Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

How to recognize late-onset hypogonadism in men wit sexual dysfunction

Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.

The effects of comprehensive nursing interventions on sexual functions in young and middle-aged patients with coronary stent implantation

Objective: To study the effects of comprehensive nursing interventions on sexual functions in young and middle-aged patients with coronary stent implantation. Methods: 96 cases of coronary stent implantation were randomly divided into control group and intervention group (experimental group) with each group of 48 cases. The control group received the routine nursing measures after the coronary stent implantation and the experimental group was treated by the comprehensive nursing interventions such as psychological nursing, education of sexual knowledge, playing the full enthusiasm of spouse and appropriate exercise therapy on basis of the routine nursing measures. The two groups were given the questionnaire of brief male sexual function questionnaire (BSFI), Chinese patients with premature ejaculation sexual function score (C-ISFPE) and the international index of erectile function (IIEF-5). The scores of BSFI, C-ISFPE and IIEF-5 were compared between the two groups. Results: There were 29 cases who were satisfied with sexual life on the whole (≤1), 26 cases with different degrees of premature ejaculation symptoms and 21 cases with erectile dysfunctions, which were respectively 27.08%, 30.2% and 21.87% of the total number. The scores of BSFI, C-ISFPE and IIEF-5 inthe experimental group were significantly increased after the interventions (P P IIEF-5 scores in the two groups were significantly different

Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.

Effects of Bisphenol A on Testosterone Levels and Sexual Behaviors of Male Mice

Objective: To evaluate the effects of bisphenol A (BPA) on testosterone levels and sexual behaviors of male mice. Methods: Forty 12-week-old male mice, 22 - 25 g, were randomly allocated into four equal groups (n = 10 per group): the control group and three BPA exposure groups including low concentration group (10 mg/kg), middle concentration group (50 mg/kg) and high concentration group (100 mg/kg). Each mouse received BPA intraperitoneally injected for 21 consecutive days. Sexual behaviors and testosterone levels in serum and interstitial tissue of testis were measured after the last administration of BPA. Furthermore, we also observed the weights of sexual organs of each group, including testis, epididymis and seminal vesicle. Results: The mount latency in the high concentration group, the intromission latency in the middle and the high concentration group were 11.64 ± 2.67 min, 20.28 ± 3.40 min and 20.13 ± 2.06 min respectively. All of them were longer than the control group (all P < 0.05). The mount frequency, intromission frequency and copulatory efficacy in the high concentration group were 0.52 ± 0.15 numbers/min, 0.37 ± 0.12 numbers/min and 0.40 ± 0.03, which were all statistically lower than the control group (all P < 0.05). The average testis weights in the low, middle and high concentration group were 0.198 ± 0.032 g, 0.203 ± 0.037g and 0.183 ± 0.032 g, and the relative testis weight in the high concentration group was 0.637 ± 0.106. All of these data were lower than the control group (P < 0.05, P < 0.05, P < 0.01 and P < 0.05, respectively). The epididymis weight and the relative epididymis weight, the weight of seminal vesicle and the relative weight of seminal vesicle were 0.069 ± 0.010 g, 0.242 ± 0.040, 0.219 ± 0.042 g and 0.760 ± 0.143, and all of them were lower than the control group (all P < 0.05). The serum testosterone levels in the high concentration group, the intratesticular testosterone levels in the middle and the high concentration group were 7.88 ± 1.62 ng/ml, 75.5 ± 7.18 ng/g and 73.00 ± 9.57 ng/g, which were all lower than the control group (all P < 0.05). Conclusions: BPA can decline the testosterone levels in mice and inhibit their sexual behaviors.

