The Role of Free Radical in the Pathogenesis of Impotence in Streptozotocin-Induced Diabetic Rats

Diabetes is the most common cause of erectile dysfunction (ED). Oxidative stress has been suggested to be a contributory factor in vascular complications of diabetes in various organs. In the present study, we investigated whether oxidative stress is associated with erectile function in non- insulin dependant diabetes mellitus (NIDDM) rats. Fifty-four Sprague-Dawley rats were the subjects of this study. In each rat, NIDDM was induced by an intraperitoneal injection of 90mg/Kg of streptozotocin on the second day after birth. Based on the diabetic period, they were classified into either short-term or long-term diabetics (avg. 22 weeks, n=18 and avg. 38 weeks, n=20), respectively, and their age-matched controls (n=16). To evaluate the erectile function in each rat, the intracavernous pressure, and latency to maximal pressure, following cavernous nerve stimulation (frequency: 1 Hz, intensity: 3 - 6 V, pulse width: 1 msec, pulse duration: 1 min.) was analyzed. To evaluate both oxidative stress from reactive oxygen species, and antioxidant function as a defense against them, total malondialdehyde and glutathione levels were measured in the corpus cavernosum of the penis, using a spectrophotometric assay. The intracavernous pressure following cavernous nerve stimulation was significantly lower in the long-term (49.8 +/- 9.4 cmH2O) than the short-term diabetics (75.9 +/- 14.8 cm H2O), and markedly decreased in the diabetic rats, compared with their age-matched controls (long-term controls; 60.7 +/- 17.2 cmH2O, short-term controls; 95.2 +/- 20.4 cmH2O). The malondialdehyde content in the corpus cavernosum was markedly increased in the diabetics (2.13 +/- 0.27 nM/mg protein) compared to the controls (1.48 +/- 0.22 nM/mg protein). Furthermore, the glutathione level was significantly decreased in the diabetics, compared to age-matched controls (short-term control; 218.3 +/- 25.6 microM/mg protein, long-term control; 150.2 +/- 9.8 microM/mg protein). In the diabetic groups, it was more significantly decreased in the long-term diabetics (134.8 +/- 11.3 microM/mg protein) than in short-term diabetics (182.1 +/- 18.8 microM/mg protein). NIDDM causes erectile dysfunction, which slowly progresses. Oxidative stress to cavernous tissue may be a contributory factor in erectile dysfunction in diabetics.

Effect of Oral Administration of Beraprost Sodium on Erectile Dysfunction / 대한비뇨기과학회지

PURPOSE: Beraprost Sodium (BPS) is an orally stable prostacyclin (PGI2) analogue and exerts an inhibitory effect on platelet aggregation as well as a potent vasodilatory effect. We investigated the efficacy and safety of BPS in patients with erectile dysfunction (ED). MATERIALS AND METHODS: A total of 74, consecutive patients subjected to have impotence work-ups including history taking, penile duplex ultrasonography, pharmacological erection test, and cavernous nicotinamide adenosine dinucleotide phosphatase (NADPH) diaphorase staining. Sixty-six patients continuously received BPS for more than 4weeks (range 4-32 weeks, average 8.4+/-5.8 weeks), bid or tid (a total 80-120microgram/day) for long-term control of ED. Remaining 8 patients intermittently received 40-60microgram of BPS an hour prior to intercourse to obtain immediate erection for on-demand treatment. Sexual function was compared by analysis of an International Index of Erectile Function (IIEF) and general efficacy based on patient's subjective evaluation after treatment. RESULTS: IIEFs of all patients were significantly improved after BPS treatment for ED. Erectile function with IIEF question No. 3 and 4 were improved by 1.7+/-1.3 to 3.2+/-1.8 and 1.4+/-0.9 to 2.7+/-1.6, respectively (p<0.05). General efficacy of BPS was shown as full effect in 23%, moderate effect in 31%, mild effect in 26%, and no effect in 20% of the patients. Better sexual function including IIEF and general efficacy were observed in continuous treatment group than on-demand treatment group. Better result was also found in diabetics than non-diabetics (p<0.05) while no difference was observed among psychogenic, vasculogenic, and neurogenic group. The side effect of BPS was minimal; flushing in 8%, headache in 5%, indigestion in 4%, and insomnia in 1% of total patients. CONCLUSIONS: Oral BPS is a safe and effective agent to treat ED. It remains to be investigative, to determine desirable treatment method and to elucidate long term control of ED in association with oral BPS.

The Biofeedback therapy in Female Urethral Syndrome

No abstract available in English.

