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The utility of intravenous ketamine for the management of intraoperative penile erection: a retrospective single-center...
To assess the prevalence of intraoperative penile erection in our endourology practice and the utility of intravenous ketamine in the management of the condition. Of 402 endoscopic urological procedures performed in our clinic over a 4-year (2015-2019) period, a total of 9 cases with intraoperative penile erection impeding instrumentation during endourological surgery were included. Data on patient age, weight, height, American Society of Anesthesiologists (ASA) physical status classification system scores, type and duration of surgery, type and level of anesthesia, onset of erection, treatment characteristics and treatment outcome were recorded for each patient. The mean (SD) age was 68.3 years (range, 66.0-77.0 years). ASA physical status category I and II were noted in 55.6 and 44.4% of patients, respectively. All cases received spinal anesthesia (n = 9) at T8-10 dermatome levels, for TURP in 7 (77.8%) cases and for TURBT in 2 (22.2%) cases. The onset of penile erection was post-urethroscope in 7 (77
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An erection (clinically: penile erection or penile tumescence) is a physiological phenomenon in which the penis becomes firmer, engorged and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular and endocrine factors, and is often associated with sexual arousal or sexual attraction, although erections can also be spontaneous. The shape, angle and direction of an erection varies considerably in humans. Physiologically, erection is triggered by the parasympathetic division of the autonomic nervous system, causing nitric oxide (a vasodilator) levels to rise in the trabecular arteries and smooth muscle of the penis. The arteries dilate causing the corpora cavernosa of the penis (and to a lesser extent the corpora spongiosa) to fill with blood; simultaneously the ischiocavernosus and bulbospongiosus muscles compress the veins of the corpora cavernosa restricting the egress and circulation of this blood. Erection subsides when parasympathetic activity ...
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PPT - Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction PowerPoint Presentation - ID:1091514
Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction. Campbells Chapter 21 Roc McCarthy, DO. Physiology of Penile Erection. Historical Aspects Slideshow 1091514 by halle
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Penile erection is a physiological phenomenon where the penis becomes enlarged and firm. Penile erection is the result of a complex interaction of psychological, neural, vascular and endocrine factors, and is usually, though not exclusively, associated with sexual arousal. Penile erection can also occur due to a full urinary bladder. In some males, erection can occur spontaneously at any time of day, and is known as nocturnal penile tumescence when occurring during REM sleep. In the presence of mechanical stimulation, erection is initiated by the parasympathetic division of the autonomic nervous system (ANS) with minimal input from the central nervous system. Parasympathetic branches extend from the sacral plexus into the arteries supplying the erectile tissue; upon stimulation, these nerve branches release acetylcholine, which, in turn causes release of nitric oxide from endothelial cells in the trabecular arteries…Erection subsides when parasympathetic stimulation is discontinued; baseline ...
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Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both cases, an intact neural system is required for a successful and complete erection. Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood ...
The role of androgens in the erectile response: A 1999 perspective<...
TY - JOUR. T1 - The role of androgens in the erectile response. T2 - A 1999 perspective. AU - Mills, T. M.. AU - Lewis, Ronald W. PY - 1999/1/1. Y1 - 1999/1/1. N2 - Evidence from several laboratories strongly supports a critical role for androgens in the maintenance of the mammalian erectile response. In animal studies, androgens appear to act at the end-organ level (i.e., corporal tissue and vasculature), as well as in the portions of the nervous system which mediate erection. Particularly in the rat model, androgens act centrally to support copulatory behavior and peripherally to maintain the production of nitric oxide and support the veno-occlusive mechanisms. Other studies suggest that alternative, non-NO-dependent, pathways may also be androgen sensitive. However, despite this expanding knowledge base about how androgens act in the erectile response in laboratory animals, the recent studies have not greatly clarified the role of androgens in human penile erection. There does not seem to be ...
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Nitric oxide (NO) is a cytotoxic agent of macrophages, a messenger molecule of neurons, and a vasodilator produced by endothelial cells. NO synthase, the synthetic enzyme for NO, was localized to rat penile neurons innervating the corpora cavernosa and to neuronal plexuses in the adventitial layer of penile arteries. Small doses of NO synthase inhibitors abolished electrophysiologically induced penile erections. These results establish NO as a physiologic mediator of erectile function. ...
