Urinary Incontinence Could Be Controlled by an Inflatable Penile Prosthesis

PURPOSE: Due to the increasing numbers of radical prostatectomies (RP) performed for prostate cancer, a substantial and increasing number of patients suffer from postoperative urinary incontinence and erectile dysfunction (ED). The objective of our study was to see whether an inflatable penile prosthesis implantation could control urinary incontinence for patients with the dual problems of ED and incontinence. MATERIALS AND METHODS: From March 2010 through May 2015, 25 post-RP patients were referred to our clinic with ED or incontinence. The degree of incontinence was classified according to the International Consultation on Incontinence Questionnaire-Short Form. Inflatable penile prostheses were implanted in all 25 patients. RESULTS: For one month after implantation, partial or full inflation was performed progressively to control urine leakage. Of 18 patients, 13 patients were categorized with mild or moderate stress incontinence. All 13 patients obtained control of incontinence with partial inflation (30% to 60%) and all reported satisfactory outcomes. Five out of the 18 patients were categorized with severe total incontinence. Three of the 5 patients could tolerate incontinence with full inflation on and off. Thirteen patients out of the total of 18 (72.2%) had their incontinence controlled by an inflating penile prosthesis. CONCLUSIONS: An inflatable penile prosthesis is highly recommended as an initial procedure, especially in patients with the dual problems of ED and incontinence.

The Analysis of Clinical Efficacy of Phosphodiesterase 5 Inhibitors for Erectile Dysfunction using SS-Penogram / 대한남성과학회지

PURPOSE: As the first-line pharmacotherapy for erectile dysfunction (ED), phosphodiesterase type 5 (PDE5) inhibitors are widely used and their clinical efficacy is well established. But up to now, most of these comparative studies have been based on questionnaires, and Udenafil and Mirodenafil, which have recently been developed in South Korea, have not yet to be compared in clinical studies. We compared and analyzed the efficacy of five PDE5 inhibitors using the sexual stimulated (SS)-Penogram. MATERIALS AND METHODS: A total of 347 patients taking PDE5 inhibitors for the treatment of ED and underwent SS-Penogram was enrolled in this study. AUC (area under the curve) of SS-Penogram was compared in each PDE5 inhibitors. Differences in AUC according to age, combined disorders, serum testostereone and prolactin, cholesterol and IIEF were also analysed using Chi-square and Kruskal-Wallis test. P-value less than 0.05 was considered as statistically insignificant. RESULTS: Ratios of Type I curves in medication groups with normal erection were not statistically different before and after medication. Ratios of the excellent response (>50 % increase in area under the curve) and non-response groups (no increase or even decrease in area under the curve) in each medication group were not statistically different. CONCLUSIONS: In this clinical comparative study of the efficacy of PDE5 inhibitors using the SS-Penogram, there were no definite differences in efficacy among PDE5 inhibitors.

Comparison of Voiding Parameters According to the Subtypes of SS-Penogram in Patients with Both Erectile Dysfunction and Lower Urinary Symptoms / 대한남성과학회지

PURPOSE: We investigated the results of voiding parameters according to the subtypes of audiovisual stimulation (AVS)- and sexual stimulation (SS)-penogram in patients with both erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Sixty seven patients with ED and LUTS were included in this study. Erectile function was evaluated by international index of erectile function (IIEF)-5, AVS-penogram, and SS-penogram. After AVS-penogram, SS-penogram was performed 30 minutes after taking mirodenafil (100mg) orally. We also evaluated voiding function with international prostatic symptom score (IPSS), quality of life score (QoL), urinary flow rate (UFR), residual urine volume (RV), and transrectal ultrasonograpy (TRUS). Voiding functionparameters were analyzed according to the subtypes of AVS- and SS-penogram. RESULTS: Although there was tendency that the IIEF-5 scores were lower in patients who showed decreased erectile responses on AVS-penogram, but it did not reach the statistical significance (p= 0.09). The RV was significantly increased as the erectile function worsens based on AVS-penogram (p= 0.003). However, no significant relationship was found betweenresults of SS-penogram and voiding function parameters. CONCLUSIONS: Our results revealed some relationship between voiding function and erectile function evaluated by AVS-penogram, but not by SS-penogram, in patients with both ED and LUTS. AVS-penogram, as well as IIEF questionnaire, may play an important role in predicting voiding function in patient with both conditions .

