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Int. j. morphol ; 38(6): 1639-1644, Dec. 2020. graf
Article in English | LILACS | ID: biblio-1134491


SUMMARY: Previous studies from our group described the consequences of using ethanol on penile erection. Nevertheless, the molecular mechanisms surrounding microRNAs, apoptosis process and their relationship with erectile dysfunction associated with alcohol consumption are still poorly understood. The objective of this analysis was to evaluate the mechanism of apoptosis by the expression of AIF and PARP, as well as their regulatory microRNAs: miR-145, miR-210 and miR-486, in the corpus cavernosum of rats submitted to a semivoluntary alcoholism model. For this study 24 Wistar rats were divided into two groups: control (C) and treated with 20 % ethanol (A) for seven weeks. The corpus cavernosum samples were prepared for immunohistochemical analysis of AIF and PARP protein expression, and microRNAs miR-145, miR-210, miR-486 gene expression in cavernous tissue was performed by real time PCR. The immunohistochemical analysis showed little nuclear positive labeling for the protein PARP and AIF in the corpus cavernosum of control and ethanol treated animals. After analysis of miR-145, -210 and -486 microRNA expression in the 12 animals studied, no results were found with significant statistical difference between the control and alcoholized groups. The expression of AIF and PARP and their regulatory microRNAs involved in apoptotic process (miR-145, miR-210 and miR-486) were not altered in the corpus cavernosum of rats submitted to semivoluntary alcoholism.

RESUMEN: Estudios previos de nuestro grupo describieron las consecuencias del uso de etanol en la erección del pene. Sin embargo, los mecanismos moleculares que rodean a los microARN, el proceso de apoptosis y su relación con la disfunción eréctil asociada con el consumo de alcohol aún no se conocen bien. El objetivo de este análisis fue evaluar el mecanismo de apoptosis mediante la expresión de AIF y PARP, así como sus microARN reguladores: miR-145, miR-210 y miR-486, en el cuerpo cavernoso de ratas sometidas a un modelo de alcoholismo semivoluntario. Se dividieron 24 ratas Wistar en dos grupos: control (C) grupo de ratas tratadas con etanol al 20 % (A) durante siete semanas. Las muestras del cuerpo cavernoso se prepararon para el análisis inmunohistoquímico de la expresión de la proteína AIF y PARP, y la expresión del gen microRNAs miR-145, miR-210, miR-486 en tejido cavernoso se realizó por PCR en tiempo real. El análisis inmunohistoquímico mostró escaso etiquetado nuclear positivo para la proteína PARP y AIF en el cuerpo cavernoso de los animales de control y tratados con etanol. Después del análisis de la expresión de microARN miR-145, -210 y -486 no se encontraron resultados con diferencias estadísticas significativas entre los grupos control y alcoholizados. La expresión de AIF y PARP y sus microARN reguladores involucrados en el proceso apoptótico (miR-145, miR-210 y miR-486) no se alteraron en el cuerpo cavernoso de las ratas sometidas a alcoholismo semivoluntario.

Animals , Rats , Apoptosis , Alcoholism/metabolism , Erectile Dysfunction/metabolism , Penis/physiopathology , Penis/chemistry , Immunohistochemistry , Rats, Wistar , MicroRNAs/analysis , MicroRNAs/genetics , MicroRNAs/metabolism , Disease Models, Animal , Alcoholism/physiopathology , Apoptosis Inducing Factor/analysis , Apoptosis Inducing Factor/genetics , Apoptosis Inducing Factor/metabolism , Real-Time Polymerase Chain Reaction , Erectile Dysfunction/physiopathology
Einstein (Säo Paulo) ; 18: eAO5070, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101101


ABSTRACT Objective To evaluate epidemiological aspects of priapism in patients with sickle cell disease, and these aspects impact on adult sexual function. Methods This was a cross-sectional study including individuals with sickle cell disease who were evaluated at a reference center for sickle cell. Participants completed a structured questionnaire about their sociodemographic characteristics and priapism events. Sexual function was assessed using validated two instruments, the Erection Hardness Score and one about the sex life satisfaction. Results Sixty-four individuals with median aged of 12 (7 to 28) years were interviewed. The prevalence of priapism was 35.9% (23/64). The earliest priapism episode occurred at 2 years of age and the latest at 42 years. The statistical projection was that 71.1% of individuals of the study would have at least one episode of priapism throughout life. Patients with episodes of priapism (10/23) had significantly worse erectile function Erection Hardness Score of 2 [1-3]; p=0.01 and were less satisfied with sexual life 3 [3-5]; p=0.02. Conclusion Priapism is usually present in childhood, and severe episodes are associated with cavernous damage, impairment in the quality of the erection, and lower sexual satisfaction.

