Treatment Of Erectile Dysfunction Research Articles

A potential treatment for erectile dysfunction: Effect of platelet-rich plasma administration on axon and collagen regeneration in cavernous nerve injury

Recent studies highlighted the role of platelet-rich plasma (PRP) in progenitor cell homing, migration, and nerve cell regeneration while also inhibiting fibrosis and apoptosis in cavernous nerve injury (CNI). The aim of this study was to investigate the effect of PRP administration on axon and collagen regeneration in CNI. A true experimental study using a post-test-only control group design was conducted. Twenty-five male Wistar rats (Rattus norvegicus), weighing 200–300 grams, were divided into five groups: two control groups (sham procedure and negative control), and three experimental groups receiving local PRP, intraperitoneal PRP, and a combination of local and intraperitoneal PRP. The cavernous nerve was injured with a hemostasis clamp for one minute before 200 µL of 200 PRP was injected locally, intraperitoneally, or both, depending on the group. After four weeks, the rats were euthanized, tissue segments (2 mm) from each cavernous nerve and mid-penis were collected and analyzed for collagen density, axon diameter, and number of myelinated axons. Our study found that collagen growth was slower in CNI group without PRP (sham procedure) compared to all PRP groups (local, intraperitoneal, and combination). The intraperitoneal PRP group had the highest collagen density at 5.62 µm; however, no significant difference was observed in collagen density among all groups (p=0.056). Similar axon diameter was found across the groups, with no statistically significant difference observed (p=0.856). In the number of myelinated axons, a significant difference was found among all groups with significantly more axons in local PRP and combined local and intraperitoneal PRP groups compared to others (p=0.026). In conclusion, PRP administration improved a number of myelinated axons in CNI, suggesting PRP role in CNI regeneration and the potential for an innovative approach to treating erectile dysfunction associated with CNI.

Forensic application of sandpaper spray ionization mass spectrometry (SPS-MS): Direct analysis of solid pharmaceutical formulations and edible cannabis products.

In this work, we employed a new ambient ionization mass spectrometry technique, sandpaper spray mass spectrometry (SPS-MS), as an efficient tool to analyze pills and tablets of pharmaceutical formulations. The following samples were analyzed: regulators of blood pressure, cholesterol, and diabetes, and drugs for the treatment of erectile dysfunction (ED). Additionally, a hard candy of Cannabis sativa containing Δ9-tetrahydrocannabinol (Δ9-THC) and its related isomer cannabidiol (CBD) was also evaluated. The surfaces of the samples, without any prior treatment, were sanded onto triangular-cut sandpaper, and full MS scans (and MS/MS) were acquired in both positive and negative ionization modes. SPS-MS (and MS/MS) allowed for prompt detection of the active pharmaceutical ingredients (APIs) in each formulation. Other components of the formulations, added as excipients, were also tentatively identified. The results described herein indicate that the SPS-MS technique can be applied to fast screening of pills and tablets being potentially used as an efficient tool to detect counterfeit pharmaceutical and illicit products, a current issue of increasing concern.

THE ANALYSIS STUDY OF EFFECTIVENESS AND SAFETY OF ORAL SILDENAFIL CITRATE FOR TREATMENT OF ERECTILE DYSFUNCTION : A COMPREHENSIVE SYSTEMATIC REVIEW

Background: Erectile dysfunction (ED) is a medical condition affecting men's sexual performance and well-being. Sildenafil citrate, a specific inhibitor of phosphodiesterase type 5, is approved for treating ED. The efficacy and safety of oral sildenafil citrate in treating ED are crucial for successful treatment procedures. Understanding the relationship between the efficacy and safety of oral sildenafil citrate can help develop successful treatment procedures for ED patients. Methods: This systematic review adhered to the PRISMA 2020 guidelines and primarily examined entire English literature published between 2000 and 2024. Only editorials and review articles published in the same publication as the submission were accepted if they possessed a Digital Object Identifier (DOI). A variety of online platforms, including ScienceDirect, PubMed, and SagePub, were utilized to gather the relevant literature. Result: The study analyzed more than 2000 papers from reputable sources such as Science Direct, SagePub, and PubMed. After deciding to subject eight publications to additional inspection, a thorough evaluation of the entire body of literature was carried out. Conclusion: Sildenafil, a potent treatment for erectile dysfunction (ED), has been found to be effective in improving men's psychosocial aspects. It is an inhibitor of PDE5, a condition that affects men's emotional well-being. The study also found that the firmness of erections was linked to improvements in psychosocial aspects. Sildenafil can be used interchangeably with tablets, providing a convenient alternative for those with difficulty swallowing. However, follow-up for men with ED is often inadequate due to improper doses and lack of understanding.