Efficacy and safety of oral SK3530 for the treatment of erectile dysfunction in Korean men: a multicenter, randomized, double-blind, placebo-controlled, fixed dose, parallel group clinical trial / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the efficacy and safety of SK3530, a newly developed type 5 phosphodiesterase inhibitor (PDE5I), in Korean men with erectile dysfunction (ED).</p><p><b>METHODS</b>A total of 119 patients were randomized at 10 centers in Korea to receive either SK3530 (50, 100, or 150 mg; n = 89) or placebo (n = 30) taken l h before anticipated sexual activity for an 8-week period. The patients were evaluated at baseline and 4 and 8 weeks after beginning therapy. Efficacy was assessed using the International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP), and the Global Assessment Question (GAQ). Safety was analyzed by adverse events, laboratory values and vital signs.</p><p><b>RESULTS</b>At the end of the study, all the primary and secondary efficacy end-points were statistically significantly improved by SK3530 compared with placebo (P<0.05). Of the 89 patients in the treatment arm, 36 (42.3%) achieved normal erectile function after treatment, including six patients with severe ED. Treatment-related adverse events occurred in 32 patients. The most common adverse events were flushing, headache, dizziness and eye redness (10.9%, 7.6%, 2.5% and 2.5%, respectively), and most were mild. Only two patients discontinued treatment during the study period because of adverse events.</p><p><b>CONCLUSION</b>The results of our phase II study have confirmed the efficacy and safety of SK3530 in a broad population of men with ED of various etiologies and severity. The optimal doses in terms of efficacy and safety were determined to be 50 mg and 100 mg, respectively.</p>

Recent Concepts of Premature Ejaculation / 대한비뇨기과학회지

Premature ejaculation(PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin(5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors(SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine(hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neurotransmission, it has been suggested that on-demand selective serotonin reuptake inhibitor(SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.

A Randomised, Double-Blind, Parallel, Placebo-Controlled Study of the Efficacy and Safety of Tadalafil Administered On-Demand to Men with Erectile Dysfunction in Korea / 대한비뇨기과학회지

PURPOSE: Tadalafil is a phosphodiesterase type 5 inhibitor that is used for the treatment of erectile dysfunction (ED). Previous clinical trials have assessed its efficacy and safety in Western populations, but this drug has not been investigated in a large clinical trial involving Korean men with ED. Thus, the aim of this study was to assess the efficacy and safety of 20 mg tadalafil in comparison to placebo when it is taken on demand by Korean men suffering with ED over a study period of 12 weeks. MATERIALS AND METHODS: Men more than 18 years of age with mild to severe ED of various etiologies were randomized to receive placebo or tadalafil 20 mg that was taken as needed (maximum once daily). Efficacy assessments included the International Index of Erectile Function (IIEF), the Sexual Encounter Profile (SEP) diary and Global Assessment Questions (GAQ). RESULTS: Tadalafil significantly improved erectile function, as measured by the erectile function domain of the IIEF, compared to placebo (p<0.001). At the endpoint, the patients receiving tadalafil 20mg reported a greater mean per-patient percentage of successful intercourse attempts (SEP3: 71% compared to 31% for placebo) and a greater proportion of improved erections (GAQ: 80% compared to 44%). The most common treatment emergent adverse events were headache (16.3%), flushing (5%) and eye pain (5%), and most of the adverse events were mild or moderate in severity. CONCLUSIONS: Tadalafil was an effective, well-tolerated therapy for Korean men suffering with ED of broad-spectrum severity and etiology.

Analysis of Survival Rate and Cause of Revision in Penile Prosthesis: A Single Center Long Term Follow-up Study / 대한비뇨기과학회지

PURPOSE: There are many reports on penile prosthesis implantation, but few on the natural history of prosthesis. We investigated the failure rate and causes for revision. MATERIALS AND METHODS: We reviewed 518 cases of penile prosthesis implantation performed by the same surgeon from December, 1983 to March, 2005 at the department of urology in Yongdong Severance Hospital. The mean follow up duration was 92 months, and average age was 49.1 years. A penile prosthesis survival is defined as a prosthesis that does not need revision due to infection, mechanical dysfunction or dissatisfaction, and a patient who is able to have intercourse. Analysis was performed by Kaplan-Meier formula and Log rank test. Significance was defined as p below 0.05. RESULTS: The survival rate of AMS 600 was significantly higher than that of the inflatable prosthesis. The survival failure rate was 22.2% in the inflatable prosthesis. Mechanical failure was the most common cause of survival failure in the inflatable prosthesis. Especially, the cylinder survival rate was lower than that of the other compartment of AMS (American medical system) 700 CXM . The AMS 700 CXM survival rate was lower in the neurogenic erectile dysfunction than the other causes of erectile dysfunction. The survival rate was reliable in the original and revised cylinder. CONCLUSIONS: The overall survival failure rate was 16.4%. Neurogenic erectile dysfunction was the most prevalent risk factor of survival failure in AMS 700 CXM . The survival rate must be considered in neurogenic patients who want to be implanted with the inflatable prosthesis. The infection rate was not increased in AMS 700 CXM revision cases. However, further research is warranted for the development of a failure- free prosthesis.