RESUMO Objetivo Avaliar aspectos epidemiológicos do priapismo em pacientes com doença falciforme e o impacto desses aspectos na função sexual de adultos. Métodos Trata-se de estudo transversal, que incluiu indivíduos com doença falciforme acompanhados em um centro de referência. Os participantes responderam a um questionário estruturado acerca das características sociodemográficas e eventos de priapismo. A função sexual foi avaliada por meio de dois instrumentos validados, a Escala de Rigidez de Ereção e um sobre satisfação com a vida sexual. Resultados Foram entrevistados 64 indivíduos com média de idade de 12 (7-28) anos. A prevalência de priapismo foi de 35,9% (23/64). O episódio mais precoce ocorreu aos 2 anos de idade e o mais tardio, aos 42 anos. A projeção estatística foi de que 71,1% desses sujeitos teriam pelo menos um episódio de priapismo ao longo da vida. Pacientes adultos com episódios de priapismo (10/23) apresentaram função erétil significativamente pior Escala de Rigidez de Ereção de 2 [1-3]; p=0,01 e estavam menos satisfeitos com a vida sexual 3 [3-5]; p=0,02. Conclusão O priapismo manifesta-se desde a infância, e episódios graves estão associados a dano cavernoso, prejuízo na qualidade da ereção e menor satisfação sexual.

Humans , Male , Child , Adolescent , Adult , Young Adult , Priapism/physiopathology , Priapism/epidemiology , Erectile Dysfunction/physiopathology , Erectile Dysfunction/epidemiology , Anemia, Sickle Cell/physiopathology , Anemia, Sickle Cell/epidemiology , Priapism/etiology , Quality of Life , Penile Erection/physiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Retrospective Studies , Age Factors , Statistics, Nonparametric , Disease-Free Survival
Int. braz. j. urol ; 45(6): 1196-1203, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056345


ABSTRACT Aims: Radical prostatectomy (RP) can result in urinary incontinence (UI) and erectile dysfunction (ED), which negatively impact quality of life (QoL). This study aimed to evaluate the effects of a perioperative pelvic floor muscle training (PFMT) program versus usual care on early recovery of urinary continence and erectile function after RP. Materials and Methods: Of 59 eligible men, 31 were randomly allocated into 2 groups: Group 1 (Control, N=15) received usual post-RP care; and Group 2 (Physical therapy, N=16) received two pre-RP physical therapist-guided PFMT sessions, including exercises and electromyographic biofeedback, and verbal and written instructions to continue PFMT until RP, which was then resumed after urethral catheter removal. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were used to evaluate UI and ED, respectively. Results: Demographic characteristics were similar in both groups. Three months after RP, the UI rate was 72.7% and 70.0% in Groups 1 and 2, respectively (P >0.05). The severity and frequency of UI and its impact on QoL were evaluated by the ICIQ-Short Form, with scores of 6.9±6.26 in Group 1 and 7.0±5.12 in Group 2 (P >0.05). The IIEF-5 scores were similar in Groups 1 and 2 (5.73±7.43 vs. 6.70±6.68, respectively) (P >0.05). Conclusion: Our pre-RP protocol of two physical therapist-assisted sessions of PFMT plus instructions did not significantly improve urinary continence or erectile function at 3 months after RP.

Humans , Male , Aged , Prostatectomy/rehabilitation , Urinary Incontinence/rehabilitation , Pelvic Floor/physiopathology , Perioperative Care/methods , Muscle Stretching Exercises/methods , Erectile Dysfunction/rehabilitation , Prostatectomy/adverse effects , Prostatectomy/methods , Prostatic Neoplasms/surgery , Prostatic Neoplasms/pathology , Quality of Life , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology , Adenocarcinoma/surgery , Adenocarcinoma/pathology , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , Neurofeedback , Neoplasm Grading , Erectile Dysfunction/etiology , Erectile Dysfunction/physiopathology , Middle Aged , Muscle Contraction/physiology , Neoplasm Staging
Int. braz. j. urol ; 45(6): 1204-1208, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1056338


ABSTRACT Purpose: This study aims to assess the association between CHA2DS2-VASc score and erectile dysfunction in patients who were admitted to cardiology outpatient clinics. Materials and methods: One hundred and two male patients who were admitted to the cardiology outpatient clinic were included to the study. Erectile dysfunction was evaluated in the urology outpatient clinic in the same hospital and scored using Turkish Version of The International Index of Erectile Function. CHA2DS2-VASc score was calculated for every patient using the current associated guidelines. Results: There was a negative correlation between The International Index of Erectile Function score and CHA2DS2-VASc score, age, hypertension, heart failure, diabetes mellitus, stroke respectively. Smoking and dislipidemia were not correlated with The International Index of Erectile Function score (p>0.05). Conclusion: CHA2DS2-VASc score can be used to detect Erectile dysfunction in patients who are admitted to the cardiology outpatient clinics.