Impact of Cellphone Radiation on Sexual Behavior and Serum Concentration of Testosterone and LH in Male Mice

Background: Cellphone radiation (CR) has been reported to be related to higher risk of many health problems, but if CR can impair sexual behavior and testosterone synthesis has seldom been studied. Objective: To evaluate the effects of CR on testosterone and luteinizing hormone (LH) levels and sexual behaviors of male mice. Methods: Forty 3-month-old male mice, 22 - 25 g, were randomly allocated into four equal groups (n = 10 per group): the control group and three CR exposure groups including 8-hour group, 16-hour group and 24-hour group. Each mouse received different dose of CR exposure for 30 consecutive days. Sexual behaviors and testosterone and LH levels in serum were measured at the end of experiment. Furthermore, we also observed the weights of reproductive organs of each group, including testis, epididymis and seminal vesicle. Results: The mount latency and intromission latency in 24-hour group were significant higher than the control (both P < 0.01), while no obvious changes were seen in 8-hour group and 16-hour group (all P > 0.05). No difference in ejaculation latency existed among each group after the experiment (all P > 0.05). The frequency of mount and intromission in 24-hour group was statistically significantly lower than that of the control group (P < 0.05 and P < 0.01, respectively). No obvious change in the frequency of mount and intromission of the 8-hour group and 16-hour group was seen (all P > 0.05). Only the copulatory efficacy in the 24-hour group was statistically lower than the control group (P < 0.05). The serum levels of testosterone and LH in the 24-hour group were obviously higher than the control group (testosterone level: P < 0.05;LH level: P < 0.01). No significant differences were seen among the other two experimental groups and the control group (all P > 0.05). After the exposure of CR, the changes in the weights of sexual organs in the 24-hour group were significant compared with the control (testis weights, relative testis weight, epididymis weight, the weight of seminal vesicle, and the relative weight of seminal vesicle, all P < 0.01;the relative epididymis weight, P < 0.05). Conclusions: High dose exposure of CR can decline the testosterone and LH levels in mice and inhibit their sexual behaviors.

Association of Body Mass Index with Semen Quality and Sexual Hormone Levels among Men in Intrauterine Insemination

Background: The available evidence on the role of obesity and BMI on male infertility has been controversial or inconclusive to some extent. Objectives: To investigate the role of BMI on semen quality and hormone levels in men received intrauterine insemination. Material and Methods: A total of 390 males seeking artificial insemination in our department were recruited. BMI, blood pressure and semen parameters were assessed. Morning blood sample was taken for serum levels of testosterone (T), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (E2). Results: Subjects were divided into four groups according to BMI. There was no significant difference among groups in any of semen parameters and serum levels of FSH, LH, PRL and E2. Obese and overweight men were found having lower serum levels of T and higher levels of E2/T ratio than those of normal and underweight men. BMI was not found to be associated with semen parameters. Conclusion: This study has not found evidence of an association between BMI and semen parameters, but obesity has a negative effect on serum testosterone levels.

Validity of self-reported male sexual function scales in a young Chinese population:a comparative study with clinician-assisted evaluation

Psychometric scales,commonly used to gauge sexual function,can sometimes be influenced by response biases.In our researchfrom June 2020 to April 2021,we examined the accuracy of self-reported sexual function scales.We invited patients from theDepartment of Infertility and Sexual Medicine at the Third Affiliated Hospital of Sun Yat-sen University(Guangzhou,China),whohave male sexual dysfunction,to participate by filling out a self-reported version of a specific questionnaire.In addition,they wentthrough a clinician-assisted version of this questionnaire,encompassing tools such as the Premature Ejaculation Diagnostic Tool(PEDT),the 6-item International Index of Erectile Function(IIEF-6),the Erection Hardness Scale(EHS),and the MasturbationErection Index(MEI).Using the clinician-assisted version as a reference,we categorized patients and applied various statisticalmethods,such as the Chi-square test,intraclass correlation coefficient(ICC),logistic regression,and the Bland–Altman plot,to gauge reliability.In our study with 322 participants,we found that while there were no notable discrepancies in error ratesbased on our categorization,certain scales showed significant differences in terms of overestimation and underestimation,withthe exception of the PEDT.The positive diagnosis rate consistency between the self-reported and clinician-assisted versions wasobserved.High ICC values between the two versions across the scales were indicative of remarkable reliability.Our findings showthat the self-reported versions of tools such as EHS,IIEF-6,MEI,and PEDT are credible and hold clinical reliability.However,employing a dual-diagnosis approach might be more prudent to circumvent potential misdiagnoses.