Aerobic Exercise: Randomized Controlled Trial Data Suggest Qualified Benefits for Erectile Dysfunction.

Erectile dysfunction (ED) refers to the difficulty in achieving and maintaining a degree of penile erection that suffices for satisfactory sexual activity. ED is multifactorial in origin; its prevalence therefore varies with the population studied. In the general population, ED is present in 18-52% of men in younger to older age groups and in 43-76% of men with different medical conditions. Phosphodiesterase-5 inhibitor drugs are gold standard treatments for ED. However, because many lifestyle disorders predispose to ED and because aerobic exercise is beneficial for these lifestyle disorders, aerobic exercise may be a possible intervention for ED. In this context, a recent systematic review and meta-analysis identified 11 randomized controlled trials (RCTs; pooled N = 1,147) of aerobic exercise vs nonexercising control conditions for the treatment of ED. These RCTs had been conducted in men with different medical and surgical conditions, commonly obesity, metabolic syndrome, diabetes mellitus, and cardiovascular disease. The exercise interventions were varied but mostly involved 30-60 minutes sessions of activity, 3-5 times a week, for a median duration of 6 months. Advice for diet and weight loss was also commonly provided. The meta analysis found that aerobic exercise was significantly superior to nonexercising control conditions, with greater improvement in erectile functioning observed in subjects with greater baseline impairment. Limitations of the findings were that subjects could not be blinded to the nature of the intervention and that the magnitude of benefit with exercise, although statistically significant, fell below thresholds suggested for clinical significance. Aerobic exercise might therefore be more useful for the primary prevention of ED, for which preliminary evidence already exists. Exercise can also be recommended, along with other lifestyle guidance, to improve sexual functioning in both men and women and to improve health across a range of domains.

Role of the Triglyceride-Glucose Index as a Predictor of Therapeutic Response to Tadalafil in Patients With Erectile Dysfunction.

The triglyceride-glucose (TyG) index is an easily calculable indicator of endothelial dysfunction. We aimed to evaluate the effect of the TyG index on treatment response in patients using tadalafil for the treatment of erectile dysfunction (ED). The data of patients who used tadalafil for ED in our urology clinic between January 2018 and January 2023 were reviewed. The patients completed the 5-item International Index of Erectile Function (IIEF-5) questionnaire before treatment and in the 3rd month of treatment. Response to tadalafil treatment was accepted as an increase in IIEF category. Patients were divided into 2 groups according to treatment response. Factors affecting response to treatment were evaluated with a multivariate analysis. Of the 134 patients included in the study, 99 (73.3%) responded to tadalafil treatment. Mean age and body mass index (BMI) of the patient group responding to treatment were significantly lower than in the untreated group. The rates of diabetes mellitus (DM) and metabolic syndrome (MetS) were significantly lower in the group responding to treatment. Fasting glucose, triglyceride and total cholesterol values were significantly lower in the group responding to treatment than in the treatment-resistant group. The TyG index was 130.0 (102.0-180.0) in the group responding to treatment and 245.0 (182.0-320.0) in the treatment-resistant group (p=0.001). In the multivariate analysis, age, BMI, DM, MetS, and TyG index were affecting treatment response. A high TyG index negatively affects the response to treatment in patients using tadalafil for ED. In addition, age, BMI, presence of DM and MetS are other factors affecting the response to treatment.

Interrogating erectile dysfunction and evaluating novel therapeutic frontiers, with emphasis on stem cell strategies.