Humans , Male , Adult , Aged , Risk Assessment/methods , Erectile Dysfunction/diagnosis , Erectile Dysfunction/physiopathology , Reference Values , Anthropometry , Cross-Sectional Studies , Reproducibility of Results , Risk Factors , Age Factors , Statistics, Nonparametric , Stroke/physiopathology , Diabetes Mellitus/physiopathology , Heart Failure/physiopathology , Hypertension/physiopathology , Middle Aged
Int. braz. j. urol ; 45(5): 1033-1042, Sept.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040068


ABSTRACT Cinnamomum cassia (Cinnamon) is a well-known traditional medicine with therapeutic benefits for centuries. We evaluated the effects of cinnamon essential oil (CEO) and its main component cinnamaldehyde (CA) on human corpus cavernosum (HCC) and rat CC. The essential oil of cinnamon was analyzed for the confirmation of the oil profile. HCC specimens from patients undergoing penile prosthesis surgery (age 48-69 years) were utilized for functional studies. In addition, erectile responses in anesthetized control and diabetic rats were evaluated in vivo after intracavernosal injection of CEO and CA, and rat CC strips were placed in organ baths. After precontraction with phenylephrine (10µM), relaxant responses to CEO and CA were investigated. CA (96.9%) was found as the major component. The maximum relaxation responses to CEO and CA were 96.4±3.5% and 96.0±5.0% in HCC and 97.5±5.5% and 96.8±4.8% in rat CC, respectively. There was no difference between control and diabetic rats in relaxation responses to CEO and CA. The relaxant responses obtained with essential oil and CA were not attenuated in the presence of nitric oxide synthase (NOS) inhibitor, and soluble guanylate cyclase inhibitor (sGS) in CC. In vivo, erectile responses in diabetic rats were lower than in control rats, which was restored after intracavernosal injection of CEO and CA. CEO and CA improved erectile function and relaxation of isolated strips of rat CC and HCC by a NO/cGMP-independent mechanism. Further investigations are warranted to fully elucidate the restorative effects of CEO and CA on diabetic erectile dysfunction.

Humans , Animals , Male , Aged , Penis/drug effects , Acrolein/analogs & derivatives , Oils, Volatile/pharmacology , Cinnamomum zeylanicum/chemistry , Muscle Relaxation/drug effects , Penis/physiopathology , Phenylephrine/pharmacology , Vasoconstrictor Agents/pharmacology , Acrolein/pharmacology , Penile Erection/drug effects , Penile Erection/physiology , Reproducibility of Results , Analysis of Variance , Rats, Sprague-Dawley , Phosphodiesterase 5 Inhibitors/pharmacology , Sildenafil Citrate/pharmacology , Erectile Dysfunction/physiopathology , Erectile Dysfunction/drug therapy , Middle Aged , Muscle Relaxation/physiology
Int. braz. j. urol ; 45(4): 703-712, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019887


ABSTRACT Introduction Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. Materials and Method Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and follow-up data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.

Humans , Male , Adult , Aged , Aged, 80 and over , Prostatectomy/methods , Urination/physiology , Penile Erection/physiology , Recovery of Function/physiology , Robotic Surgical Procedures/methods , Prostatic Neoplasms/surgery , Prostatic Neoplasms/physiopathology , Time Factors , Urinary Incontinence/physiopathology , Brazil , Adenocarcinoma/surgery , Adenocarcinoma/physiopathology , Body Mass Index , Retrospective Studies , Age Factors , Treatment Outcome , Kaplan-Meier Estimate , Erectile Dysfunction/physiopathology , Middle Aged
Acta cir. bras ; 34(8): e201900803, 2019. graf
Article in English | LILACS | ID: biblio-1038126


Abstract Purpose To evaluate changes in the quantity of elastic fibers in the corpora cavernosa of rats during the natural aging process, and to assess the degree of this change by determining volumetric density (Vv) at different ages via stereological analysis. Methods Forty-eight rats, raised under similar conditions, were subjected to the natural aging process and divided into four groups (G1 to G4), according to age at the time of penectomy (6, 9, 12, and 24 months, respectively). Histological sections of the middle segment of the penis were stained with Weigert's resorcin-fuchsin, and the volumetric density (Vv) of elastic fibers of the corpora cavernosa were determined via stereological analysis. Results There were no statistically significant differences in Vv among groups G1, G2, and G3. These three groups were therefore considered as a single group. The mean Vv of this group showed a statistically significant reduction compared to that of G4 (0.16 vs. 0.11, p<0.05). Conclusion Natural aging in rats was responsible for a reduction in volumetric density of elastic fibers of the corpora cavernosa (approximately 30% decrease in Vv) during senescence.

Animals , Male , Rats , Penis/cytology , Aging/physiology , Endothelial Cells/physiology , Elastic Tissue/ultrastructure , Penis/physiology , Aging/pathology , Collagen/physiology , Collagen/ultrastructure , Rats, Wistar , Models, Animal , Elastic Tissue/physiology , Elastic Tissue/pathology , Erectile Dysfunction/physiopathology
Int. braz. j. urol ; 44(4): 680-687, July-Aug. 2018. tab
Article in English | LILACS | ID: biblio-954070


ABSTRACT Background: Obesity is a worldwide challenging health problem. Weight loss through medical management of obesity has not always been successful, thus, giving rise to the need for surgical intervention. Bariatric surgery has been shown to be helpful for morbidly obese patients. However, studies have also shown the effect of surgery on stone formation, fertility and erectile function. This review summarizes the main findings of several studies that analyze stone formation and fertility in men as well as erectile function post bariatric surgery. The underlying pathophysiologic alterations post bariatric surgery include increased absorption of oxalate leading to hyperoxaluria, hypocitraturia and increased urinary calcium oxalate supersaturation. Contradicting data exist on the effect of bariatric surgery on fertility and erectile function. Further studies are needed to analyze the mechanisms.

