demonstrate a superior outcome when compared to the second night of Group A. Interestingly, it was found that only the disparities in sleep parameters accounted for the variation in NPTR parameters between the two groups on the first night. After correlation and ROC analysis, we identified the rapid eye movement (REM) sleep time and wake after sleep onset (WASO) time monitoring by the Fitbit Charge 2 as the primary parameters for predicting abnormal NPTR results in the first night.ConclusionsTherefore, our study strongly suggests a close association between sleep parameters and NPTR parameters. It emphasizes the importance of incorporating sleep monitoring alongside nocturnal erection monitoring to enhance the reliability of the NPTR results.

Nocturnal penile tumescence devices: past, present and future.

Erectile function is an important part of men's health that can significantly impact quality of life. Naturally occurring nighttime erections experienced by men throughout their lifespan provides insight into penile health as well as overall health. Nocturnal penile tumescence (NPT) and nocturnal penile tumescence and rigidity (NPTR) devices that can non-invasively evaluate the presence and quality of erections can have valuable diagnostic and clinical utility. Early devices have several limitations that limit their current use. New, wearable devices have promising applications for the evaluation of erectile function over time. Continued advancements in this technology have the potential to render future generations of these devices as invaluable tools that are useful for both men and healthcare professionals.

Erection Hardness Score in Masturbation Can Serve as a Preliminary Screening Tool for Organic Erectile Dysfunction

To explore the efficacy, in terms of sensitivity and specificity, of Erection Hardness Score (EHS) applied to masturbation in diagnosing predominantly organic erectile dysfunction (ED), compared to the actual standard, which is nocturnal penile tumescence and rigidity (NPTR). A total of 189 consecutive patients who came to our outpatient clinic from October 2019 to October 2020, reporting ED and an abridged International Index of Erectile Function (IIEF-6) score <26 were enrolled. Patients filled out two psychometric questionnaires: the IIEF-6 applied to partnered intercourse and the EHS applied to masturbation, then they underwent the NPTR test with Rigiscan for 2 consecutive nights in good sleep condition. Sensitivity, specificity, positive predictive value, and negative predictive value of EHS and IIEF-6 scales with NPTR as the standard, as well as the correlation between EHS, IIEF-6, and NPTR results were calculated. Results show that the sensitivity of the EHS scale for the diagnosis of ED was 60.0%, the specificity was 95.7%, the positive predictive value was 83.3%, the negative predictive value was 86.9%, and the coincidence rate was 86.2%. The correlation coefficient was 0.572 and the area under the ROC curve was 0.78, which means the strength of erection in masturbation as evaluated by the EHS can effectively help in discriminating between predominantly organic and apparently nonorganic ED. An EHS score of 3-4, meaning good-optimal erectile function during masturbation, decreases the likelihood of predominantly organic ED and reduces the need for further NPTR testing.

The relationship between serum 25-hydroxy vitamin D and arteriogenic erectile dysfunction.

This study aimed to assess the relationship between 25(OH) levels and erectile dysfunction (ED), particularly arteriogenic ED (A-ED). From September 2020 to January 2022, 150 patients diagnosed with ED by the International Index of Erectile Function-5 (IIEF-5) questionnaire were included. All patients were classified as organic ED and psychological ED by nocturnal penile tumescence and rigidity (NPTR) examination. Organic ED patients were divided into A-ED and NA-ED by penile doppler ultrasound (PDU) examination. Finally, 150 patients complaining of ED were enrolled in our study. 25(OH)D levels were significantly lower in patients with organic ED (18.24 ± 6.04 ng/ml) than in patients with psychogenic ED (20.90 ± 8.79 ng/ml) (p=0.032). In A-ED and NA-ED, the mean of peak systolic flow velocity (PSV) values was 18.94 ± 5.28 cm/s and 51.57 ± 15.42 cm/s (p < 0.001), and the mean of 25(OH)D was 15.66 ± 5.86 ng/ml and 20.48 ± 5.90 ng/ml, respectively (p < 0.001). The results showed that 25(OH)D levels were positively correlated with IIEF-5 scores and the PSV values in A-ED patients. The 25(OH)D cut-off value differentiating between A-ED and NA-ED was 15.05 ng/ml. Low 25(OH)D levels may be an independent risk factor for ED, especially A-ED. ED patients should routinely undergo serum 25(OH)D level measurement, and 25(OH)D replacement therapy is necessary for patients with low vitamin D levels.