The usefulness and significance of assessing rapidly progressive spermatozoa

It is possible and clinically relevant to distinguish between slow and rapid progressive spermatozoa in basic semen analysis. This is discussed in light of the different purposes of semen analysis for the subfertile couple and the male patient. The two groups of progressive spermatozoa should be distinguished to help ensure that pertinent information available in the semen sample is not neglected.

Prevalence and medical management of erectile ：lysfunction in Asia

Erectile dysfunction （ED） is an important worldwide health issue that has a significant negative impact on the quality of life and life satisfaction of both the affected individual and his partner. Here we review the prevalence of ED in Asia, associated factors that may influence sexual attitudes and sexual behaviours, and randomized clinical trials （RCTs） of phosphodiesterase-5 （PDE-5） inhibitors to evaluate the clinical efficacy and safety of PDE-5 inhibitors in Asian men. We searched for English-language articles in MEDLINE and PubMed from January 2000 to September 2010. Our results showed that the overall reported prevalence rate of ED in Asia ranged widely, from 2% to 88%. This finding indicates that ED is a common and major health problem in this region. However, sociocultural and economic factors in Asia prevent people from seeking and obtaining appropriate medical care. We found reports on five kinds of PDE-5 inhibitors for the management of ED.＇ sildenafil, vardenafil, tadalafil, udenafil and mirodenafih The results of RCTs showed that these five PDE-5 inhibitors are more effective than placebo in improving erectile function in Asian men with ED and that these drugs have similar efficacy and safety profiles.

Clinical application of a new device for minimally invasive circumcision

Aim： To study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin. Methods： One thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis. Results： In 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08 % of cases with excess foreskin and in 2.58 % of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence. Conclusion： The new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.

Erectile dysfunction and central obesity： an Italian perspective

Erectile dysfunction （ED） is a frequent complication of obesity. The aim of this review is to critically analyze the framework of obesity and ED, dissecting the connections between the two pathological entities. Current clinical evidence shows that obesity, and in particular central obesity, is associated with both arteriogenic ED and reduced testosterone （T） levels. It is conceivable that obesity-associated hypogonadism and increased cardiovascular risk might partially justify the higher prevalence of ED in overweight and obese individuals. Conversely, the psychological disturbances related to obesity do not seem to play a major role in the pathogenesis of obesity-related ED. However, both clinical and preclinical data show that the association between ED and visceral fat accumulation is independent from known obesity-associated comorbidities. Therefore, how visceral fat could impair penile microcirculation still remains unknown. This point is particularly relevant since central obesity in ED subjects categorizes individuals at high cardiovascular risk, especially in the youngest ones. The presence of ED in obese subjects might help healthcare professionals in convincing them to initiate a virtuous cycle, where the correction of sexual dysfunction will be the reward for improved lifestyle behavior. Unsatisfying sexual activity represents a meaningful, straightforward motivation for consulting healthcare professionals, who, in turn, should take advantage of the opportunity to encourage obese patients to treat, besides ED, the underlying unfavorable conditions, thus not only restoring erectile function, but also overall health.

Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction

Aim： To examine the treatment efficacy of Korean Red Ginseng （KRG） in impotent men with erectile dysfunction （ED）. Methods： A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind, placebo-controlled study in which the efficacies of KRG and a placebo were compared. The patients received either 1 000 mg （3 times daily） of KRG or a placebo. Results： The five-item version of the International Index of Erectile Function （IIEF-5） score after the treatment was significantly higher in the KRG group compared with that before the treatment （from 16.4±2.9 to 21.0±6.3, P 〈 0.0001）. In contrast, there was no difference before and after the treatment in the placebo group （from 17.0±3.1 to 17.7±5.6, P 〉 0.05）. In the KRG group, 20 patients （66.6%）, reported improved erection, significant in the global efficacy question （P 〈 0.01）; in the placebo group there was no significance. Scores on questions 2 （rigidity）, 3 （penetration）, 4 and 5 （maintenance）, were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment （P 〈 0.01）. When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score （IIEF-5 score） in questions 3 and 5 for the KRG-treated group （P 〈 0.001 and P 〈 0.0001, respectively）. The levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group （P 〉 0.05）. Conclusion： Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.