Expression of Sperm-specific Cation Channel CatSper in Human Spermatozoa / 대한비뇨기과학회지

PURPOSE: We aimed to elucidate the expression and intracellular localization of sperm-specific cation channel CatSper in human spermatozoa. Moreover, the relationship between the expression of CatSper mRNA and the motility of ejaculated human spermatozoa were investigated. MATERIALS AND METHODS: Using cDNAs extracted from the ejaculated sperm of patients (n=39), the expression of CatSper mRNA was observed by RT-PCR. Semi-quantitative analysis of the CatSper mRNA expression was performed by comparing with the expression of GAPDH mRNA. To elucidate the expression and intracellular localization of CatSper protein, double fluorescent immunocytochemistry for CatSper and beta-tubulin was performed. RESULTS: The CatSper mRNA was expressed in all of the sperm samples. Using semi-quantitative analysis for the amount of CatSper mRNA expression, no significant difference was found between the normozoospermia and asthenozoospermia groups (1.5+/-0.6 vs. 1.4+/-0.6, p=0.623). Polyclonal antiserum, generated against a recombinant protein of the N-terminal 160 amino acids of human CatSper, was used. In double fluorescent immunocytochemistry, CatSper protein was found to be expressed in the flagellum of the ejaculated human spermatozoa, and localized in the connecting piece, mid-piece and principal piece, with the exception of the end piece of the flagellum. Moreover, the proportion of CatSper-positive sperm was similar in both the normozoospermia and asthenozoospermia groups. CONCLUSIONS: To the best of our knowledge, this is the first time ejaculated human spermatozoa have been shown to express the mRNA and protein of CatSper. The results of our RT-PCR and immunocytochemistry suggest that CatSper may play a role in the motility of ejaculated human spermatozoa.

Plasma transforming growth factor-beta1 levels in patients with erectile dysfunction / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the plasma TGF-beta1 level in erectile dysfunction (ED) patients of various causes.</p><p><b>METHODS</b>Sixty-two patients with ED and 26 potent men were subjected to the study. Based on multidisciplinary work-ups, including medical history, physical examinations, blood tests with lipid profile and hormones, penile duplex Doppler ultrasonogram and neurophysiological tests, causes for ED were classified as psychogenic (n=15), neurogenic (n=16) and vasculogenic (n=31). The plasma TGF-beta1 level was measured by the ELISA method.</p><p><b>RESULTS</b>The plasma TGF-beta1 level was significantly increased in the ED group (6.7+/-4.9 ng/mL), compared to the control (4.0 +/-2.1 ng/mL) (P<0.01). In the ED groups, there was a significant increase in the vasculogenic group (9.0 +/-5.5 ng/mL), compared to the psychogenic (3.8 +/-1.8 ng/mL) and neurogenic groups (4.8+/-3.2 ng/mL) (P<0.01). Of the vascular risk factors, both the smoking (7.5 +/-4.7 ng/mL) and dyslipidemia groups (7.4+/-4.4 ng/mL) showed significantly increased plasma TGF-beta1 levels, compared to the non-smokers (5.5+/-2.8 ng/mL), and those without dyslipidemia (4.8+/-2.8 ng/mL) (P<0.05).</p><p><b>CONCLUSION</b>Vascular risk factors are associated with an elevated plasma TGF-beta1 level, which may contribute to cavernous fibrosis and ED.</p>

Multicenter Study on the Efficacy and Safety of Intracavernous 'TM' (Standro(R)) for the Treatment of Erectile Dysfunction in Korean / 대한비뇨기과학회지