Humans , Male , Penile Erection/physiology , Kidney Calculi/etiology , Bariatric Surgery/adverse effects , Infertility, Male/etiology , Postoperative Complications/physiopathology , Calcium Oxalate/metabolism , Gastric Bypass/adverse effects , Kidney Calculi/physiopathology , Risk Factors , Erectile Dysfunction/physiopathology , Infertility, Male/physiopathology , Obesity/complications , Obesity/physiopathology , Obesity/therapy
Int. j. cardiovasc. sci. (Impr.) ; 30(6): f:542-l:544, Nov.-Dez. 2017.
Article in Portuguese | LILACS | ID: biblio-876171


Na fisiopatologia da Insuficiência Cardíaca (IC) tem-se dado destaque à hiperatividade simpática e à inflamação sistêmica de baixa intensidade, aspectos também presentes na disfunção erétil (DE). O exercício físico constitui-se estratégia que proporciona melhora desses parâmetros sendo plausível a hipótese de que quando exercido por meio da dança proporcionaria melhores resultados. Ao unir atividade física e música, a dança seria capaz, dentre outros mecanismos favoráveis, aprimorar o funcionamento das redes neurais centrais e periféricas, contribuindo para o restabelecimento da normalidade da função neuro-hormonal e redução da resposta inflamatória, o que aumentaria a eficácia do tratamento tanto da IC quanto da DE.

Humans , Male , Dancing , Erectile Dysfunction/physiopathology , Heart Failure/mortality , Heart Failure/physiopathology , Exercise , Inflammation
Int. braz. j. urol ; 43(4): 753-761, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-892855


ABSTRACT Objective Diabetes affects the erectile function significantly. However, the penile alterations in the early stage of diabetes in experimental animal models have not been well studied. We examined the changes of the penis and its main erectile components in diabetic rats. Materials and methods Male Sprague-Dawley rats were divided into 2 groups: streptozotocin (STZ)-induced diabetics and age-matched controls. Three or nine weeks after diabetes induction, the penis was removed for immunohistochemical staining of smooth muscle and neuronal nitric oxide synthase (nNOS) in midshaft penile tissues. The cross-sectional areas of the whole midshaft penis and the corpora cavernosa were quantified. The smooth muscle in the corpora cavernosa and nNOS in the dorsal nerves were quantified. Results The weight, but not the length, of the penis was lower in diabetics. The cross-sectional areas of the total midshaft penis and the corpora cavernosa were lower in diabetic rats compared with controls 9 weeks, but not 3 weeks after diabetes induction. The cross-sectional area of smooth muscle in the corpora cavernosa as percentage of the overall area of the corpora cavernosa was lower in diabetic rats than in controls 9 weeks, but not 3 weeks after diabetes induction. Percentage change of nNOS in dorsal nerves was similar at 3 weeks, and has a decreased trend at 9 weeks in diabetic rats compared with controls. Conclusions Diabetes causes temporal alterations in the penis, and the significant changes in STZ rat model begin 3-9 weeks after induction. Further studies on the reversibility of the observed changes are warranted.

Animals , Male , Rats , Penis/physiopathology , Diabetes Mellitus, Experimental/complications , Diabetes Mellitus, Type 1/complications , Erectile Dysfunction/etiology , Muscle, Smooth/physiopathology , Penis/innervation , Rats, Sprague-Dawley , Diabetes Mellitus, Experimental/physiopathology , Diabetes Mellitus, Type 1/physiopathology , Nitric Oxide Synthase Type I/metabolism , Erectile Dysfunction/physiopathology
Int. braz. j. urol ; 43(2): 317-324, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-840825


ABSTRACT Objective To investigate the effect of a 5mg daily tadalafil treatment on the ejaculation time, erectile function and lower urinary tract symptoms (LUTS) in patients with erectile dysfunction. Materials and Methods A total of 60 patients diagnosed with erectile dysfunction were retrospectively evaluated using the international index of erectile function questionnaire-5 (IIEF-5), intravaginal ejaculatory latency time (IELT) and international prostate symptoms scores (IPSS). After the patients were treated with 5mg tadalafil once a day for three months, their erection, ejaculation and LUTS were assessed again. The fasting levels of blood glucose, total testosterone, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol were measured. The independent-samples t-test was used to compare the pre- and post-treatment scores of the patients. Results The mean age of the 60 participants was 50.4±7.9 and the mean baseline serum total testosterone, total cholesterol, and fasting blood sugar were 444.6±178.6ng dL-1, 188.7±29.6mg/dL-1,104 (80-360) mg dL-1, respectively. The mean baseline scores were 2.2±1.4 min for IELT, 9.5±3.7 for IIEF-5 and 14.1±4.5 for IPSS. Following the three-month daily 5mg tadalafil treatment, the scores were found to be 3.4±1.9 min, 16.1±4.7, and 10.4±3.8 for IELT, IIEF and IPSS, respectively. When the baseline and post-treatment scores were compared, a statistically significant increase was observed in the IELTs and IIEF-5 values whereas there was a significant decrease in IPSS (p<0.01). Conclusion A daily dose of 5mg tadalafil can be safely used in the treatment of erectile dysfunction and LUTS, that prolongs the ejaculatory latency time.