Penile revascularization--contemporary update

Contemporary therapies for erectile dysfunction are generally targeted towards older men and universally engage pharmacological and/ or device related treatment options. Penile revascularization, using microvascular arterial bypass surgical techniques, is a non-pharmacological, non-device-related, and reconstructive surgical strategy for men with erectile dysfunction that was first described by Dr Vaclav Michal in 1973.

Metabolic syndrome and prostate abnormalities in male subjects of infertile couples

No previous study has evaluated systematically the relationship between metabolic syndrome （MetS） and prostate-related symptoms and signs in young infertile men. We studied 171 （36.5 ±8.3-years-old） males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal （including total testosterone （TT） and insulin）, seminal （including interleukin-8 （IL-8）, seminal plasma IL-8 （sIL-8））, scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and the International Prostate Symptom Score （IPSS）. Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components （Wald = 29.5, P〈 0.0001） and showed an inverse correlation with TT （adjusted r = -0.359, P 〈 0.0001）. No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology （Wald -- 5.59, P〈 0.02） and positively with slL-8 levels （Wald = 4.32, P〈 0.05）, which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound （Wald = 17.6 and 12.5, both P〈 0.0001）, with arterial peak systolic velocity （Wald = 9.57, P= 0.002）, with texture nonhomogeneity （hazard ratio （HR） = 1.87 （1.05-3.33）, P 〈 0.05）, with calcification size （Wald = 3.11, P 〈 0.05）, but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical （slL8） and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.

Inhibition of histone deacetylase 2 mitigates profibrotic TGF-β1 responses in fibroblasts derived from Peyronie＇s plaque

Epigenetic modifications, such as histone acetylation/deacetylation, have been shown to play a role in the pathogenesis of fibrotic disease. Peyronie＇s disease （PD） is a localized fibrotic process of the tunica albuginea, which leads to penile deformity. This study was undertaken to determine the anti-fibrotic effect of small interfering RNA （siRNA）-mediated silencing of histone deacetylase 2 （HDAC2） in primary fibroblasts derived from human PD plaque. PD fibroblasts were pre-treated with HDAC2 siRNA and then stimulated with transforming growth factor-p1 （TGF-β1）. Protein was extracted from treated fibroblasts for Western blotting and the membranes were probed with antibody to phospho-Smad2/Smad2, phospho-Smad3/Smad3, smooth muscle α-actin and extracellular matrix proteins, including plasminogen activator inhibitor-β 1, fibronectin, collagen I and collagen IV. We also performed immunocytochemistry to detect the expression of extracellular matrix proteins and to examine the effect of HDAC2 siRNA on the TGF-β1-induced nuclear translocation of Smad2/3 in fibroblasts. Knockdown of HDAC2 in PD fibroblasts abrogated TGF-β1-induced extracellular matrix production by blocking TGF-β1-induced phosphorylation and nuclear translocation of Smad2 and Smad3, and by inhibiting TGF-β1-induced transdifferentiation of fibroblasts into myofibroblasts. Decoding the individual function of the HDAC isoforms by use of siRNA technology, preferably siRNA for HDAC2, may lead to the development of specific and safe epigenetic therapies for PD.

Antioxidative Protective Effect of Icariin on the FeSO_4/H_2O_2-damaged Human Sperm Based on Confocal Raman Micro-spectroscopy