Male infertility arises from a complex interplay of factors affecting reproductive organs and various physiological pathways. Among these, erectile dysfunction (ED), a widespread global issue, plays a key role. While existing ED treatments address some aspects, achieving complete reversibility and avoiding side effects remains a challenge. In this context, stem cell therapy emerges as a promising, potentially transformative approach. Preliminary evidence from preclinical animal models and clinical trials highlights stem cell therapy's remarkable efficacy and effectiveness for ED. This novel strategy offers several advantages, including enhanced effectiveness and a reported absence of adverse side effects. This review delves into the causes of male infertility, with a particular focus on ED and its pathophysiology. We explore the current treatment landscape, highlighting therapy's existing strategies' limitations and stem cell therapy's unique potential. By examining relevant preclinical and clinical studies, we provide a comprehensive picture of this innovative approach and its promising future in restoring men's fertility and quality of life.

Carvacrol prevents D-( +)-galactose-induced aging-associated erectile dysfunction by improving endothelial dysfunction and oxidative stress in rats.

Aging is one of the risk factors involved in the development of erectile dysfunction (ED). Growing evidence suggests that oxidative stress is the critical mediator of changes in endothelial function and penile vascular tone in the aging process. Thus, reducing reactive oxygen species (ROS) levels may preserve the bioactivity of the penile vasculature. Antioxidant compounds, such as carvacrol, limit the damage caused by ROS and, therefore, benefit the treatment of ED. Thus, this study aims to evaluate the effects of carvacrol on ED using the D-( +)-galactose aging model. The animals were divided into five groups: control, D-( +)-galactose 150mg/kg, carvacrol 50mg/kg or 100mg/kg, and sildenafil 1.5mg/kg treated daily for 8weeks. The physiological, functional, and morphological characteristics of aging-associated ED were evaluated after treatment with carvacrol. Carvacrol prevented ED in a D-( +)-galactose-induced aging model by reducing hypercontractility, enhancing endothelial dysfunction in the rat corpus cavernosum, and improving endothelial health of rat cavernous endothelial cells. In addition, carvacrol prevented the destruction of erectile components essential for penile erection and promoted a reduction of penile tissue senescence, probably through mechanisms that involve the harmful modulation of oxidative stress. Carvacrol significantly improved the erectile function of rats in a D-( +)-galactose-induced aging model and has excellent potential as a new therapeutic alternative in treating erectile dysfunction.

The I-Guana Shot Protocol, An Intracavernosal Application of Wharton's Jelly Stem Cells for the Treatment of Erectile Dysfunction, Phase II Study

Umbilical cord has become an increasingly used source of mesenchymal stromal cells for preclinical and, more recently, clinical studies. Different clinical uses on multiple anatomical structures have demonstrated the safe use of the umbilical cord tissue and derivates with multiple potentially different options to treat difficult diseases or clinical conditions. Immunophenotypic analysis and characterization of stem cells isolated from Wharton’s jelly via various methods is currently underway in clinical research. Stem cells are the body’s basic cells from which all other cells with specialized functions are generated. Under the right conditions in the body or perinatal environment, stem cells divide to form more new cells. These new cells become stem cells (self-renewal type of cells), and can also become specialized cells (differentiated) with more specific functions, such as blood cells, brain cells, heart muscle, urinary and genital tract, bone, etc. No other cell in the body has the natural ability to generate new cell types as stem cells do. As with any emerging scientific/medical field having such incredible potential, numerous research trials and data gathering efforts are currently being conducted world-wide. New data is being reported daily that present compelling cases for therapies using certain pathologies on selected patients. Scientists have been working for decades to harness the regenerative “power” of stem cells for the possible repair and rejuvenation of certain organs to activate tissue regeneration. The ultimate objectives of all these studies are the same: deliver transformative therapies. The capacity for these cells to transform into whatever cells or tissues that the body may need to regenerate itself could, within the next 3 generations, potentially provide the means to successfully treat blindness, spinal cord injuries, diabetes, cystic fibrosis, muscular dystrophy, or even erectile dysfunction in affected patients. Such future outcomes may be possible for candidate patients who are fortunate enough to have access to those scientific and evidence- based medical protocols that use such potent biological sources. It is vital that, in the light of the dazzling potential, mesenchymal stem cells research and medical applications continue, especially for compassionate medical use (e.g. for No Option patients).

