Effect of Shanhaidan Granules combined with tadalafil on erectile dysfunction: A multi-center clinical trial / 中华男科学杂志

Objective@#To observe the clinical effect and safety of Shanhaidan Granules (SHDG) combined with tadalafil tablets (TT) in the treatment of ED.@*METHODS@#In this open multi-center case-control clinical trial, we enrolled 247 ED patients according to the designed criteria, and treated them orally with SHDG at 10 g per time tid (n = 74), TT at 5 mg per time bid (n = 52), or SHDG + TT at the above doses (n = 121), all for 8 weeks. Before and after medication, we recorded the IIEF-6, erection hardness scores (EHS), traditional Chinese medicine syndromes (TCMS) scores, penile cavernous blood flow parameters and adverse reactions, and compared them between the 3 groups of patients.@*RESULTS@#After 8 weeks of treatment, all the patients showed significantly increased IIEF-6, EHS and TCMS scores in comparison with the baseline (P < 0.05). The total effectiveness rates in the SHDG, TT and SHDG + TT groups were 60.8%, 67.3% and 69.4% respectively based on the IIEF-6 scores, remarkably higher in the TT and SHDG + TT groups than in the SHDG group (P < 0.05), and 40.5%, 32.7% and 63.6% respectively according to the TCMS scores, markedly higher in the SHDG and SHDG + TT groups than in the TT group (P < 0.05). Single-center data manifested significantly increased peak systolic velocity (PSV) of the penile artery in the SHDG + TT and TT groups (P < 0.05). The improvement values of relevant parameters were remarkably higher in the SHDG + TT group than in the TT and SHDG groups, so were IIEF-6 scores in the TT than in the SHDG group, and TCM syndromes in the SHDG than in the TT group. No medication-related adverse events were found in any of patients after treatment, except for some mild side effects including muscle soreness and gastrointestinal reactions in a few cases, all soon relieved, none with abnormalities in blood and urine routine tests or hepatic and renal function indicators.@*CONCLUSIONS@#Shanhaidan Granules combined with tadalafil can significantly improve the erectile function and reduce TCM syndromes in ED patients, and therefore can be applied effectively and safely in clinical practice./.

Animal models of erectile dysfunction: Establishment and evaluation / 中华男科学杂志

At present, the study of erectile dysfunction depends heavily on animal models, but the differences in anatomy and physiology of currently used animals make it difficult to exceed the limitations on the experiment. In order to make the results of experiments more applicable and beneficial to the public, it is essential to establish most suitable animal models for the study of the sexual function of humans. Moreover, a consensus has not yet been reached on the methods of detecting and evaluating the erectile function of animals, and therefore an informative and instructional summary of the existing methods seems even more necessary. This article discusses how to establish and evaluate the animal models of different types of erectile dysfunction.

Application of adipose-derived stem cells in lower urinary tract reconstruction / 中华男科学杂志

Adipose-derived stem cells have self-renewal and multi-differentiation potentials, which can differentiate into smooth muscle cells, urinary epithelial-like cells, endothelial cells, neuron-like cells, etc. and secrete a variety of growth factors. As a result, the research on adipose-derived stem cells in lower urinary tract reconstruction using tissue engineering has been a highlight in recent years. This review focuses on the application of adipose-derived stem cells as seed cells to lower urinary tract reconstruction by tissue engineering in such diseases as bladder defect, stress urinary incontinence, and erectile dysfunction.

Human foreskin acellular matrix graft: a good scaffold for urethral tissue engineering / 中华男科学杂志

<p><b>OBJECTIVE</b>To provide evidence of using the human foreskin acellular matrix graft for urethral tissue engineering. METH-ODS: The human foreskin acellular matrix graft was prepared, its safety and biocompatibility as urethral material were determined by histological observation, cytotoxicity test using primary epithelial cells and experiment in vivo.</p><p><b>RESULTS</b>Intact cells were absent from the foreskin acellular matrix graft. The cytotoxicity test showed that the relative growth rate of the cells was between 75% and 99%, and the cytotoxicity of the foreskin acellular matrix graft was grade 1, consistent with the national standard. With the lengthening of time, the foreskin acellular matrix graft became perfectly compatible with the urothelial cells and the urethral multi-layer structure was restored to normal gradually.</p><p><b>CONCLUSION</b>The human foreskin acellular matrix graft, with its low antigenicity and good biocompatibility, could be a good scaffold for urethral tissue engineering.</p>