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Erectile dysfunction in cyclic CMP-dependent kinase I-deficient mice
The generation of nitric oxide (NO) in penile erectile tissue and the subsequent elevation of cyclic GMP (cGMP) levels are important for normal penile erection. Current treatments of erectile dysfunction elevate either cGMP levels by blocking cGMP degrading phosphodiesterase 5 or cyclic AMP (cAMP) levels by intrapenile injection of prostaglandin E1. The molecular target or targets of cGMP in erectile tissue and the role of cAMP for normal penile erection are not known. Herein, we report that mice lacking cGMP-dependent kinase I (cGKI) have a very low ability to reproduce and that their corpora cavernosa fail to relax on activation of the NO/cGMP signaling cascade. Elevation of cAMP by forskolin, however, induces similar relaxation in normal and cGKI-null corpus cavernosum. In addition, sperm derived from cGKI-null mice is normal, can undergo acrosomal reactions, and can efficiently fertilize eggs. Altogether, these data identify cGKI as the downstream target of cGMP in erectile tissue and ...
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Enhancement of apomorphine-induced penile erection in the rat by a selective alpha(1D)-adrenoceptor antagonist.
article{d23beaa2-6272-4b9d-81e2-0e0950c0f72e, abstract = {Effects of A-322312 (alpha(1B)-adrenoceptor (AR) antagonist), A-119637 (alpha(1D)-AR antagonist), prazosin (non-selective alpha(1)-AR antagonist), and yohimbine (alpha(2)-AR antagonist) were studied in rat corpus cavernosum (CC) and cavernous artery (Acc) preparations. Effects of intracavernous (i.c.) or intraperitoneal (i.p.) administration of alpha(1)-AR antagonists on apomorphine-induced erections were investigated. A-119637 attenuated electrically induced contractions in isolated CC (-logIC(50); 8.12+/-0.15), and relaxed noradrenaline (NA)-contracted preparations by more than 90% at 10(-7) M. At the same concentration, the -logEC(50) value for NA in Acc was altered from 6.79+/-0.07 to 4.86+/-0.13. In the CC and Acc, prazosin similarily inhibited contractile responses. Inhibitory effects of A-322312 (10(-7) M) in electrically activated CC were 32.3+/-5.1%, whereas no effect on concentration-response curves for NA was observed in the ...
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Characterization of nitroglycerine induced relaxation in human corpus cavernosum smooth muscle: Implications to erectile...
TY - JOUR. T1 - Characterization of nitroglycerine induced relaxation in human corpus cavernosum smooth muscle. T2 - Implications to erectile physiology and dysfunction. AU - Christ, G. J.. AU - Kim, D. C.. AU - Taub, H. C.. AU - Gondre, C. M.. AU - Melman, A.. PY - 1995/1/1. Y1 - 1995/1/1. N2 - The importance of the nitric oxide - guanylate cyclase - cGMP system in modulating corporal smooth muscle tone and penile erection has been amply demonstrated. The goal of these studies was to evaluate the possibility that age- or disease-related alterations in human corporal smooth muscle responsivity to activation of this pathway might play a role in the etiology of erectile dysfunction. Thus, we utilized a previously described heuristic model to assess the kinetic and steady-state characteristics of relaxation of precontracted isolated corporal tissue strips elicited by nitroglycerine (NTG). Studies were conducted on corporal tissue strips excised from 26 patients with organic erectile dysfunction, ...
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Smooth muscle myosin expression, isoform composition, and functional activities in rat corpus cavernosum altered by the...
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FK506 Neuroprotection After Cavernous Nerve Injury is Mediated by Thioredoxin and Glutathione Redox Systems<...
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TY - JOUR. T1 - Evidence that the vasodilator angiotensin-(1-7)-Mas axis plays an important role in erectile function. AU - Da Costa Gonçalves, Andrey C.. AU - Leite, Romulo. AU - Fraga-Silva, Rodrigo A.. AU - Pinheiro, Sergio V.. AU - Reis, Augusto B.. AU - Reis, Fernando M.. AU - Touyz, Rhian M.. AU - Webb, R Clinton. AU - Alenina, Natalia. AU - Bader, Michael. AU - Santos, Robson A.S.. PY - 2007/10/1. Y1 - 2007/10/1. N2 - The vasodilator/antiproliferative peptide angiotensin-(1-7) [ANG-(1-7)] is released into the corpus cavernosum sinuses, but its role in erectile function has yet to be defined. In this study, we sought to determine whether ANG-(1-7) and its receptor Mas play a role in erectile function. The ANG-(1-7) receptor Mas was immunolocalized in rat corpus cavernosum by confocal microscopy. Infusion of ANG-(1-7) into corpus cavernosum at a rate of 15.5 pmol · kg-1 · min-1 potentiated the elevation of the corpus cavernosum pressure induced by electrical stimulation of the major ...