An objective correlation of specific haematological parameters with ED severity.

This study aims to investigate the role of nocturnal penile tumescence and rigidity (NPTR) and laboratory features in patients with mild, moderate and severe ED and then explored the correlation between ED severity with certain blood count parameters such as WBC and NLR. A total of 86 ED patients (age 29.8 ± 7.09 years) were enrolled. Classification of ED severity according to IIEF-5 scores was as follows: mild ED, 43.02% (37/86); moderate ED, 27.91% (24/86) and severe ED, 29.07% (25/86). Patients with moderate and severe ED had declined IIEF-5 scores and increased GAD-7 and PHQ-9 scores compared with mild ED. The mean NLR value of the mild, moderate and severe ED groups was 1.43 ± 0.39, 1.74 ± 0.45 and 2.0 ± 0.58, respectively. Stratification analysis according to NPTR results indicated that there was a significant difference in WBC and NLR between the two groups. Patients with abnormal NPTR had increased WBC and NLR levels compared with the normal groups. Multivariate logistic regression analysis suggested that severe ED (OR [95% CI]: 5.736 [1.248-26.354]), WBC (OR [95% CI]: 1.676 [1.094-2.567]) and NLR (OR [95% CI]: 5.595 [1.478-21.178]) were identified as independent risk factors for severe ED (abnormal NPTR results). In conclusion, this study indicates a significant difference in NLR, PLR, PDW, MPV and HDL between the mild, moderate and severe ED groups. The WBC and NLR are significantly increased in patients with severe ED (abnormal NPTR results) and it can be available as a quick, easy and cheap investigation compared with the RigiScan to evaluate the severity of ED with good sensitivity and specificity, which is important for the diagnosis and evaluation of ED.

Selecting an Individualized Treatment Approach: The Predictive Value of Erotic Stimulation and Nocturnal Erections for Efficacy of Tadalafil and Cure in Patients With Erectile Dysfunction.

PurposeThis study aimed to evaluate two modes of Rigiscan for predicting tadalafil response, and to identify which Rigiscan variables are the most efficient at making these predictions.MethodsAll patients received at least two rounds of nocturnal penile tumescence and rigidity (NPTR) testing and/or audiovisual sexual stimulation (AVSS), then completed the International Index of Erectile Function-5 (IIEF-5) questionnaire, followed by oral 5 mg tadalafil daily for 4 weeks. After a 4-week washout period, all respondents underwent an the IIEF-5 questionnaire again. ED patients were then categorized into tadalafil responders and tadalafil non-responders, who were then further divided into cured patients and uncured patients.ResultsWhen predicting tadalafil responders, the area under the curve (AUC) of NPTR was superior to that of AVSS (0.68~0.84 VS 0.69~0.73), and the predicted optimal cut-off values were DOEE60≥17.75 min in NPTR, compared to other parameters regardless of AVSS or NPTR (P<0.05). When predicting which patients would be cured, the AUC of AVSS was superior to NPTR parameters (0.77~0.81 vs 0.61~0.76), and the determined best diagnostic cut-off values were DOEE≥4.125min in AVSS, compared to other parameters regardless of AVSS or NPTR (P < 0.05).ConclusionRigiscan was able to predict the efficacy of daily tadalafil accurately and efficiently. Its diagnostic value was at maximum when DOEE60 ≥17.75 min of NPTR in tadalafil responders and DOEE ≥ 4.125 min of AVSS in cured patients.

Erectile Dysfunction Is Associated With Excessive Growth Hormone Levels in Male Patients With Acromegaly.