Humans , Male , Adult , Aged , Penile Erection/drug effects , Ejaculation/drug effects , Phosphodiesterase 5 Inhibitors/administration & dosage , Lower Urinary Tract Symptoms/drug therapy , Premature Ejaculation/drug therapy , Tadalafil/administration & dosage , Erectile Dysfunction/drug therapy , Testosterone/blood , Time Factors , Blood Glucose/analysis , Penile Erection/physiology , Drug Administration Schedule , Cholesterol/blood , Surveys and Questionnaires , Retrospective Studies , Treatment Outcome , Statistics, Nonparametric , Ejaculation/physiology , Lower Urinary Tract Symptoms/physiopathology , Premature Ejaculation/physiopathology , Erectile Dysfunction/physiopathology , Middle Aged
Int. braz. j. urol ; 43(1): 127-133, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-840809


ABSTRACT Objectives To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? Materials and Methods In this prospective study, consecutive male patients presenting with PFUDD were included from Feb 2011 till Dec 2012. Those with traumatic spinal cord injury and pre-existing ED were excluded. Patients were assessed using IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU) and MRI pelvis. Primary end point was erectile function and secondary end point was surgical outcome. Results Twenty patients were included in this study. Fourteen patients (70%) were ≤40years; fifteen patients (75%) had ED, seven patients (35%) had severe ED. MRI findings associated with ED were longer median UDD (23mm vs. 15mm, p=0.07), cavernosal injury (100%, p=0.53), rectal injury (100%, p=0.53), retropubic scarring (60%, p=0.62) and prostatic displacement (60%, p=0.99). Twelve patients (60%) had a good surgical outcome, five (25%) had an acceptable outcome, three (15%) had a poor outcome. Poor surgical outcome was associated with rectal injury (66.7%, p=0.08), cavernosal injury (25%, p=0.19), retropubic scarring (18.1%, p=0.99) and prostatic displacement (16.7%, p=0.99). Five patients with normal erections had good surgical outcome. Three patients with ED had poor outcome (20%, p=0.20). Conclusions MRI did not offer significant advantage over MCU in the subgroup of men with normal erections. Cavernosal injury noted on MRI strongly correlated with ED. Role of MRI may be limited to the subgroup with ED or an inconclusive MCU.

Humans , Male , Adolescent , Adult , Young Adult , Pelvis/injuries , Pelvis/diagnostic imaging , Urethra/injuries , Urethra/diagnostic imaging , Urethral Diseases/diagnostic imaging , Magnetic Resonance Imaging/methods , Erectile Dysfunction/diagnostic imaging , Pelvis/surgery , Prostatic Diseases/physiopathology , Prostatic Diseases/diagnostic imaging , Urethra/surgery , Urethra/physiopathology , Urethral Diseases/surgery , Urethral Diseases/physiopathology , Urination/physiology , Radiography , Pilot Projects , Prospective Studies , Surveys and Questionnaires , Reproducibility of Results , Treatment Outcome , Statistics, Nonparametric , Preoperative Period , Erectile Dysfunction/etiology , Erectile Dysfunction/physiopathology , Middle Aged
Braz. J. Pharm. Sci. (Online) ; 53(4): e17141, 2017. tab
Article in English | LILACS | ID: biblio-889423


ABSTRACT Alcohol is the most commonly consumed substance in the world. The objective of this study was to evaluate the influence of alcoholic beverages on male reproduction and possible alterations in their offspring. The mice were divided into 4 groups: beer, wine, cachaça (a type of sugarcane rum), with ethanol concentrations of 1.9 g/kg, and control group treated with PBS. The treatment period was 35 days. The animals which received cachaça, demonstrated significant weight loss in the testes and epididymis. The alcoholic beverages promoted significant testosterone level and fertilization index diminution, and morphological alterations in the spermatozoa. The beer group presented decreased implantation sites and a high frequency of dominant lethal. The number of reabsorptions in the wine group was increased. The fermented beverages presented higher potential to induce visceral malformations, while the cachaça caused fetal skeletal malformations. The cachaça treated group presented a negative impact on semen quality and fertilization potential. The treatment with different alcoholic beverages, during spermatogenesis, demonstrated contrasting degrees of induction of toxic effects, interfering in a general aspect in male reproductive performance, fetal viability during intrauterine life, and birth defects. From the data, it is possible to infer that the distillated beverage caused more harmful effects to reproduction in this study.