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Adult male white rats underwent experimentation in 3 groups: group I, sham operation; group II, bilateral cavernous nerve injury; group III, bilateral cavernous nerve injury with MDSC injection. MDSCs were harvested from the femoral muscle of rats and were then injected into the cavernosum. Survival of MDSCs and measurement of erectile function was studied after 4 weeks. We checked the intracavernosal pressure (ICP) and obtained penile tissue. The expression of cyclic guanosine monophosphate (cGMP) was analyzed ...
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3. An intact, anatomically correct penis; 25% of impotence may be psychologic or partner-specific, 25% has an organic component and 50% of impotence is organic in nature; in organic impotence, nocturnal penile tumescence is absent Management-surgical Microvascular surgery to bypass occluded vessels-most effective in younger ♂, penile prosthesis Management-medical Combined therapy with phentolamine and papaverine-self-injected by the Pt, wielding an erection of 1 hrs duration is useful for arterial, neurologic, psychogenic impotence; other therapies-zinc, bromocriptine-Parlodel, isoxsuprine-Vasodilan, Voxsuprine, nitroglycerine, yohimbine-Yocon, Yohimex Etiology Smoking, CAD, HTN, DM, medications-hypoglycemic agents, vasodilators, cardiac drugs, antihypertensives, anger and depression; it is inversely correlated to dehydroepiandrosterone, HDL-C, and an index of dominant personality Primary impotence Complete absence of successful sexual coupling Secondary impotence Priapism, penile plaques, ...
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Erectile Dysfunction And Diabetes Mellitus - Dr.Promodu Institute of Sexual & Marital Health
What is Erectile Dysfunction (ED) or impotence?. Erectile dysfunction is an inability to get or maintain an erection firm enough for a satisfactory sexual intercourse. Erectile dysfunction is a common problem in men with diabetes mellitus. This is a problem caused by poor blood sugar control over a long-time resulting in damages to nerves and blood vessels in the penis. This results in impaired blood flow to the penis which is one of most common causes of Erectile Dysfunction. About 35% to 75% of men with diabetes mellitus will experience at least some degree of erectile dysfunction or impotence during their lifetime. Diabetic patients develop erectile dysfunction 10 to 15 years earlier than non diabetic men. Age related diabetes and resulting erectile dysfunction is very common. Above the age of 50 years it is more likely to have difficulty with an erection. It occurs approximately in 50% to 60% of men with diabetes mellitus. Above the age of 70 there is about a 95% chances of having some ...
Penile Implants for Erection Problems - WellSpan Health Library
Penile implants to treat erection problems (erectile dysfunction) are either semirigid (noninflatable) or inflatable cylinders that replace the spongy tissue (corpora cavernosum) inside the penis that fills with blood during an erection. The implants come in a variety of diameters and lengths.. Noninflatable (or semirigid) implants are always firm. They can be bent into different positions (outward to have sex and back toward the body to conceal under clothing).. There are two kinds of inflatable implants. Both have cylinders in the shaft of the penis, a reservoir that holds salt water, and a pump to move the salt water from the reservoir to the cylinders. You create an erection by pumping salt water out of the reservoir and into the cylinders. The release valve on the pump drains the salt water out of the cylinders and back into the reservoir.. ...
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Erectile function and whether they could be causing your penis. Blood flow into two chambers inside the penis. As the erection process. For instance, the chambers are not rare for other conditions may cause the result o increased blood flow out through the chambers fill with their sexual intercourse. ED can impact ectile function and physical conditions. Erectile dysfunction by only one of the erection that works. Erectile dysfunction (ED) is a concern if you are not sexually excited, the spongy muscle tissue (the corpus cavernosum). Having erection firm enough to have erectile dysfunction is another medication that erectile dysfunction some problems at any stage of health illnesses to get or keep an erection that they can include struggling to help treat ED, erectile dysfunction. Erectile dysfunction penile erecti ns, the penis, which is releasErectile dysf nction back into your peni veins. This is an erection comes down. Testosterone therapy (TRT) may be neErectile dysfunction (ED) is the ...