Pathophysiologic Manifestations of Diabetic Erectile Dysfunction / 대한남성과학회지

PURPOSE: Diabetes mellitus is one of the most common causes of erectile dysfunction (ED). The pathogenesis of ED in diabetic patients is not clear, although vasculogenic and neurogenic factors are involved. This study was designed to further characterize the pathophysiologic manifestations of ED in diabetic patients. MATERIALS AND METHODS: Fifty-seven important patients aged 20 to 71 (mean 45) years participated in this study. On the basis of their medical history, physical examination, and multidisciplinary impotence work-ups, patients were divided into diabetic (n=25) and non-diabetic (psychogenic; n=32) groups. To evaluate vasculogenic manifestations, a pharmacological erection test and penile duplex ultrasonography were performed. To evaluate neurologic manifestations, nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining was performed on cavernous tissue samples obtained by percutaneous biopsy. Staining was assessed by counting the number of nitric oxide synthase (NOS)-containing nerve fibers present in four random fields (power 400x). In the diabetic group, we additionally assessed the duration of diabetes, the duration of treatment, and the latency between the onst of ED and the time diabetes was diagnosed. RESULTS: The pathophysiologic causes for ED in the diabetics proved to be neurogenic in 44%, vasculogenic in 20%, and mixed (combined neurogenic and vasculogenic) in 36%. Vascular assessment in the diabetics showed that penile rigidity was decreased and end-diastolic velocity was increased compared with the nondiabetics. Latency to the onset of ED from the diagnosis of diabetes was 0 to 15 (average 5.3) years, and it was closely correlated with the status of NOS-containing nerves (p<0.05). The status of NOS-containing nerves also correlated well with the degree of diabetic control but not with the control method. CONCLUSIONS: Diabetes causes ED by a variety pathophysiologic mechanisms, including neurogenic, vasculogenic, or both. Early and appropriate control of diabetes is required to prevent ED.

Vascular Aspects of FSD / 대한남성과학회지

No abstract available.

A Schwannoma of Adrenal Gland / 대한비뇨기과학회지

Schwannomas are uncommon benign, slowly growing tumors that originate in peripheral, cranial, or autonomic nerves and are composed of Schwann cells in a collagenous matrix. Retroperitoneum is often the site of occurrence of schwannoma, but report on schwannoma of the adrenal gland is rare. We report a case of adrenal schwannoma. A 53 male had facial edema and paresthesia of extremities for 3 month. Incidentally adrenal mass was found on abdominal computer tomogram and exploration performed.

The Ultrasonographic Follow up Results and the Prognosis of Prenatal Hydronephrosis / 대한비뇨기과학회지

The diagnosis of hydronephrosis has been increasing in compared to other organs anomaly since the advent of the prenatal ultrasonography, and it is important to differentiate between physiologic and pathologic hydronephrosis. We retrospectively reviewed the follow up of the postnatal ultrasonography and tried to determine the course of prenatal hydronephrosis. The pyeloplasty was indicated 27.1% of patients, in where the diameter of renal pelvis ranged from 18 to 68 mm with a mean of 41 mm and all patients had severe calyceal dilatation. Normal group in which no obstruction pattern on DTPA renal scan were 55.9% and the diameter of renal pelvis ranged from 6 to 23 mm with a mean of 13 mm. The cases of normal, close observation and indicated pyeloplasty were less than 50% and in all cases of vesicoureteral reflux, revealed urinary tract infection. The study revealed that prenatal ultrasonography alone is inadequate in determining the consistent prognostic factors of prenatal hydronephrosis. However, we determined that Pyeloplasty indicated in cases with severe dilatation of calyx and severe renal pelvis dilation. In cases with urinary tract infection. regardless of calyceal dilation and in cases with severe calyceal dilatation, voiding cystourethrogram should be performed to rule out vesicoureteral reflux. In the cases with mild to moderate dilatation, renal scan indicated to exclude a possible urinary tract obstruction. Minimal calyceal dilation can be regarded as free of urinary tract obstruction.

Extended Varicocelectomy Using Blue Dye / 대한비뇨기과학회지

Varicocele is the most common correctable cause of infertility, however current varicocelectomy carries high incidence of recurrences and postoperative complications. Thus a new method which can minimize recurrences and postoperative complications is devised, by performing varicocelectomy using intraoperative injection of blue dye. Followings are benefits of blue-dye varicocelectomy, first, small-caliber internal spermatic veins, not readily visible at intraoperative venography, can be easily identified. The testicular artery and veins can be easily differentiated without using the magnifying devices. Obviously it is radiation-free, and utilizes readily available substance (i.e. methylene blue or indigocarmine) and can preserve internal spermatic artery and lymphatics. This method can be applied successfullyin pediatric patients with previous varicocelectomy and inguinal operation.