Research Progress of Shaofu Zhuyu Decoction in the Treatment of Male Diseases

Research Progress of Shaofu Zhuyu Decoction in the Treatment of Male Diseases

Molecular Docking Approach to Identify Flavonoids as Potential Phosphodiesterase 5 Inhibitors for Erectile Dysfunction Treatment

An erection that is not strong enough for sexual activity might be caused by erectile dysfunction. Periodically experiencing difficulties achieving an erection is not always a reason for alarm. On the other hand, if erectile dysfunction persists, it may lead to stress, undermine confidence, and exacerbate interpersonal issues. In addition to being a risk factor for heart disease, difficulties achieving or maintaining an erection may also indicate an underlying medical issue that needs to be treated. Many studies have also steadily examined flavonoids' capacity to inhibit the phosphodiesterase 5 enzyme in several recent studies. This is an enzyme expressed in erectile tissue that is the most important substance that degrades cGMP in the body's smooth muscle cells. This study identified two prominent flavonoids that had inhibitory effects on the phosphodiesterase 5 enzyme: Amenoflavone and Umbralisib. Our research suggests new molecular pathways by which these substances might influence biological processes. One compound that shows promise for treating erectile dysfunction and is safe for healthy cells is Amentoflavone.

Pharmacokinetics and Bioequivalence of Vardenafil Hydrochloride in Healthy Chinese Volunteers.

Vardenafil hydrochloride tablet is an inhibitor of phosphodiesterase type 5, primarily for the treatment of erectile dysfunction. This postprandial study evaluated the pharmacokinetics and bioequivalence of the test and reference formulations of vardenafil hydrochloride tablets in healthy Chinese volunteers. An open, randomized, single-center, single-dose, 2-period, 2-sequence bioequivalence test was conducted on 66 healthy subjects under fed conditions. Subjects were randomly assigned to a 20-mg test or reference formulation with a 7-day washout period. Venous blood samples (4mL) were collected from each subject 25 times spanning predose (0hour) to 24hours after dosing. The plasma concentration of vardenafil was determined by high-performance liquid chromatography-tandem mass spectrometry. Sixty-two volunteers completed the study. Under fed conditions, the maximum plasma concentration was 29.1ng/mL, the area under the concentration-time curve (AUC) from time 0 to the time of the last measurable concentration was 85.3ng•h/mL, and AUC from time 0 to infinity was 87.1ng•h/mL. The 90% confidence intervals of the geometric mean ratio of AUC time 0 to the time of the last measurable concentration and AUC from time 0 to infinity were within the bioequivalence acceptance range of 0.80-1.25. The test formulation was a bioequivalent alternative to the reference formulation when taken under fed conditions in healthy Chinese subjects.

Single-cell transcriptome analysis of cavernous tissues reveals the key roles of pericytes in diabetic erectile dysfunction.

Erectile dysfunction (ED) affects a significant proportion of men aged 40-70 and is caused by cavernous tissue dysfunction. Presently, the most common treatment for ED is phosphodiesterase 5 inhibitors; however, this is less effective in patients with severe vascular disease such as diabetic ED. Therefore, there is a need for development of new treatment, which requires a better understanding of the cavernous microenvironment and cell-cell communications under diabetic condition. Pericytes are vital in penile erection; however, their dysfunction due to diabetes remains unclear. In this study, we performed single-cell RNA sequencing to understand the cellular landscape of cavernous tissues and cell type-specific transcriptional changes in diabetic ED. We found a decreased expression of genes associated with collagen or extracellular matrix organization and angiogenesis in diabetic fibroblasts, chondrocytes, myofibroblasts, valve-related lymphatic endothelial cells, and pericytes. Moreover, the newly identified pericyte-specific marker, Limb Bud-Heart (Lbh), in mouse and human cavernous tissues, clearly distinguishing pericytes from smooth muscle cells. Cell-cell interaction analysis revealed that pericytes are involved in angiogenesis, adhesion, and migration by communicating with other cell types in the corpus cavernosum; however, these interactions were highly reduced under diabetic conditions. Lbh expression is low in diabetic pericytes, and overexpression of LBH prevents erectile function by regulating neurovascular regeneration. Furthermore, the LBH-interacting proteins (Crystallin Alpha B and Vimentin) were identified in mouse cavernous pericytes through LC-MS/MS analysis, indicating that their interactions were critical for maintaining pericyte function. Thus, our study reveals novel targets and insights into the pathogenesis of ED in patients with diabetes.