Oxidative stress is implicated in male infertility and significantly higher reactive oxygen species are detected in 25% of infertile males. Although different agents of various alternative medicines, including traditional Chinese medicine, have been tried with varying success, evidence remains limited on whether and how much herbs or supplements might help increase the anti-oxidant ability of the sperm. This study examined the anti-oxidative effects of icariin, a flavonoid isolated from Herba Epimedii, on the human sperm. We prepared the FeSO4/H202-damaged human sperms, which were co-cultured with icariin in vitro, and then observed the changes of the sperm by employing Raman mi- cro-spectroscopy. The results showed that Raman mapping with a 514 nm excitation laser allowed clear differentiation of the nucleus, neck, and, in particular, the mitochondria-rich middle piece of a human sperm cell. The effect oficariin on different organelles of the sperm was quantified by localized spectral Raman signatures obtained within milli-seconds, and icariin could keep the ＂Raman fingerprint＂ of the human sperm the same as the control groups, suggesting that icariin could protect the human sperm from being damaged by FeSO4/H202. Icariin may serve as a tonifying and replenishing agent of herbal origin for enhancing reproductive fimctions.

评估快速前向运动精子的作用和意义

常规精液分析中可区分慢速和快速前向运动精子,且具有重要的临床应用价值。讨论了精液分析对于生育力低下夫妇和男性不育患者的不同意义。临床上应重视区分2种形式的前向运动精子,以避免丢失精液样本原有的重要信息。

What do most erectile dysfunction guidelines have in common？ No evidence-based discussion or recommendation of heart-healthy lifestyle changes and/or Panax ginseng

Sexual health or erectile dysfunction （ED） state of the art guidelines provide a thorough overview of conventional prescription or other notable extrinsic treatment options. Yet, over the past 10-15 years, a plethora of international researchers have established that individual and comprehensive lifestyle changes can prevent and potentially improve ED. We review the lifestyle evidence that should equate to grade A or level 1 evidence recommendations for ED. We also review the evidence for Panaxginseng, an over-the-counter （OTC） dietary supplement with a 35-year history of laboratory investigations, multiple positive randomized trials over approximately 15 years and several independent meta-analyses and systematic reviews. Perhaps it is time to at least discuss and even emphasize lifestyle and other non-conventional interventions in ED guidelines so that patients can explore a diversity of potentially synergistic choices with their physicians and can improve their quality and quantity of life. Ignoring the consistent, positive data on lifestyle modifications in ED guidelines, for example, is tantamount to ignoring diet and lifestyle changes to reduce the risk of or ameliorate cardiovascular diseases.

Relationship between Gut Microbiota and Type 2 Diabetic Erectile Dysfunction in Sprague-Dawley Rats

In order to investigate the relationship between gut microbiota and type 2 diabetic erectile dysfunction（T2DED）, we analyzed the characteristics of gut microbiota in the Sprague-Dawley（SD） rats with T2DED. Thirty-five SD rats were randomly divided into two groups： control group（n=15） with normal diet, and experimental group（n=20） with construction of T2D model. Faecal and serum samples were collected at 2nd and 8th week after establishment of T2D model, respectively. Faecal samples were used for analysis of gut microbiota, and serum samples for detection of trimethylamine N-oxide（TMAO）, lipopolysaccharide（LPS）, and inflammatory factors like interleukin-1（IL-1）, IL-2, IL-10, and monocyte chemoattractantprotein-1（MCP-1）. The main compositions of gut microbiota were Bacteroidetes, Proteobacteria and Firmicutes at the phylum level, and Oscillospira, Allobaculum, Bacteroides, Ruminococcus, SMB53, Prevotella, Coprococcus, Sutterella and Blautia at the genus level with relatively higher abundance in all SD rats. The relative abundance of Enterococcus, Corynebacterium, Aerococcus, Facklamia（opportunistic pathogens in most case） increased, and that of Allobaculum, Bifidobacterium, Eubacterium, Anaerotruncus（beneficial bacteria） decreased in T2DED group as compared with that at 2nd week after establishment of T2D model（T2D2 group）. The serum contents of TMAO, LPS, IL-1, IL-2, IL-10 and MCP-1 in T2DED group were significantly higher than those in control group. The gut microbiota of T2DED rats was inhibited. The gut microbiota of T2DED rats had changed, as the relative abundance of beneficial bacterium was decreased while that of opportunistic pathogens was increased. The variations of gut microbiota might lead to inflammation and prompt the emergence of erectile dysfunction in the rats with T2D. TMAO might play an important role in the formation of T2DED.