ObjectiveTo determine the risk factors for erectile dysfunction (ED) in male patients with acromegaly and to prospectively investigate the short-term changes of erectile function after surgery or medical treatment.MethodsSixty-three male patients were subjected to nocturnal penile tumescence and rigidity (NPTR) test for the evaluation of erectile function. The measurement of serum nitric oxide (NO) was also performed. Twenty-seven patients were re-evaluated by NPTR after surgery or long-term somatostatin analogues (SSA) treatment.ResultsTwenty-two patients (34.9%) had ED. Patients with ED showed higher random GH (17.89 [10.97-44.19] μg/L vs 11.63 [4.31-28.80] μg/L, p = 0.020) and GH nadir (GHn) (10.80 [6.69-38.30] μg/L vs 8.76 [3.62-18.19] μg/L, p = 0.044) during oral glucose tolerance test (OGTT). The NO levels of ED patients were lower than non-ED patients (9.15 [5.58-22.48] μmol/L vs 16.50 [12.33-31.78] μmol/L, p = 0.012). After treatment, patients who present improvement in erectile function showed lower post-GHn (0.07 [0.03-0.12] ng/ml vs 1.32 [0.09-3.60] ng/ml, p = 0.048) and post-IGF-1 index (1.03 ± 0.38 vs 1.66 ± 0.95, p = 0.049). The multivariate analysis indicated post-GHn was still associated with the improvement of erectile function after correction of other covariates (OR: 0.059, 95% CI: 0.003-1.043, p = 0.053).ConclusionsExcessive GH is related to ED in male patients with acromegaly. GH normalization after treatment is beneficial for short-term erectile function recovery.

Effect of low-intensity extracorporeal shockwave therapy on nocturnal penile tumescence and rigidity and penile haemodynamics.

The study aims to evaluate the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on nocturnal erection and penile haemodynamics. Patients with erectile dysfunction (ED) were enrolled from January 2018 to March 2019. Self-reported erectile symptoms, the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Scores (EHS), nocturnal penile tumescence and rigidity (NPTR) and cavernous duplex Doppler ultrasound (CDDU) were evaluated. NPTR and CDDU were evaluated by Rigiscan and vascular ultrasound system respectively. Comparisons of NPTR and CDDU parameters were performed before and after Li-ESWT (Renova, once a week, 4weeks in total). A total of 35 cases (mean age 36.51±11.47years) were enrolled for analysis. The IIEF-5 (10.60±5.99 vs. 15.13±6.22, p=.003), EHS (p=.016) and self-reported erectile hardness (p=.014) were significantly improved after 1-month treatment. Nocturnal erection frequency (p=.010), duration of total erection (p=.017), duration of erectile rigidity ≥60% at penile tip and base (p=.014 and p=.002) and the best erectile rigidity at penile tip and base (p=.012 and p=.005) improved significantly after treatment. However, no CDDU parameters improved after Li-ESWT (all p>.05). Li-ESWT can effectively improve subjective erectile function and nocturnal erection in ED patients. Large sample and well-designed studies need to be developed for supporting the current findings.

Consecutive nightly measurements are needed for accurate evaluation of nocturnal erectile capacity when the first-night laboratory recording is abnormal.

Multiple measurements of nocturnal penile tumescence and rigidity (NPTR) are widely accepted as a method to differentiate psychogenic erectile dysfunction (ED) from organic ED. However, direct evidence remains limited regarding the first-night effect on NPTR measurement using the RigiScan. Here, we evaluated the first-night effect on the results of NPTR measurement to validate the necessity of NPTR measurement for two consecutive nights, particularly when abnormal first-night measurements are recorded in a laboratory setting. We retrospectively reviewed 105 patients with a complaint of ED, who underwent NPTR measurement using the RigiScan in the Department of Infertility and Sexual Medicine, the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China), for two consecutive nights, during the period from November 2015 to May 2016. NPTR parameters were collected and analyzed. We found that more effective nocturnal erections were detected during the second night than during the first night (P <0.001). Twenty percent of all patients had no effective erection during the first night, but exhibited at least one effective erection during the second night. The negative predictive value of NPTR measurement during the first night was 43.2%; this was significantly lower than that on the second night (84.2%; P = 0.003). Most NPTR parameters were better on the second night than on the first night. The first-night effect might be greater among patients younger than 40 years of age. In conclusion, two consecutive nightly measurements of NPTR can avoid a false-abnormal result caused by the first-night effect; moreover, these measurements more accurately reflect erectile capacity, especially when the first-night record is abnormal in a laboratory setting.