PURPOSE: To evaluate the efficacy and safety of an intracavernous injection of lyophilized papaverine/phentolamine/alprostadil (Standro(R)) for the treatment of erectile dysfunction (ED) in Koreans. MATERIALS AND METHODS: 249 men (>20 years old), with ED (>6 month duration), were enrolled from 14 clinical centers. The intracavernous 'TMs' were titrated in a stepwise fashion at the clinic, from 0.05-0.25ml (17.64mg papaverine, 0.6mg phentolamine, and 6mug alprostadil per ml), with increment of 0.02-0.05ml, according to the etiology and severity of the ED and the patients' ages. RESULTS: Of the 249 men, 238 completed the dose titration, and progressed to home treatment of 3 months duration. Of these 238, 193 (psychogenic 13.0%, organic 75.5%, mixed 11.5%) completed the home treatment (4 or more self-injections), with the other 45 dropping out (lost to follow-up in 24, patient refusal in 9, no chance to have intercourse in 7 and omitted recording of patient diary in 2). The success rate per trial (a total number of sufficient erection for vaginal intromission/a total number of injections) and per patient (number of patients who had one or more sufficient erections for vaginal intromission/the enrolled patients at beginning or 193 patients), and the satisfaction rate per patient (number of patients who had both patient and partner satisfaction with erection/193 patients) were 74.1, or 91.2 and 75.1%, respectively. The adverse reactions were prolonged erections in 3, urethral pain in 1 and penile skin edema in 2. Three patients complained of penile pain during an erection, but there was no dropout due to the pain. No significant changes in laboratory tests were found after the home treatment. CONCLUSIONS: A 'TM' seems to be effective and safe for an intracavernous injection for the treatment of men with erectile dysfunction.

New PDEs Inhibitors for Erectile Dysfunction

Phosphodiesterases (PDEs) are functionally diverse enzymes with wide organ and tissue distributions. Of these enzymes, PDE5 has received particular attention largely because of the introduction and widespread use of the selective PDE5 inhibitor sildenafil citrate (Viagra(R)) as an oral therapy for erectile dysfunction(ED). Within the corpus cavernosum of the penis, PDE5 influences regulation of vascular and trabecular smooth muscle contractile tone by enzymatically degrading the cyclic 3',5'guanosine monophosphate(cGMP), the key second messenger. By reversibly inhibiting this enzymatic activity, the competitive inhibitors of PDE5, including sildenafil and newly introducing tadalafil(Cialis(TM)) and vardenafil(Lebitralm(TM)) act as potent 'agonists' of the erectile response. Data from separate 12-week multicenter, randomized, doubleblind, placebocontrolled trials involving sildenafil, as well as tadalafil and vardenafil, have demonstrated that approximately 80% (or more) of men reported improved erections after treatment with each of these PDE5 inhibitors at the upper end of the dosing range. PDE5 inhibitors have been well tolerated. In clinical studies, vasodilator effects(e.g. headache and flushing) have generally been mild, transient, and infrequently associated with premature study discontinuation. The present article reviews the characteristics of new PDE5 inhibitors in experimental and clinical studies.

SS-Penogram: a New Diagnostic Test for Erectile Dysfunction

The clinical reports on Sildenafil sulfate (Viagra) are mainly based on individual observations. However, there is a paucity of objective studies in the literature. In order to objectively examine the effect of Sildenafil, a SS (Sexual Stimulation)- Penogram that is a non-invasive, simple and physiologic method was developed using a radioisotope (RI). One hundred and four SS-penograms were performed on patients who had a documented erectile dysfunction (ED) lasting for more than 6 months. After an intravenous injection of 99mTc-RBC (15 mCi), the first penogram was taken immediately after sexual stimulation, which was done by 30 minutes of erotic videotape viewing. Forty minutes after administering 25 to 100 mg of Sildenafil, a second penogram was taken. The characteristics of each penogram were analyzed according to a previously reported method. The results were graded as follows; Type I(normal function; 5 min or more of peak erectile response with an induction period of 1 to 6 min), Type II-A (impossible function type; i.e., showing less than 2 times the basal radioactivity level), Type II-B (the unstable type; showing less than 5 min of peak erectile response), and Type II-C (the delayed type; which showed a delay of more than 15 min after the start of sexual stimulation). The patients were grouped according to their response after Sildenafil administration, and the effect of Sildenafil was assessed by comparing the radioactivity from between 7 to 22 minutes and the changes in the characteristics of the penogram. The mean age of the patients was 44.9 +/- 10.2 (23 - 68) years. In the first penogram, Type I was found in 12 patients, and Type II-A in 14, Type II-B in73, Type II-C in 1 and a mixed (II-B + C) type was found in 4 patients. A second penogram after Sildenafil administration, showed Type I in 46 patients, and Type II-A in 10, Type II-B in 46 and a mixed type was found in 2 patients. The responses after Sildenafil were categorized as follows: 1) An excellent response group (consisting of 56 patients-53.9%); Those who showed greater than 50% increase in the RI area after Sildenafil treatment. 2) A good response group consisting of (23 patients-22.1%); i.e., those who showed a less than 50% but greater than a 20% increase in the RI area after Sildenafil administration. 3) A borderline group (consisting of 15 patients-14.4%); showing less than a 20% change in the RI area after Sildenafil treatment. 4) non-response group (consisting of 10 patients-9.6%). The therapeutic efficacy of Sildenafil, as determined by the SS-penograms, revealed that there was an augmentation in the erectile capabilities in 76% of men (79/104) but a non-response was observed in 9.6% (10/104). The efficacy of Sildenafil on the SS-penogram did not correlate with the patient's age (p=0.198). It is believed that the SS-penogram can be used to accurately evaluate the natural erectile status in sexual and pharmacological stimulation, and provides the most objective erectile response in any therapeutic trial. Consequently, the primary challenge for any erectile dysfunction remedy is to be able to demonstrate its efficacy. A further evaluation is warranted in the non-response group, which was not based on any severe organic dysfunction.