Animals , Male , Female , Mice , Reproduction/drug effects , Wine/adverse effects , Alcoholic Beverages/analysis , Fertilization , Beer/adverse effects , Erectile Dysfunction/physiopathology , Infertility, Male/prevention & control
Braz. j. otorhinolaryngol. (Impr.) ; 82(5): 529-535, Sept.-Oct. 2016. tab, graf
Article in English | LILACS | ID: biblio-828225


ABSTRACT INTRODUCTION: The complex relationship between sleep disorders and hormones could lead to alterations in the production of cortisol and testosterone in obstructive sleep apnea (OSA) patients. OBJECTIVE: The purpose of this study was to determine the diurnal trajectories of salivary free-testosterone, free-cortisol and their ratio (T/C). METHODS: Ten subjects newly diagnosed with OSA, based on nocturnal polysomnography evaluation and excessive daytime sleepiness, and seven matched controls were consecutively recruited. Cortisol and testosterone were measured in salivary samples collected upon awakening, at noon and in the evening. The psychometric evaluation of anxiety/depression and referred sexual function disturbances was performed to evaluate the presence of neuropsychological comorbidities. RESULTS AND CONCLUSION: The main finding was that OSA subjects displayed hypocortisolism upon awakening and a significant reduction in testosterone concentration in the evening in comparison with the control group, which has maintained the physiological testosterone and cortisol diurnal fluctuation, with higher hormone concentrations in the morning and lower concentrations in the evening. The use of data from multiple diurnal measurements rather than a single point allowed the detection of T/C ratio changes of opposite signs at the beginning and end of the day: the OSA subjects had a higher T/C ratio than the controls in the morning, while their T/C ratio was significantly lower than that of the controls in the evening. The imbalances in the anabolic-catabolic diurnal equilibrium suggest that OSA is associated with a dysregulation of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes, potentially an underlying cause of some of the neuropsychological comorbidities observed in OSA patients.

Resumo Introdução: A relação complexa entre os distúrbios do sono e os hormônios pode levar a alterações na produção de cortisol e testosterona em pacientes com Apneia obstrutiva do sono (AOS). Objetivo: O objetivo deste estudo foi determinar as curvas diurnas de testosterona e cortisol livres na saliva e sua proporção (razão T/C). Método: Dez indivíduos recém-diagnosticados com AOS com base na avaliação por polissonografia noturna e sonolência diurna excessiva e sete controles pareados foram recrutados, consecutivamente. Cortisol e testosterona foram medidos em amostras de saliva coletadas ao acordar, ao meio-dia e à noite. A avaliação psicométrica dos distúrbios de ansiedade/depressão e função sexual mencionados foi realizada para detectar a presença de comorbidades neuropsicológicas. Resultados: O achado principal foi que os indivíduos com AOS apresentam hipocortisolismo ao acordar e uma redução significante na concentração de testosterona à noite, em comparação com o grupo controle, que manteve a variação fisiológica diurna de testosterona e cortisol com concentrações hormonais mais elevadas pela manhã e concentrações mais baixas durante a noite. O uso de dados de várias mensurações diurnas, em vez de uma única mensuração, permitiu detectar as alterações na razão T/C de sinais opostos no início e no final do dia: os indivíduos com AOS apresentaram razão T/C maior que os controles na parte da manhã, enquanto que a razão T/C foi significantemente inferior à dos controles durante a noite. Conclusão: Os desequilíbrios no balanço anabólico-catabólico diurno sugerem que a AOS está associada a uma desregulação dos eixos hipotálamo-hipófise-adrenal e hipotálamo-hipófise-gonadal, potencialmente a causa subjacente de algumas das comorbidades neuropsicológicas observadas em pacientes com AOS.

Humans , Male , Female , Adult , Middle Aged , Saliva/chemistry , Testosterone/metabolism , Hydrocortisone/metabolism , Sleep Apnea, Obstructive/metabolism , Anxiety/physiopathology , Anxiety/metabolism , Pituitary-Adrenal System/physiopathology , Pituitary-Adrenal System/metabolism , Severity of Illness Index , Case-Control Studies , Prospective Studies , Circadian Rhythm , Polysomnography , Sleep Apnea, Obstructive/physiopathology , Depression/physiopathology , Depression/metabolism , Hypothalamo-Hypophyseal System/physiopathology , Hypothalamo-Hypophyseal System/metabolism , Erectile Dysfunction/physiopathology , Erectile Dysfunction/metabolism
Int. braz. j. urol ; 42(4): 825-837, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-794686