The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review.

Nocturnal penile tumescence and rigidity (NPTR) monitoring with RigiScan was considered one of the most reliable methods to differentiate psychogenic erectile dysfunction (pED) from organic ED. However, its reliability has been questioned because of some limitations in the practice. To present contemporary views on the role of NPTR monitoring in the diagnosis of pED. We performed a comprehensive review of English-language literature on NPTR and pED by a PubMed search. Studies were included if the mechanisms of pED and nocturnal erection and the practice of NPTR monitoring in ED were the main research contents. The pED results from not only psychosocial factors but also physiological changes containing central nervous abnormality. NPTR monitoring with RigiScan is still considered a useful method for the diagnosis of pED. A normal NPTR recording in a man with ED complaints probably suggests pED, whereas an abnormal recording may represent organic ED. Radial rigidity of no more than 60% is correlated well with axial rigidity, but, when it is more than 60%, the correlation between them is questioned. The consistency between NPTR and sex-stimulated erection is questionable, and the correlation of NPTR with different patient-reported outcome scoring systems is different. A normal NPTR recording in patients with ED does not necessarily mean pED, especially in patients with spinal cord injury. NPTR recordings can be influenced by depression, smoking, aging, negative dream content, and sleep disorders. NPTR monitoring with the RigiScan is still considered a useful diagnostic tool for pED at the present stage. However, there are some disputes regarding the correlation between penile radial rigidity and axial rigidity and between NPTR and sex-related erection, as well as normative evaluation criteria for ED and the possibility of a false NPTR result, that need to be further studied. Zou Z, Lin H, Zhang Y, etal. The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review. Sex Med Rev 2019;7:442-454.

AB039. The application of RigiScan in the diagnosis and treatment of erectile dysfunction

Nocturnal penile tumescence (NPT) was firstly described by Halverson in 1940’s and eventually applied in erectile function examination in 1970 for the first time. However, synchronous assessment of nocturnal penile tumescence and rigidity (NPTR) was not available before 1985 until the invention of RigiScan Plus. Unlike other instruments, RigiScan Plus is still the only one which is able to evaluate NPTR so far. Clinicians can distinguish psychogenic from organic erectile dysfunction (ED) employing RigiScan Plus NPTR inspection. Comparing with the international index of erectile function questionnaire (IIEF) scores, RigiScan Plus assessment provides an objective and intuitive way to judge erectile function. Therefore, it has been widely accepted as a gold standard of ED diagnosis listed in a series guideline of urology and andrology societies, including European Association of Urology (EAU), Chinese Urological Association (CUA), American Urology Association (AUA) and Canadian Urological Association (CAU). Besides NPTR evaluation, RigiScan Plus can be also applied in audio visual sexual stimuli (AVSS), which facilitates daily simple examination for those cases visiting outpatient clinics. Nowadays, RigiScan Plus assessment provides reliable and accurate profiles in various clinical and judicial applications, including ED treatment suggestion, medication or physical therapy evaluation, prediction of prognosis and curative effect in traumatic ED, evaluation of pelvic surgery influence on erectile function, as well as legal and medical authentication.