Clinical Experience of Transurethral Ethanol Injection of Prostate (TUEIP) for Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Animal and clinical experiments have recently shown that TUEIP resulted in a reduction of the prostate volume and an increase of the lumen of the prostatic urethra. We assessed the clinical efficacy of TUEIP for BPH. MATERIALS AND METHODS: Between February 2001 and December 2001, 27 patients diagnosed with BPH, and had undergone surgical management, were evaluated. With endoscopic injection set, 99% alcohol was injected into the inferior portion of the bladder neck and around the verumontanum, depending on the individual endoscopic findings. Pre-operatively, immediately after removal of the Foley catheter and at 3 months post-operatively, all the patients were evaluated with uroflowmetry and PVR, with 15 patients receiving transrectal ultrasound at 3 months post-operatively. RESULTS: The pre-operative Qmax was 8.1ml/sec, which increased to 11.8ml/sec (p<0.05) after removal of the Foley catheter, and was further increased to 13.0ml/sec (p<0.05) at 3 months post-operatively. The pre-operative PVR was 14.2ml, which increased to 15.8ml and 16.5ml after removal of the Foley catheter and at 3 months post- operatively, respectively. The pre-operative prostate volume was 39.7cc, which was reduced to 25.9cc (p<0.05) at 3 months post-operatively. There was no systematic adverse effect from alcohol absorption. CONCLUSIONS: TUEIP is considered as an effective alternative treatment of symptomatic bladder outlet obstruction caused by BPH, showing a significant increase in Qmax and reduction of the prostate volume.

Effect of Carbon Monoxide on the Relaxtion of the Rabbit Corpus Corpus Cavernosal Smooth uscle / 대한비뇨기과학회지

PURPOSE: Carbon monoxide (CO) is produced during the degradation of hemoglobin to heme (iron protoporphyrin) and present in various tissues including brain. CO is believed to activate soluble guanylate cyclase to exert its action on the smooth muscles. the effects of CO and its relationships to adrenergic or cholinergic mechanisms were studied using the isolated rabbit corpus cavernosal strips, and the effects of CO and NO were further investigated. MATERIALS AND METHODS: Using adult New Zealand rabbits, the corpus cavernosal strip was carefully prepared from rabbit penis and suspended in an 10ml organ bath containing Tyrode solution. When a stable tension level of the strip had been attained, drugs were added to the organ bath the change of motility of the strip was recorded on a computerized polygraph. RESULTS: The NO donor, sodium nitroprusside (SNP) and CO caused a dosedependent relaxation of the cavernosal strip of the rabbit penis. Pretreatment of SNP and CO had no effect on contraction induced by adrenergic drugs and the effects of SNP and CO was not affected by atropine. The relaxation effects of SNP were inhibited by NO scavenger pyrogallol, inhibitor of soluble guanylate cyclase 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ) and methylene blue. The relaxation effects of CO were significantly inhibited by ODQ and methylene blue. the relaxation effects by acetylcholine were inhibited by NO synthase inhibitor L-nitroarginine methyl ester (NAME) and deendothelialization, but not affected by zinc protoporphyrin (ZnPP), the heme oxidase inhibitor. On the immunostaining of heme oxidase (HO) in corpus cavernosal smooth muscle strip, the positive staining for HO was observed in the perivascular nerve fibers. CONCLUSIONS: The relaxation effect of NO was confirmed, and CO exerts an endothelium dependent relaxing effect on the cavernosal strip of the rabbit penis similar to NO. This action is seem to be mediated by soluble guanylate cyclase, and the actions of CO is also mediated by similar guanylate cyclase system.