Long-term results of three-part penile prosthesis implantation with Ectopic reservoir placement in the treatment of erectile dysfunction: is supramuscular tubulation a reliable method?

BackgroundPenile prosthesis implantation is the last resort for refractory erectile dysfunction. Reservoir placement is one of the biggest challenges in inflatable penile prosthesis implant surgery in several cases, especially in patients with abnormal pelvic anatomy. Ectopic reservoir placement with supramuscular approach has many advantages in these cases.ResultsNo complications were encountered except wound site infection in 2 patients which could be controlled with antibiotic treatment. EDITS scores were not statistically different between patients divided into 2-year groups according to follow-up time. Median values of EDITS scores were high in all groups, suggesting that couples had high sexual satisfaction both in the long term and in the short term.ConclusionsWe recommend placement of the supramuscular tube and reservoir through the incision described, especially in patients whose pelvic anatomy has been modified by lower abdominal surgery.

Platelet-rich plasma therapy in erectile dysfunction and Peyronie’s disease: a systematic review of the literature

PurposePlatelet-rich plasma (PRP) as a regenerative therapy has gained interest in the field of andrology for the treatment of erectile dysfunction (ED) and Peyronie’s disease (PD). This systematic review aims to critically evaluate the current evidence on the use of PRP for these conditions.MethodsWe performed a systematic literature search according to the PRISMA guidelines using PubMed and Scopus databases in December 2023. Studies were included if they evaluated the effect of PRP therapy for ED or PD in humans.ResultsWe identified 164 articles, 17 of which were included, consisting of 11 studies on ED, 5 studies on PD, and 1 study on both. We included four randomized controlled trials, 11 prospective cohort studies, and three retrospective cohort studies including a total of 1099 patients. The studies on ED and PD generally showed small to moderate benefits with mild and transient side effects and no major adverse events were reported. General limitations included variations in PRP protocols, small sample sizes, short follow-up periods, and lack of control groups except in the three randomized trials on ED and the one on PD.ConclusionThe literature on PRP therapy in andrology is limited and difficult to interpret due to variations in protocols and methodological drawbacks. Further research is necessary to determine the optimal preparation and treatment protocols for PRP therapy and clarify its effectiveness in andrology.

Analysis of phosphodiesterase type 5 inhibitors and analogues as adulterants in herbal dietary food supplements in Saudi market using green UPLC-MS/MS method: Assessment of the greenness and whiteness profiles

Herbal dietary supplements are popular alternatives to oral phosphodiesterase type 5 inhibitors (PDE5Is) for treating Erectile Dysfunction (ED), yet concerns arise regarding their adulteration with undeclared synthetic PDE5Is or analogues, posing health risks. The aim of this study was to develop and validate a green UPLC-MS/MS method for sensitive and rapid detection of PDE5Is and analogues in sexual enhancement herbal dietary supplements marketed in Saudi Arabia. Method validation revealed good linearity with determination coefficients (r2) ≥ 0.9990, and LODs and LOQs in the range of 0.4 – 32 ng g−1 and 1––96 ng g−1, respectively. The accuracy ranged from 80.8 % to 103.4 % while inter-day precision was ≤ 8.6 % and intra-day precision was ≤ 8.4 %. The method was successfully utilized to analyze 32 herbal dietary supplements. The results revealed that 18 samples (56.3 %) tested positive for at least one of the target analytes. Sildenafil emerged as the most frequently detected analyte, found in 15 samples (20.1 µg g−1 to 37,492 µg g−1). Tadalafil was detected in 7 samples, with concentrations ranging from 4.46 µg g−1 to 19,986 µg g−1. Yohimbine was detected in only 4 samples, while icariin was detected at lower concentrations in 3 samples. Furthermore, the method greenness and whiteness profiles were evaluated using four metrics including the Analytical Eco-Scale, Green Analytical Procedure Index (GAPI), Analytical GREEnness (AGREE) metric, and Red-Green-Blue 12 (RGB 12) metric.This study provides foundational data on the adulteration of dietary supplements in Saudi Arabia and offers insights for future interventions to promote consumer safety and awareness regarding herbal dietary supplement consumption.