THE USE OF RIGISCAN® EXAMINATION IN DIAGNOSING PATIENTS WITH ERECTILE DYSFUNCTION IN JAKARTA

Objective: The aim of this study is to describe the characteristic of patients with Erectile Dysfunction (ED) and results of Nocturnal penile tumescence and rigidity (NPTR) based on Rigiscan® examination in patients with ED in Jakarta. Material &amp; Methods: Descriptive-prospective study of patients with ED in Cipto Mangunkusumo Referral Hospital, Bunda General Hospital Jakarta, and ASRI-Siloam Urology Hospital are recorded during 2015. Patients’ age (in years), marital status (yes/no), duration of ED (in months), and International Index of Erectile Function-5 (IIEF-5) were recorded. NPTR examination were performed while patients were sleeping. Number of events, duration of each event (in minutes) as well as the rigidity (in percentage) and tumescence (in cm) were recorded. The elevation of tip and base penile circumference (in cm) during erection were also noted. Results: There were 34 patients who agreed to perform NPTR test. Most patients were married with the average age of 40.94 ± 10.81 years old. The duration of ED were varied from 5 to 96 months with average duration of 33.7 ± 44.34 months and IIEF-5 score was 6.38 ± 5.14. In general number of erections was 4 ± 3 with 23.4% of them had normal erection. The comparison between organic and psychogenic ED showed that the increment of circumference was significantly less in organic ED patients. Other parameters showed insignificant difference in statistical results. Conclusion: NPTR examination is an objective, effective, and easy-to-use measurement in order to differentiate between organic and psychogenic ED. One third of patients who complained with ED suffered from psychogenic ED and needed referral to other specialists.

Nocturnal penile erections: A retrospective study of the role of RigiScan in predicting the response to sildenafil in erectile dysfunction patients

Sildenafil enhances the nitric oxide–cGMP pathway of erection, which is claimed to have a role in nocturnal penile tumescence and rigidity (NPTR). This study aimed to find whether RigiScan can predict the response to sildenafil among erectile dysfunction (ED) patients and to find which RigiScan parameter produces the best prediction. Medical records of 172 ED patients were revised regarding their full sexual history, standard andrology examination, NPTR monitoring by the RigiScan device, and the degree of response to sildenafil. Of 172 ED patients, 94 patients (54.7%) were sildenafil responders. All RigiScan parameters were higher in the sildenafil responder group. The RigiScan parameters with the most differentiating power between both sildenafil responders and non-responders were base rigidity (AUC 0.860) and then tip rigidity (AUC 0.831). The cut-off value of base and tip rigidity with the highest diagnostic accuracy was 42.5%. This finding was found to be more specific than the sensitivity in predicting a positive response to sildenafil (85.9% vs. 70.2% and 92.3% vs. 59.6%, for base and tip rigidity, respectively). Sildenafil response in ED cases can be predicted through NPTR monitoring using the RigiScan device and ED patients with RigiScan base or tip rigidity less than 42% are not expected to respond well to sildenafil.

