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Correspondence to Carmine Gazzaruso, MD, IRCCS Maugeri Foundation Hospital, Internal Medicine Unit, Via Ferrata 8, 27100 Pavia, Italy. E-mail c.gazzaruso@tele2.it
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HealthDay Reporter FRIDAY, Oct. 5 (HealthDay News) -- Few men may realize it, but if they're having problems achieving or sustaining erections, it may signal underlying heart trouble.
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"There are lots of different ways to be sexual, and if one way becomes difficult or even impossible, you have to explore, together, the things you can do with each other that are sexually exciting," says Downey.
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Normal penile erection is dependent on the integrity of the endothelium. Endothelial-derived NO plays an important role in the physiological mechanism of erection. Alteration in the concentration of NO, due to damage to endothelium or to increased destruction, appears to be the most important causes for ED, especially in the presence of vascular disease. In vitro studies showed that increased production of reactive oxygen species is associated with decreased normal erectile response, primarily because of reduced NO concentrations. Increased production of reactive oxygen species in diseases such as diabetes and hypertension might be an important cause of an increased risk of ED. Novel strategies and interventions are needed to prevent and treat endothelial damage.
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The results suggest it is likely that the two disorders share common mechanisms, said lead author Xiang Gao, MD, PhD, instructor at Harvard Medical School, associate epidemiologist at Brigham and Women's Hospital and research scientist at the Harvard School of public health in Boston, Mass.
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Sildenafil is the first oral agent to be well documented as an effective form of treatment for men experiencing ED. Since its introduction in March, 1998, no other therapy for ED has achieved such prominent public recognition. Of the 250,000 American physicians who have written prescriptions for sildenafil, 14% have been written by urologists and 82% by nonurologists.
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Figure 5. Sildenafil down-regulates IL-4R expression on CD11b+ cells. CD4+, CD8+, CD11b+, or CD11c+ cells were magnetically purified from spleens of C26GM-bearing mice challenged 9 d earlier. CD4+ or CD8+ T cells were stimulated with ConA for 3 d, with or without 50 µg/ml sildenafil. (A) Purified cells were cultured separately for 2 d with or without sildenafil, harvested, and used to determine cGMP levels, as described in Materials and methods. (B) T cell proliferation was determined by [3H]thymidine incorporation. (C) CD11c+ cells were analyzed for B7.2 and MHC class II expression. (D) CD11b+ cells were analyzed for IL-4R expression by flow cytometry. The t test p-value is reported. Error bar values are shown. MFI, multiplicity of infection.
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Penile Implant Backgrounder - Before the advent of injectable and oral medications, penile implant surgery was the only effective treatment for ED. The penile implant was used by men with irreversible ED from physical causes, such as diabetes, pelvic surgery, or physical trauma to the penis. The prosthetic implant and surgery, which costs between $12,000 and $20,000, was their only option.
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