Long-term Effects of Phosphodiesterase-5 Inhibitors on Cardiovascular Outcomes and Death: A Systematic Review and Meta-analysis.

Phosphodiesterase 5 inhibitors (PDE-5i), which are widely used for the treatment of erectile dysfunction (ED), have been found to exhibit systemic vascular benefits by improving endothelial function. In this context, we sought to evaluate the effects of PDE5i on long-term cardiovascular outcomes and mortality. A comprehensive search of electronic databases was conducted up to May 30, 2023. Cohort studies comparing PDE5i treatment at any dose with other ED treatment, placebo or no treatment and minimum follow-up duration of 6 months were considered eligible. The primary endpoints were: (1) major adverse cardiovascular events (MACE) and (2) all-cause mortality. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated. Sixteen studies were included (1,257,759 subjects - 10.5% treated with PDE5i). The majority of patients (99.4%) were men[median age 61.5 years (range 30 - 72.8)]. The median follow-up duration was 4.3 years (range 6 months - 7.5 years). PDE5i use was associated with a significant reduction in the composite of MACE (RR 0.78, 95% CI 0.69-0.89). Moreover, the analysis of pooled data from 13 studies, demonstrated that the use of PDE5i was associated with a significantly lower risk of all-cause mortality (RR 0.70, 95% CI 0.56-0.87). The use of PDE5i primarily in men with or without known coronary artery disease was associated with a lower risk for cardiovascular events and overall mortality. This information underlines that PDE5i could provide clinical benefit beyond ED treatment and could instigate the conduction of further, large-scale randomized clinical trials.

Phosphodiesterase type 5 inhibitors as treatment for erectile dysfunction: a webinar-based poll unveiling perceptions of healthcare professionals.

Aim: Erectile dysfunction (ED) is marked by a recurring incapacity to achieve or uphold a satisfactory erection during sexual activities. The study aims to increase awareness about male reproductive health, dispel misconceptions about ED and encourage physician-patient discussions. Materials & methods: A live online poll was conducted during a 3-day webinar titled "Turning the Tide of Men's Health" organized by Viatris™ in collaboration with the Saudi Society of Family and Community Medicine and attended by healthcare professionals (HCPs) from diverse specialties. The attendees voluntarily responded to nine poll questions on adherence to ED medication, use of phosphodiesterase type 5 inhibitors (PDE5is) as cure versus management of ED and patients' challenges. The responses to the poll questions were recorded and assessed to understand the perceptions of HCPs. Results: The poll garnered 10,423 responses from 5831 attendees on the second day of the webinar. The key findings included HCPs' perceptions that PDE5is contribute to ED management not complete cure. The respondents acknowledged that adherence to ED medications might decline on days without planned sexual activity, and long-term adherence on a daily PDE5i is exhibited by a relatively modest percentage of ED patients. The consensus among respondents was that PDE5is do not enhance or generate sexual desire, and the daily schedule of ED treatment may be burdensome for some patients. Conclusion: The findings from this poll offer insights into the perspectives of HCPs regarding the usage of PDE5is to treat ED. Responders of the poll generally agreed that PDE5is can help manage ED without affecting desire, though adherence may be lower on days without planned sexual activity. Furthermore, most respondents acknowledged that adhering to a daily pill regimen posed a greater burden than waiting for the medication to take effect.

Development and psychometric properties of an instrument to measure perception of aphrodisiac use among undergraduates in a southwestern Nigerian university.