MP74-10 NOCTURNAL PENILE ERECTIONS EVALUATION USING A NEW GENERATION OF RIGISCAN: SMALL SOMETIMES IS BETTER

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II1 Apr 2018MP74-10 NOCTURNAL PENILE ERECTIONS EVALUATION USING A NEW GENERATION OF RIGISCAN: SMALL SOMETIMES IS BETTER Andrea Cocci, Michele Rizzo, Gianmartin Cito, Giovanni Cacciamani, Giorgio Ivan Russo, Marco Capece, Marco Falcone, Massimiliano Timpano, and Giacomo Tanganelli Andrea CocciAndrea Cocci More articles by this author , Michele RizzoMichele Rizzo More articles by this author , Gianmartin CitoGianmartin Cito More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Giorgio Ivan RussoGiorgio Ivan Russo More articles by this author , Marco CapeceMarco Capece More articles by this author , Marco FalconeMarco Falcone More articles by this author , Massimiliano TimpanoMassimiliano Timpano More articles by this author , and Giacomo TanganelliGiacomo Tanganelli More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine the etiology of cases with organic erectile dysfunction (ED), invasive techniques can induce patient anxiety and disturb test results. To test the effectiveness of a new type of RigiScan in patients with normal erectile function. Specifically new kind of stretch sensors has been tested and a preliminary evaluation showed good performances. Moreover, thanks to novel technologies used in the development process, the RigiScan can be seen as a new smart device that will be integrated in future e-Health scenarios in a seamless manner. METHODS This study included 10 patients. A disorder-free medical, IIEF-15 value of 25, sexual history and normal erectile function were the only inclusion criteria. All patients were subjected to nocturnal penile tumescence and rigidity (NPTR) monitoring using the developed RigiScan device. The device has been designed around a Bluetooth Low Energy (BLE) transceiver that periodically reports measurements to a mobile application, called RigiMonitor, deployed on a connected Android smartphone. The app collects all the measurements and, on one side, provides a comprehensive report to the patient, on the other hand, it stores all measurements to a cloud application in order to allow the patient to share the data with his doctor. In order to measure tumescence/rigidity, two conductive rubber cords, arranged on the base and on the tip of the penis, respectively, have been connected to two different ADC ports of the BLE Nano board. NPTR testing was performed at home for three consecutive nights, recording the numbers of erectile episodes, duration and tumescence/rigidity level. RESULTS Different RigiScan parameters are shown in Table 1: number of erectile episodes; duration of tip rigidity >60%, RAU tip, RAU base, TAU tip and TAU base. CONCLUSIONS The newly RigiScan units have an highest diagnostic accuracy in patients with normal erection. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1003-e1004 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrea Cocci More articles by this author Michele Rizzo More articles by this author Gianmartin Cito More articles by this author Giovanni Cacciamani More articles by this author Giorgio Ivan Russo More articles by this author Marco Capece More articles by this author Marco Falcone More articles by this author Massimiliano Timpano More articles by this author Giacomo Tanganelli More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Efficacy and Safety of Treatment of High-flow Priapism with Superselective Transcatheter Embolization

This study is aimed to evaluate the effectiveness and safety of the treatment of highflow priapism with superselective transcatheter embolization. From Sep. 1999 to Jan. 2013, six patients with high-flow priapism underwent superselective transcatheter embolization of the cavernous artery. Recurrence of priapism, and change in erectile function detected by nocturnal penile tumescence and rigidity (NPTR) test and the International Index of Erectile Function 5-item questionnaire (IIEF-5) were evaluated during a mean follow-up of 12 months. A single superselective transcatheter embolization was sufficient for complete resolution of priapism in the six patients. None of the patients had a relapse of priapism after embolization, and all the patients who had premorbid normal erectile function showed maintained potency with normal results of NPTR and a mean postoperative IIEF-5 score of 23.5 (range 23 to 24) during the follow-up period. In conclusion, superselective transcatheter embolization is an effective and safe treatment method for high-flow priapism, and it can ensure a high level of preservation of premorbid erectile function.

Comparison of the effects of extracorporeal shock wave therapy and a vacuum erectile device on penile erectile dysfunction: a randomized clinical trial.

Background:This randomized clinical trial (October 2012–December 2013) compared extracorporeal shock wave therapy (ESWT) and a vacuum erectile device (VED) for management of erectile dysfunction (ED).Methods:Consecutive Chinese patients (20–55 years) with ED, abnormal nocturnal penile tumescence and rigidity (NPTR), and international index of erectile function-5 items (IIEF-5) score <22 were randomized to receive ESWT or VED (twice weekly, 4 weeks). Primary outcomes were treatment efficacy and success rate 4 weeks after completion of therapy. Secondary outcomes included changes in IIEF-5 score, sex encounter profile (SEP) score, erection hardness score (EHS) and NPTR assessments 4 weeks post-therapy. All enrolled patients (n = 30 per group) completed the study. At baseline, age, IIEF-5 score, SEP score, EHS, and NPTR assessments were similar between groups.Results:Four weeks post-therapy, IIEF-5 score increased in the ESWT (15.03 ± 3.00 vs. 11.60 ± 2.28) and VED (15.10 ± 3.06 vs. 11.53 ± 2.27) groups, as did SEP score, EHS, and NPTR measures (all P < .05). Efficacy in the ESWT and VED groups was excellent in 10% and 13.3%, respectively, and moderate in 63.3% and 53.3%, respectively. Treatment success rate in the ESWT and VED groups was 73.3% and 67.7%, respectively.Conclusion:VED use and ESWT have comparable efficacies in the treatment of ED in Chinese patients.