ABSTRACT Introduction: We investigate the effect of active peptide from Urechis unicinctus (UU) by high temperature/pressure and ultra-wave assisted lysis on erectile dysfunction in streptozotocin-induced diabetic rats. Materials and Methods: Forty 12-week-old Sprague-Dawley rats were used in this study. Diabetes was induced by a one-time intraperitoneal injection of streptozotocin (50mg/kg). One week later, the diabetic rats were randomly divided into four groups: normal control, untreated diabetes control, and groups treated with 100 or 500mg/kg/d UU peptide. Rats were fed with UU peptide by intragastric administration for 8 weeks. After 8 weeks, penile hemodynamic function was evaluated in all groups by measuring the intracavernosal pressure after electrostimulating the cavernous nerve. Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) activities were measured and endothelial nitric oxide synthase (eNOS) and neuronal NOS (nNOS) protein expression was determined by Western blot. Results: Maximum intracavernosal pressure in diabetic control rats decreased significantly compared to normal control rats, and was increased significantly compared to untreated diabetic rats after UU peptide supplementation. Treatment with the higher dose of UU peptide significantly increased the NO and cGMP levels compared with the diabetic control group. Decreased activity and expression eNOS and nNOS were found in the diabetic rats compared with the normal control group. Decreased eNOS and nNOS in diabetic rats were improved by UU peptide administration. Conclusions: Active peptide from UU ameliorates erectile function in a streptozotocin induced diabetic rat model of erectile dysfunction.

Animals , Male , Rats , Peptides/pharmacology , Diabetes Mellitus, Experimental/complications , Erectile Dysfunction/drug therapy , Annelida/chemistry , Penis/drug effects , Peptides/analysis , Peptides/therapeutic use , Temperature , Random Allocation , Cells, Cultured , Rats, Sprague-Dawley , Streptozocin , Diabetes Mellitus, Experimental/chemically induced , Erectile Dysfunction/etiology , Erectile Dysfunction/physiopathology
Int. braz. j. urol ; 42(3): 540-545, tab, graf
Article in English | LILACS | ID: lil-785726


ABSTRACT This prospective analysis assessed the effect of histological prostatitis on lower urinary tract functions and sexual function. The patients were separated into two groups as histologically observed prostatitis (Group A) and no prostatitis (Group B) according to the biopsy outcomes. International prostate symptom score, international index of erectile function-5 scores, maximal and average flow rate, and residual urine volumes were compared statistically between groups. There was no significant difference (P>0.05) in baseline age (t=0.64), body mass index value (t=0.51), prostate volume (t=0.87), prostate-specific antigen levels (t=0.43), maximal (t=0.84) and average flow rate (t=0.59), and post-void residual urine volume (t=0.71). Mean international prostate symptom score in patients with prostatitis was numerically but not significantly higher than that in those without prostatitis (t=0.794, P=0.066). Mean international index of erectile function-5 score in the prostatitis group was significantly lower than that in those without prostatitis (t=1.854, P=0.013). Histological prostatitis notably affected sexual function of patients and may serve as a major risk factor for sexual dysfunction while having little effect on lower urinary tract symptoms.

Humans , Male , Aged , Prostatitis/physiopathology , Prostatitis/pathology , Lower Urinary Tract Symptoms/physiopathology , Erectile Dysfunction/physiopathology , Organ Size , Prostate/pathology , Prostatic Hyperplasia/physiopathology , Prostatic Hyperplasia/pathology , Biopsy, Needle , Severity of Illness Index , Body Mass Index , Chronic Disease , Multivariate Analysis , Prospective Studies , Prostate-Specific Antigen/blood , Statistics, Nonparametric , Disease Progression , Lower Urinary Tract Symptoms/pathology , Erectile Dysfunction/pathology , Middle Aged
Int. braz. j. urol ; 42(1): 123-131, Jan.-Feb. 2016. tab, graf
Article in English | LILACS | ID: lil-777334


ABSTRACT Objective To investigate the association between the severity of erectile dysfunction (ED) and coronary artery disease (CAD) in men undergoing coronary angiography for angina or acute myocardial infarct (AMI). Material and Methods We studied 132 males who underwent coronary angiography for first time between January and November 2010. ED severity was assessed by the international index of erectile function (IIEF-5) and CAD severity was assessed by the Syntax score. Patients with CAD (cases) and without CAD (controls) had their IIEF-5 compared. In the group with CAD, their IIEF-5 scores were compared to their Syntax score results. Results We identified 86 patients with and 46 without CAD. The IIEF-5 score of the group without CAD (22.6±0.8) was significantly higher than the group with CAD (12.5±0.5; p<0.0001). In patients without ED, the Syntax score average was 6.3±3.5, while those with moderate or severe ED had a mean Syntax score of 39.0±11.1. After adjustment, ED was independently associated to CAD, with an odds ratio of 40.6 (CI 95%, 14.3-115.3, p<0.0001). The accuracy of the logistic model to correctly identify presence or absence of CAD was 87%, with 92% sensitivity and 78% specificity. The average time that ED was present in patients with CAD was 38.8±2.3 months before coronary symptoms, about twice as high as patients without CAD (18.0±5.1 months). Conclusions ED severity is strongly and independently correlated with CAD complexity, as assessed by the Syntax score in patients undergoing coronariography for evaluation of new onset coronary symptoms.