A tool to measure perception of aphrodisiac use by undergraduates students of University of Ibadan, Oyo State, Nigeria was developed and validated. The study was hinged on several theories that could explain potential to use aphrodisiac among the youths. An exploratory mixed methods design was used to develop a scale to measure perception of aphrodisiac use by undergraduate students of University of Ibadan. Qualitative data collection was performed among thirty equally represented male and female students and five key informant interview participants while 919 participants completed the quantitative phase (surveys). Integration of matched qualitative themes from FGD/KII to survey domains was achieved through the 'building approach'. Qualitative themes assessing perceptions of aphrodisiac use by university undergraduate students were used to develop original survey items as well as new survey items peculiar to research subjects. Exploratory factor analysis was deployed on polychoric correlation matrix of the items using R-statistical packages. Further model fit analysis was conducted using confirmatory factor analysis on the items suggested by EFA as well as composite reliability and construct validity tests for the constructs. Mean Z-scores of factors were computed against socio-demographics and symptoms of aphrodisiac use among respondents that have ever used it. Most respondents (84.3%) were under 25 years, mostly male (58.4%) and singles (96.3%), with 41.3% earning ≤20,000 naira monthly. The enhanced content validity of the items from mixed method analysis yielded two major domains. Two succession of factor analyses and a structural equation modeling suggested that a first-order model is good fit for experimental data (TLI = 0.931; CFI = 0.948; SRMR = 0.047; RMSEA = 0.083). The four-factor solution to the model included: prolonged sexual performance, use without erectile dysfunction or medical advice, treatment of erectile dysfunction and recreational purposes with an internal and composite reliability that ranged from 0.62-0.92 and 0.63-0.92. The validation with socio-demographics and consequences of aphrodisiac use indicated that: Male respondents, those older than 20years, the married, those from poorly educated parent and sufferers of all related consequences had statistically significant differences with poor perception of aphrodisiac use' domains. This validated instrument is good for assessment of perception of aphrodisiac use among students in tertiary institution albeit with caution. A version of the scale that is broadened with highly refined items and tested for high internal validity is suggested.

Prevalence and trends in physical therapy interventions for erectile dysfunction: A Scopus-based bibliometric analysis (1989-2022).

Erectile dysfunction (ED) is a condition that affects many males. Physical therapy (PT) is the one potential treatment for ED that may improve blood flow, muscle strength, and other factors that may contribute to the issue. Data on the prevalence and trends of research on PT for ED are lacking. This study aimed to evaluate the literature trends in PT for ED via bibliometric and visualized analysis. Data on publications were collected from Scopus covering the period between 1989 and 2022. To refine the data, bibliometric analyses were conducted using Microsoft Access, Microsoft Excel, an online visualization platform, and BiblioAnalytics. Power BI and Bibliomaster were used to generate figures and tables, while Biblioshiny and VOSviewer were used for visualization. A total of 494 documents were identified. The year 2019 generated the largest number of publications, with a total of 54. These studies have received 12,917 citations related to PT for ED. The most common document type was the original article with 283 publications. The University of California, USA, was the most productive institution on this topic, with 21 publications and 2,035 citations. The USA led all countries with 114 publications on the topic. The Journal of Sexual Medicine secured the top ranking with an h-index of 18. The main topics studied were erectile dysfunction, shockwave therapy, and physiotherapy. The number of publications on PT for ED has demonstrated an upward trend over the last three decades.

Androgens and erectile dysfunction: from androgen deficiency to treatment.

Androgens play important roles in regulating the growth and development of the male reproductive system and maintaining libido and erectile function. The specific mechanisms by which androgen deficiency leads to erectile dysfunction (ED) are not yet fully understood. To understand the mechanisms and treatment of androgen deficiency-related ED. A literature search in the past 10years was conducted in PubMed and Google Scholar to determine the effects of androgen deficiency on erectile function and the treatment of androgen deficiency. Androgen deficiency can be caused by hypothalamic-pituitary lesions and injuries, testicular-related diseases and injuries, endocrine and metabolic disorders, the side effects of medication, and age. Androgen deficiency can lead to ED by inhibiting the NOS/NO/cGMP pathway (nitric oxide synthase/nitric oxide/cyclic guanosine monophosphate) and altering the expression of ion channel proteins, as well as by inducing oxidative stress, death, and fibrosis in penile corpus cavernosum cells. Testosterone replacement therapy is effective at improving the serum testosterone levels and erectile function in patients with androgen deficiency. For patients who need to maintain a low androgenic state, erectile function can be improved by lifestyle changes, treatment with phosphodiesterase type 5 inhibitors, low-intensity extracorporeal shock wave therapy, and stem cell therapy. Androgen deficiency can affect the structure and function of the penile corpus cavernosum, leading to ED. Areas of further study include how androgen replacement therapy can improve erectile function and how to improve the maintenance of erectile function in patients with hypoandrogenic status.