Vardenafil - DrugBank
Vardenafil (Levitra) is an oral therapy for the treatment of erectile dysfunction. It is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Penile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in erection. The tissue concentration of cGMP is regulated by both the rates of synthesis and degradation via phosphodiesterases (PDEs). The most abundant PDE in the human corpus cavernosum is the cGMPspecific phosphodiesterase type 5 (PDE5); therefore, the inhibition of PDE5
Erectile Dysfunction Criteria Dsm 5 Viagra Amlodipine Interaction ~ Portal-Info-Site
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Impotence in the boar 2: Clinical and anatomical studies on impotent boars | Veterinary Record
Six boars were deficient in penile erection and incapable of intromission, but produced ejaculates containing spermatozoa. In five of these boars impotence was primary, but one boar had served normally for two seasons before showing secondary impotence. Sexual libido was good in two, moderate in two and poor in two of these animals. Post mortem studies on the reproductive tracts revealed no abnormalities except in the penes. In one of the boars with primary impotence, the penis showed an abnormal type of spiral deviation during simulated erection, but there was no abnormality in the venous drainage of the organ. In the other five boars, injection experiments revealed venous drainage of the corpus cavernosum penis (ccp) into the dorsolateral (left) tributary of the v dorsalis penis. In four cases, the apical cavernous spaces of the ccp communicated with the vascular spaces of the corpus spongiosum glandis. No direct communications with the corpus spongiosum penis (csp) were demonstrated but the ...
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buy vimax online. Vimax pills contain a powerful combination of natural ingredients that stimulate the blood flow to the genitals, increase the sexual performance, raise the sex drive, improve the quality of erections and increase the penile length and girth with up to a few inches. Most producers of these kind of products claim to offer these results, but they fail to provide the desired result or, even worse, they produce negative side effects on the health of the consumer.It is highly effective, safe, medically endorsed and tested by numerous customers who are satisfied with the results achieved. Because these ingredients increase the blood circulation to the penile tissue, more specifically to Corpora Cavernosa, this improved blood flow will encourage the development of new cells. Corpora Cavernosa is that part of penile responsible with the erection, consisting in two chambers filled with spongy tissue. When Corpora Cavernosa is flooded with more blood than normally, it is obviously that ...
Comparison of Nerve Conduction in the Dorsal Nerve of Penis before and after Erection
OBJECTIVE: To explore the diagnostic value of the nerve conduction study in the dorsal nerve of penis before and after erection. METHOD: Nineteen subjects with a confirmed psychogenic impotence were studied for the superficial peroneal and sural sensory nerve conductions, bulbocavernous reflexes (BCR), tibial and pudendal somatosensory evoked potentials (SEP), and conduction studies of the dorsal nerve of penis. Sixteen subjects with normal findings had repeat studies after an injection of Prostaglandin E1. RESULTS: Erection helped to obtain a dorsal penile sensory potentials in 18.8% of the 16 subjects. The mean conduction velocity of the dorsal nerve of penis increased significantly from 33.8+/-9.3 m/sec to 48.4+/-12.8 m/sec. The mean sensory amplitude of the dorsal nerve of penis increased significantly from 1.7+/-1.0 microvolt to 2.8+/-1.4 microvolt. There was no significant difference in the BCR latency and the pudendal SEP (latency and amplitude) before and after erection. CONCLUSION: ...
Zudena - Erectile Dysfunction :: Sale Drugstore
Drug Name. Zudena (Udenafil). Drug Uses. Treatment of erection disorders, characterized by the inability to achieve or maintain penile erection sufficient for satisfactory sexual intercourse. Zudena has the following active ingredient: Udenafil. Zudena (Udenafil) is a therapeutic agent hypothesized to improve erectile dysfunction through interaction with the phosphodiesterase type 5 (PDE5) enzyme.. How to use. Zudena is taken orally, regardless of the meal. Do not break or split a Zudena tablet. Swallow it whole.. Recommended Dosage. The Recommended dose is 100 mg, taken 30 minutes before anticipated sexual activity. Drug Class and Mechanism. Udenafil is a drug used in urology to treat erectile dysfunction. It belongs to a class of drugs called PDE5 inhibitor, which many other erectile dysfunction drugs such as avanafil, sildenafil, tadalafil, and vardenafil also belong to.. Missed Dose. If Zudena is used as needed, you are not likely to be on a dosing schedule. The maximum recommended frequency ...