Humans , Male , Female , Severity of Illness Index , Coronary Artery Disease/physiopathology , Coronary Artery Disease/diagnostic imaging , Coronary Angiography/methods , Erectile Dysfunction/physiopathology , Time Factors , Coronary Artery Disease/complications , Risk , ROC Curve , Analysis of Variance , Statistics, Nonparametric , Angina, Stable/complications , Angina, Stable/physiopathology , Angina, Stable/diagnostic imaging , Erectile Dysfunction/etiology , Angina, Unstable/complications , Angina, Unstable/physiopathology , Angina, Unstable/diagnostic imaging , Middle Aged , Myocardial Infarction/complications , Myocardial Infarction/physiopathology , Myocardial Infarction/diagnostic imaging
Int. braz. j. urol ; 42(1): 139-145, Jan.-Feb. 2016. graf
Article in English | LILACS | ID: lil-777321


ABSTRACT Purpose To investigate whether intracavernosal injection of short hairpin RNA for IGFBP-3 could improve erectile function in streptozotocin-induced diabetic rats. Materials and methods After 12 weeks of IGFBP-3 short hairpin RNA injection treatment, intracavernous pressure responses to electrical stimulation of cavernous nerves were evaluated. The expression of IGFBP-3 and IGF-1 at mRNA and protein levels were detected by quantitative real-time PCR analysis and Western blot, respectively. The concentration of cavernous cyclic guanosine monophosphate was detected by enzyme-linked immunosorbent assay. Results At 12 weeks after intracavernous administration of IGFBP-3 shRNA, the cavernosal pressure was significantly increased in response to the cavernous nerves stimulation compared to the diabetic group (P<0.05). Cavernous IGFBP-3 expression at both mRNA and protein levels was significantly inhibited. At the same time, cavernous IGF-1 expression was significantly increased in the IGFBP-3 shRNA treatment group compared to the diabetic group (P<0.01). Cavernous cyclic guanosine monophosphate concentration was significantly increased in the IGFBP-3 shRNA treatment group compared to the diabetic group (P<0.01). Conclusions Gene transfer of IGFBP-3 shRNA could improve erectile function via the restoration of cavernous IGF-1 bioavailability and an increase of cavernous cGMP concentration in the pathogenesis of erectile dysfunction in streptozotocin-induced diabetic rats.

Animals , Male , Penis/drug effects , Insulin-Like Growth Factor Binding Protein 3/pharmacokinetics , RNA, Small Interfering/pharmacokinetics , Diabetes Mellitus, Experimental/physiopathology , Erectile Dysfunction/physiopathology , Erectile Dysfunction/drug therapy , Insulin-Like Growth Factor I/analysis , Insulin-Like Growth Factor I/drug effects , Enzyme-Linked Immunosorbent Assay , Biological Availability , Random Allocation , Blotting, Western , Reproducibility of Results , Rats, Wistar , Streptozocin , Diabetes Mellitus, Experimental/complications , Real-Time Polymerase Chain Reaction , Erectile Dysfunction/etiology , Injections
Int. braz. j. urol ; 41(3): 547-551, May-June 2015. tab
Article in English | LILACS | ID: lil-755874



Pseudoexfoliation syndrome (PES) is a common age-related fibrillopathy related to accumulation of pseudoexfoliation material (PEM) in certain places in the body, especially blood vessels. Erectile dysfunction (ED) is another condition related to vascular pathology and in this study it is aimed to identify the relationship between ED and PES.

Materials and Methods:

Data of 92 patients were investigated. There were 34 patients in the PES group and 58 patients in the control group. Presence of diabetes, hypertension, smoking history, BMI, and serum levels of lipids and testosterone were recorded. The groups were compared for ED rates and severity. Also logistic regression analysis was performed to identify independent risk factors for development of ED.


Mean age of the population was 67.3. No significant difference was observed between the two groups regarding the presece of DM, HT, smoking, BMI and laboratory measurements. ED rate was significantly higher in the PES group (70.6% vs 48.3%, p=0.002). Also, severe ED rate was higher in the PES group (p=0.002). PES was detected as an independent risk factors for the development of ED.


ED is a possible consequence of PES. ED rate and severity is found to be higher in the PES group and PES is detected as an independent risk factor for development of ED. Patients with PES should be informed about development of ED and further prospective trials with objective measurements of penile blood flow should be conducted to verify the erectile status and penile blood fow in PES patients.


Aged , Humans , Male , Middle Aged , Endothelium, Vascular , Erectile Dysfunction/etiology , Exfoliation Syndrome/complications , Vascular Diseases/complications , Age Factors , Body Mass Index , Cholesterol/blood , Diabetes Complications , Epidemiologic Methods , Endothelium, Vascular/physiopathology , Erectile Dysfunction/physiopathology , Exfoliation Syndrome/physiopathology , Hypertension/complications , Penis/blood supply , Risk Factors , Smoking/adverse effects , Triglycerides/blood , Vascular Diseases/physiopathology