Repair and functional reconstruction of the penis (a report of 62 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of surgery treatment on serious penile lesions and malformation.</p><p><b>METHODS</b>Sixty-two patients, aged from 19 to 63 years old (mean 35 ys), were included in the study. Among them, 4 patients suffered from penis partial defection were respectively treated with restoring defective penis, penis lengthening and urethroplasty; three patients with penis completely missing were treated with penis reconstruction surgery; 22 cases with serious penile curvature were treated with the 16-dot plication technique (Lue's procedure); 15 cases with penile fracture were treated with conservative treatment for 1 case and with patch penis, corpus spongiosum, and deep penile dorsal vein ligation for 14 cases; 5 cases with post-operative complications of 3-pieces of penile prosthesis, including the prosthesis perforating to the urethra, water pump failure, broken connection tube, erection angle < 60 degrees and failure to expansion the corpus cavernosum, were treated by taking out prostheses, urethral repair cracks, replacement of the prostheses, excision of fibrosis scar and re-implantation prostheses respectively. Four cases with penis complete amputation were treated with the penis replantation; three cases of avulsion injury were treated with the replantation and free flap skin; 6 with Paget's disease of penises were treated with the lesion free skin buried in the scrotum and penis.</p><p><b>RESULTS</b>All these patients were followed up for 3 months to 4 years, with the average of 9 months. Among the 4 cases of penis partial defection, 2 patients were satisfied with the penile appearance and sexual function; 1 got some satisfactory and 1 was unsatisfied. Three cases with the loss of the penis completely were satisfied with both the postoperative appearance and urination, and 1 was not satisfied. Twenty-two cases of penile curvature deformities were corrected, and one case was recurrence. Fourteen of the 15 patients with penile fracture were followed, and all got the restoration of sexual function. Among them, 5 cases with post-operative complications, including mild bending, algopareunia, subcutaneous induration, poor hardness and poor sexual pleasure, were not further treated, and another case lost; Five cases with post-operative complications of three-pieces penile prosthesis were treated successfully, and 4 of their spouses were satisfied with their sexual function after operation, only 1 of their spouse not satisfied. Among four cases with complete amputation of penis, two cases of penis were replanted successfully while two necrosis. Three cases with avulsion were treated with skin grafting successfully. All 6 cases with penile Paget's disease were followed for 2 -4 years, and free skin grafts were all survival. One patient died of brain metastases 18 months after operation and five cases were disease-free survival.</p><p><b>CONCLUSION</b>The patients should be treated based on the procedure of andrological and urological surgery, together with microsurgical, flap or skin graft technique. The urologist should design personalized surgical procedure. Most of the patient's penis shape and erectile dysfunction can be reconstructed by our procedures, but some patients can not achieve the desired appearance or function of penis. New approaches of the treatment ought to be developed to restore both of the shape and function for those severe injury of the penis.</p>

Construction of urethra mucosa structure in vitro by tissue engineering / 中华男科学杂志

<p><b>OBJECTIVE</b>To construct a structure of urethra mucosa in vitro by tissue engineering.</p><p><b>METHODS</b>Primary porcine urothelial cells (UC) were obtained from the porcine bladder by enzymatic digestion and detected by immunofluorescence and RT-PCR. Bladder acellular matrix grafts (BAMG) were prepared, used as the scaffold and then evaluated by HE staining, Masson's trichrome staining, immunohistology and scanning electron microscopy. After in vitro culture and amplification, the UCs were seeded on the luminal surface the BAMGs.</p><p><b>RESULTS</b>After 1 week of in vitro culture, the UCs formed a multilayer structure on the luminal surface of the BAMGs along the basement membrane. The tissue-engineered urothelium and BAMG complex was well formed and pan cytokeratins were positively expressed in the UCs on the scaffold.</p><p><b>CONCLUSION</b>By tissue engineering, the urethra mucosa structure can be rapidly constructed in vitro, which can be applied to the repair of such urethral defect as hypospadias and urethral stricture.</p>

Duplex ultrasonography and internal pudendal arteriogram in the diagnosis of trauma-associated arteriogenic erectile dysfunction (a report of 7 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To make a comparative study of duplex ultrasonography (DU) and internal pudendal arteriogram (IPA) in the diagnosis of trauma-associated arteriogenic erectile dysfunction (ED).</p><p><b>METHODS</b>Seven patients suffering from arteriogenic erectile dysfunction caused by pelvic fracture trauma underwent comprehensive history inquiries and physical examinations by duplex ultrasonography and internal pudendal arteriogram, which ruled out neurogenic erectile dysfunction.</p><p><b>RESULTS</b>DU suggested penile artery blood flow injury, and IPA indicated artery injury in all the cases, including left internal pudendal artery injury, right or left common penile artery injury and bilateral common penile artery injury.</p><p><b>CONCLUSION</b>Trauma-associated arteriogenic erectile dysfunction may result from common penile artery injury and internal pudendal artery injury. DU is proved valuable for evaluating hemodynamic abnormalities of cavernous artery flow, and IPA useful in locating common penile artery and internal pudendal artery injury. DU can be used as the first line diagnostic means to define trauma-associated arteriogenic ED.</p>