International Journal of Impotence Research最新文献

Over the years, numerous epidemiological studies have shown that chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) promotes erectile dysfunction. Nonetheless, the precise underlying mechanism remains to be fully clarified. The objective of this research was to identify crucial signaling pathways responsible for CP/CPPS-induced erectile dysfunction. Thirty 8-week-old male Sprague‒Dawley rats were randomly assigned to either the CP/CPPS model group or the control group. The CP/CPPS rat model was established through subcutaneous injection of a combination of rat prostate protein and Freund's adjuvant. Penile erectile function assessment was conducted 45 days after immunization through electrical stimulation of the cavernous nerve. RNA sequencing of the corpus cavernosum of the penis was then performed using the Kyoto Encyclopedia of Genes and Genomes and protein‒protein interaction network analysis. Western blotting was performed on the cavernous tissue. Cell apoptosis assays, cell counting kit-8 assays, cell cloning assays, and Western blotting were conducted on rat endothelial cells. Erectile function was significantly lower in the CP/CPPS model group than in the control group (p < 0.001). Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that differentially expressed genes were predominantly enriched in the apoptosis pathway. Moreover, an increase in apoptosis in the rat corpus cavernosum, along with a decrease in the protein expression of CD31 (p = 0.0089) and eNOS (p = 0.0069) following CP/CPPS induction, was observed. In a protein‒protein interaction network, Pitx2 was recognized as a central gene. The role of Pitx2 in regulating apoptosis was demonstrated in experiments using rat endothelial cell lines, and it was found to be regulated by the Wnt/β-catenin pathway. This study highlights the occurrence of cavernous endothelial cell apoptosis in CP/CPPS-induced erectile dysfunction, and the potential mechanism of apoptosis may involve inhibition of the Wnt/β-catenin/Pitx2 pathway.

The incidence of low serum testosterone has been increasing in men of all ages across a period which also corresponds to an increasing prevalence of kidney stones. Currently, the relationship between testosterone and kidney stones is unclear. Using the TriNetX Research Network, we performed a retrospective cohort study to evaluate the risk of developing an initial kidney stone in men based on their total testosterone level. Men aged ≥18 were divided into a low testosterone (<300 ng/dL) and normal testosterone (≥ 300 ng/dL) cohort. Men were excluded if they had a history of a kidney stone encounter diagnosis before testosterone measurement and a history of testosterone therapy prescription at any point. Propensity score matching was employed with an absolute standardized mean difference of less than 0.1 used as an indicator of successful matching. Our main outcome of interest was risk of developing an initial kidney stone in men aged ≥18 and within age-based subgroups. In men 18 and older, low testosterone was associated with a higher risk of one or more kidney stone encounter diagnoses (HR 1.12, 95% CI [1.09-1.15]). When stratified by age, no significant association between low testosterone and kidney stone encounter diagnoses was seen in men aged 18-24 (HR 1.09, 95% CI [0.85-1.39]). The highest risk was observed in men with low testosterone aged 34-44 (HR 1.29, 95% CI [1.17-1.38]). In this study, low serum testosterone was associated with an increased risk of initial kidney stone diagnosis in adult men without testosterone therapy prescriptions at any point in their life. Stratifying by age, the increased risk appears to begin in men aged 25, with the highest observed risk in men aged 33-44.

Despite the widespread use of narrow diameter inflatable penile prosthesis (IPP) cylinders in patients with corporal fibrosis, outcomes data is sparse. We evaluated patients who underwent IPP placement with AMS™ 700 Controlled Expansion Restricted (CXR) cylinders from 2007-2021. Patient characteristics, device details, and surgical outcomes were assessed. A non-validated questionnaire was also distributed to patients to assess satisfaction. Among 982 IPPs placed over the study period at our institution, 49 (5.0%) used CXR cylinders. Indications for narrow cylinders: prior explant for infection (67.3%), ischemic priapism (16.3%), and idiopathic fibrosis (16.3%). Median corporal length was 19 cm (IQR 17-21 cm). Discordant intraoperative corporal measurements (24.5%) and RTE lengths (26.5%) were common. Post-operative complications occurred in 8 patients (16.3%) and included 3 infections (6.1%), 2 cylinder herniations (4.1%), 2 mechanical failures (4.1%), and one case of glans necrosis (2.0%). Five of these (10.2%) required explantation, while 4 (8.2%) were managed with revision. Over the follow-up period, 73.5% of patients reported satisfaction with rigidity. Primary drivers of dissatisfaction were perceived loss of penile length and girth. The AMS™ 700 CXR is a useful tool for challenging corporal fibrosis cases and shows acceptable surgical outcomes with moderate patient acceptability.

The COVID-19 pandemic has markedly influenced people's lifestyle and sexual behaviors, including masturbation patterns. This study delved into how masturbation frequency could impact anxiety levels, sleep quality, and somatic symptoms post-masturbation among Chinese adults during this period. From December 2022 to January 2023, we conducted a cross-sectional survey, gathering data via WenJuanXing, a leading online survey platform in China. This platform facilitated the recruitment of a diverse cohort, spanning various age groups and geographical locations. Masturbation frequency among participants was subjectively categorized into three levels: 'lesser' (a few times over the past year), 'moderate' (once to three times a month), and 'greater' (weekly to almost daily). To assess anxiety levels and sleep quality, we employed the Generalized Anxiety Disorder 7-item (GAD-7) scale and the Pittsburgh Sleep Quality Index (PSQI), respectively. Among 1500 participants, we received 1423 valid responses. Among these, 65% (n = 930) reported engaging in masturbation in the past year, of whom 87.5% reported subjectively experiencing various levels of fatigue post-masturbation. These 930 responses were subsequently analyzed in-depth (e.g., non-parametric test and pathway analysis), with ages ranging from 18 to 54 years (mean age = 30.5, SD = 7.42). Notably, our findings indicate that participants with greater masturbation frequency exhibited higher anxiety levels [GAD-7 median score: 6 (lesser) vs. 4 (moderate) vs. 8 (greater), p < 0.001, Cohen's f = 0.41] and poorer sleep quality [PSQI median score: 5 (lesser) vs. 4 (moderate) vs. 7 (greater), p < 0.001, Cohen's f = 0.46]. A rough positive correlation between masturbation frequency and PSQI score was also observed (β = 0.16, p < 0.001). These results suggest potential mental and sleep benefits at moderate frequencies, especially in contrast to greater frequencies. However, the cross-sectional design and subjective categorization of masturbation frequency in our study limit our ability to draw definitive causal conclusions. These limitations highlight the need for future longitudinal research employing more precise categorizations of masturbation behavior, such as frequency, to delve deeper into these relationships and understand their underlying mechanisms.

Priapism is a rare condition characterized by prolonged and often painful penile erection unrelated to sexual stimulation. Ischemic priapism, the most common subtype, requires immediate attention to prevent irreversible damage to erectile tissue. This narrative review explores the initial management strategies for ischemic priapism. Intracavernosal phenylephrine injection and aspiration with or without irrigation are recommended as first-line treatments, with alternative options available depending on clinical settings and patient factors. While guidelines offer clear recommendations for priapism lasting more than 4 h, management of shorter-duration cases remains challenging due to limited evidence.