A Comparison of Baseline Erectile Function after Ondemand 20 Mg Tadalafil vs. Daily 5 mg Tadalafil in Men with Erectile Dysfunction and Diabetes: A Prospective, Observational 2-Year Study

Objective: We studied whether long-term use of 5 mg tadalafil once daily improved baseline erectile function or prevented erectile dysfunction (ED) in men with diabetes. Design and Method: Men with ED and diabetes were assigned to 20 mg tadalafil on-demand or 5 mg tadalafil once daily. When men completed the questionnaire after 2 years of treatment, they also stopped the medication for 4 weeks to check baseline erectile function. The primary efficacy variable was the IIEF-EF score. Secondary variables included a change in the scores IIEF Q3 and Q4 from baseline, changes in all domain scores on the IIEF from baseline, SEP2 and SEP3, and GAQ. Rigiscan® measurements of nocturnal penile tumescence and rigidity (NPTR) were also carried out after the 2year treatment. Results: The study enrolled 118 men. After 2 years, daily treatment group had a greater change in IIEF-EF score from baseline (7.3 vs. 2.4, P &lt; 0.0001). The changes in IIEF from baseline on Q3 (1.4 vs. 0.4, P &lt; 0.0001) and Q4 (1.4 vs. 0.3, P &lt; 0.0001) were higher in the daily group. Differences between daily and on-demand groups were significant for SEP2 (53.8% vs. 32.3%) and SEP3 (56.6% vs. 15.4%). Normal EF domain scores at the end of study were achieved by 20.7% in daily groups. Normal NPTR at tend of study was achieved by 13.2% only in the daily group. Conclusions: Long-term use of 5 mg tadalafil once daily was more beneficial for improving baseline erectile function or preventing ED than the on-demand pattern in men with ED and diabetes.

Weaker Masturbatory Erection May Be a Sign of Early Cardiovascular Risk Associated with Erectile Dysfunction in Young Men Without Sexual Intercourse

Although increasing evidences emphasize the importance of early cardiovascular evaluation in men with erectile dysfunction (ED) of unexplained aetiology, impaired masturbation-induced erections in young men are usually overlooked and habitually presumed to be psychological origin. To evaluate the young men presenting weaker masturbatory erection with no sexual intercourse (WME-NS) and verify if this cohort have early cardiovascular risks associated with ED. Male subjects aged 18-40 years with WME-NS were screened by analyzing detailed sexual intercourse and masturbatory history. The age-matched ED and non-ED population were identified by using International Index of Erectile Function-5 (IIEF-5). All subjects with acute and/or chronic diseases (including diagnosed hypertension and diabetes) and long-term pharmacotherapy were excluded. Nocturnal penile tumescence and rigidity (NPTR), systemic vascular parameters and biochemical indicators related to metabolism were assessed. Comparison analysis and logistic regression analysis were conducted among WME-NS, ED and non-ED population. In total, 78 WME-NS cases (mean 28.99 ± 5.92 years), 179 ED cases (mean 30.69 ± 5.21 years) and 43 non-ED cases (mean 28.65 ± 4.30 years) were screened for analysis. Compared with non-ED group, WME-NS group had higher prevalence of early ED risk factors including endothelial dysfunction, insulin resistance, high level of glycosylated serum protein and abnormal NPTR. Multivariable-adjusted logistic regression analysis showed endothelia dysfunction (odds ratio: 8.83 vs. 17.11, both P < 0.001) was the independent risk factor for both WME-NS and ED. Weaker masturbatory erection may be a sign of early cardiovascular risk associated with ED in young men without sexual intercourse. More studies are warranted to elucidate the clinical benefits by targeting these formulated strategies.