Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19:A randomized placebo-controlled trial

Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05).Conclusion: Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.

The mechanistic study on Wa medicine Niang-Mu-Liang medicinal liquor mitigating diabetes mellitus erectile dysfunction in rats by inhibiting ferroptosis

Background:This study aims to investigate the therapeutic effect of Wa medicine Niang-Mu-Liang medicinal liquor(NML)on rats with diabetes mellitus erectile dysfunction(DMED)and its impact on the ferroptosis signaling pathway.Methods:Thirty Sprague-Dawley rats were randomly divided into three groups:Control,DMED,and NML.After establishing the DMED model,treatments were administered for 8 weeks.After the administration,apomorphine hydrochloride tests were conducted to measure the mass and organ index of testes and epididymides,sperm concentration and viability in each group.Penile corpus cavernosum tissues were stained with hematoxylin and eosin.Nitric oxide and cyclic guanosine monophosphate levels in the penile corpus cavernosum tissues were determined using biochemical kits and enzyme-linked immunosorbent assay,while the expression of proteins related to the ferroptosis signaling pathway was measured by Western blot.Results:Compared to the DMED group,the DMED rats treated with NML showed significantly increased erection frequency,testicular and epididymal mass and index,sperm count and viability,along with noticeable improvement in the pathological morphology of penile corpus cavernosum.The content of nitric oxide and cyclic guanosine monophosphate,and the expression of ferritin heavy chain,ferritin light chain,and glutathione peroxidase 4 proteins in penile corpus cavernosum tissue were elevated,while the expression of transferrin and STEAP3 proteins was reduced.Conclusion:NML can improve erectile function in DMED rats by inhibiting the ferroptosis signaling pathway.

Pathogenesis and treatment of diabetes mellitus-related erectile dysfunction: current therapies and potential challenges

Erectile dysfunction(ED)is one of the important complications of diabetes,which is very common in diabetic patients,affecting more than half of male patients,and the incidence of the disease is about 3.5 times that of the normal population.The pathogenesis of diabetic erectile dysfunction(DMED)is complex,involving nerve,vascular,endocrine,muscular and psychological aspects.At present,the therapeutic approaches of DMED include drug therapy,surgery,physical therapy and so on.This article provides a review of current research on the pathogenesis and treatment of DMED.Further elucidation of the pathogenesis of DMED and the development of new therapeutic approaches are of great significance for the prevention and treatment of DMED.

Electrophysiological evaluation of alterations in penile sensation due to penile prosthesis implantation in patients with erectile dysfunction

Objective The present study was aimed to determine the effect of penile prosthesis implantation(PPI)surgery on penile sensation by evaluating the penile electromyography(EMG)variables.Methods The research was designed as a prospective study.Thirty patients who were diagnosed with organic erectile dysfunction and had underwent PPI surgery between January 2017 and January 2018 in the Urology Clinic of Antalya Training and Research Hospital were included in this study.Penile sensory EMG was performed on each patient 1 day prior to the surgery by the Physical Therapy and Rehabilitation clinic.Additionally,the control EMG study was also performed in the 3rd and 6th postoperative months.Results We included 27 patients in this study who attended regular follow-ups and had complete EMG results.Out of the 27 patients,23(85.2%)patients had received malleable(ProMedon)penile prosthesis,one(3.7%)patient had received a two-piece inflatable(Ambicor)penile prosthesis,and three(11.1%)patients had received a three-piece inflatable(AMS 700 CXR)penile prosthesis.The mean nerve conduction value(NCV)of the patients was 29.85(standard derivation:22.54;range:0-78.4)m/s during the preoperative period,whereas it was 27.64(standard derivation:24.72;range:0-83.3)m/s in the 3rd postoperative month and 24.80(standard derivation:22.31;range:0-88.4)m/s in the 6th postoperative month.There was no significant difference between preoperative NCV and 3rd postoperative month NCV(p=0.607).Similarly,no significant difference was observed between preoperative NCV and 6th postoperative month NCV(p=0.276).Additionally,the change between NCV values at postoperative 3rd and 6th months was not statistically significant(p=0.553).Conclusion Significant loss of penile sensation does not occur in patients who undergo PPI surgery.