The Combination Effect of Sildenafil (Viagra(R)) and SS-cream in Patients with Erectile Dysfunction and Premature Ejaculation / 대한남성과학회지

PURPOSE: Premature ejaculation is the most common problem in patients with ejaculatory dysfunction and frequently occurs with erectile dysfunction. Although sildenafil (Viagra(R)) has dramatically improved the treatment of patients with erectile dysfunction, many still complain of premature ejaculation. We investigated the combined clinical efficacy of sildenafil and SS-cream in patients with erectile dysfunction and premature ejaculation. MATERIALS AND METHODS: Of men aged over 20 years who visited our Andrology clinic with erectile dysfunction, a total of 52 patients with concomitant premature ejaculation were enrolled. Each patient was administered with sildenafil for 4 weeks and then sildenafil plus SS-cream for 4 weeks. Sexual function was measured before and after therapy using an abbreviated version of the International Index of Erectile Function-5 (IIEF-5), which includes 5 categories regarding sexual function. RESULTS: Mean score of IIEF-5 was 10.2+/-4.1 at baseline, 18.8+/-5.2 after treatment with sildenafil and 22.2+/-4.2 after treatment with sildenafil and SS-cream, respectively. Mean score of four domains of sexual function, that is, overall satisfaction, orgasmic function, erectile function, intercourse satisfaction was 1.8+/-0.4, 2.1+/-0.5, 3.8+/-0.9, 1.8+/-0.4 at baseline, 4.0+/-0.6, 3.6+/-0.6, 8.0+/-1.2, 3.4+/-0.6 after treatment with sildenafil, and 4.4+/-0.8, 4.2+/-0.6, 9.2+/-1.4, 4.4+/-0.8 after treatment with sildenafil and SS-cream, respectively. Patient satisfaction was significantly higher after sildenafil and SS-cream administration (90.4%) compared to sildenafil alone 80.8%. CONCLUSIONS: The combination of sildenafil and SS-cream is more effective in patients with erectile dysfunction and premature ejaculation compared to sildenafil alone.

Mechanical Reliability of the AMS 700CXM Inflatable Penile Prosthesis for the Treatment of Male Erectil Dysfunction / 대한비뇨기과학회지

No abstract available.

Mechanical Reliability of the AMS 700CXM Inflatable Penile Prosthesis for the Treatment of Male Erectil Dysfunction / 대한비뇨기과학회지

No abstract available.

The Relationship between Findings of Duplex Ultrasonography and ErectileDysfunction in Patients with Penile Curvature / 대한비뇨기과학회지

No abstract available.

Value of Tip/Base Rgidity Activity Unit on Interpretation of Nocturnal Penile Tumescence & Rigidity Monitoring / 대한비뇨기과학회지

No abstract available.

Penile vibratory threshold changes with various doses of SS-cream in patients with primary premature ejaculation

SS-cream made with extracts from natural products is a topical agent for treating premature ejaculation (PE). In order to elucidate the penile vibratory threshold changes and clinical effects of various doses of SS-cream, 53 patients with primary PE were investigated in a double-blind randomized placebo-controlled study. The mean age was 37.3 +/- 6.4 years and mean ejaculatory latency was 1.37 +/- 0.52 minutes. Neither the patients nor their sexual partners were satisfied with their sexual lives. Vibratory threshold at the glans penis, penile shaft, scrotum and index finger were measured using a biothesiometer twice during the screening period and three times one hour after the application of respective creams (SS-cream 0.05, 0.10. 0.15, 0.20 gm and placebo 0.10 gm) on the glans penis according to the order of the allocation table in a randomized fashion. The efficacy of SS-cream was defined as when the vibration threshold increased by more than 4 microns compared to the value tested during the screening period. The vibratory thresholds at the glans penis increased significantly in a dose-dependent manner after the application of various doses (0.05, 0.10, 0.15, 0.20 gm) of SS-cream (p < 0.001), and the efficacy of SS-cream on the penile vibration threshold increased according to the increased dosage (penile shaft: 48.4, 51.6, 54.8, 64.5%, glans penis: 58.1, 67.7, 77.4, 83.9%, respectively). With these results, we concluded that SS-cream increased the penile sensory threshold dose dependently, and therefore it is clinically effective for treating the heightened penile sensory response in patients with PE.