Mechanism of the Xuefu Zhuyu decoction in treating diabetes mellitus erectile dysfunction based on the CaSR/Gq-PLC-PKC pathway

Background:To investigate the mechanism of Xuefu Zhuyu decoction in the treatment of diabetes mellitus erectile dysfunction.Methods:Rats with diabetes mellitus erectile dysfunction were developed using streptozocin and randomly assigned into model,low-dose herbal,and high-dose herbal groups.All rats were administered normal saline or the corresponding drugs by oral gavage for 4 weeks.The related indices were detected using enzyme-linked immunosorbent assays,immunohistochemistry,western blotting,and transmission electron microscopy.Results:The levels of lectin-like oxidized low-density protein receptor-1,endothelin-1,NADH oxidase,vascular cell adhesion molecule-1,and intercellular adhesion molecule-1 in the model group were significantly higher than they were in the mock group but lower than they were in the herbal treatment group.The level of nitric oxide was lower in the model group than was in the mock group but higher than the level in the herbal treatment group.The calcium-sensitive receptor,phospho-protein kinase Cδ/protein kinase Cδ,phosphorylated c-Jun amino-terminal kinase/c-Jun amino-terminal kinase,and phospho-P38 mitogen-activated protein kinase/P38 mitogen-activated protein kinase expression levels in the model group were higher than were in the mock group but lower than were in the herbal treatment group.The structures of the Corpus cavernosum penis endothelial cells were significantly improved in the herbal treatment group than they did in the model group.Conclusion:Xuefu Zhuyu decoction can decrease injury to the endothelium,improve vascular endothelial diastolic and contractive function,and inhibit vascular fibrosis in rats with diabetes mellitus erectile dysfunction.This mechanism may be related to the CaSR/Gq-PLC-PKC pathway.

Frequency and Associated Factors of Erectile Dysfunction among Patients with Liver Cirrhosis in Parakou, Republic of Benin in 2022

Introduction: Erectile dysfunction is a pathology less expressed by patients, but it affects their quality of life. The objective of this work is to study erectile dysfunction among patients with cirrhosis in Parakou in 2022. Patients and Methods: This was a descriptive and analytical cross-sectional study with prospective data collection, conducted from February 1 to June 30, 2022 at the Teaching Hospital of Borgou/Alibori and the Military Teaching Hospital of Parakou. Men with liver cirrhosis who gave their informed verbal consent were included. Erectile dysfunction was diagnosed using IIEF-5 score. The prognosis of cirrhosis was assessed using Child-Pugh score. The data were analyzed by Epi Data analysis 2.3 software. Results: A total of 64 patients were included. Their mean age was 43.53 ± 13.13 years. Cirrhosis was secondary to chronic hepatitis B virus infection in 55 patients (85.94%). In this study, 42 patients (65.63%) had at least one decompensation of cirrhosis. Among the 64 patients included, 27 (42.18%) had erectile dysfunction. This erectile dysfunction was moderate in 12 patients (44.44%). The other sexual disorders found in these patients were decreased libido and ejaculation disorders. After multivariate analysis, the factors statistically associated with erectile dysfunction were: age (p Conclusion: Erectile dysfunction is common in patients with liver cirrhosis. It is more frequent when the cirrhosis is complicated and the patients are elderly. Nevertheless, it should be systematically sought in any patient with liver cirrhosis.

Headaches and Erectile Dysfunction Medications at UTH-Kara (Togo)

Introduction: Headaches are a common symptom affecting individuals worldwide, including in the tropical zone, and have been extensively studied in Togo. Phosphodiesterase-5 inhibitors, commonly prescribed for erectile dysfunction, are known to induce headaches, yet there is a lack of research on this topic in sub-Saharan Africa and Togo. Methods: A cross-sectional study conducted from February 1st to June 30th, 2023, including adult patients seeking erectile dysfunction treatment and prescribed PDE-5 inhibitors. Results: A total of 28 patients were included in the study, with an average age of 34.46 ± 7.5 years. The age group of 30 - 39 years was the most represented (53.57%). Among the participants, 67.86% had a history of chronic headaches. During the intake of PDE-5 inhibitors, 71.43% reported the onset of headaches. Among the 19 patients with chronic headaches, 68.42% developed headaches following PDE-5 inhibitor use (RR = 0.88, 95% CI: 0.55 - 1.40, p = 0.484). The characteristics of the induced headaches were similar to the patients’ pre-existing headaches in 78.95% of cases. Additional symptoms included nasal congestion (36.84%) and an urge to have a bowel movement (26.32%). Sildenafil (75.00%) and Tadalafil (25.00%) were the primarily prescribed PDE-5 inhibitors. The incidence of headaches did not significantly differ between the two groups (RR = 1.33, 95% CI: 0.67 - 2.64, p = 0.306). Treatment for the induced headaches involved self-medication with paracetamol (65.00%) and nonsteroidal anti-inflammatory drugs (NSAIDs) (35.00%). Conclusion: Headaches induced by PDE-5 inhibitors are a well-established reality, emphasizing the need for caution and warning in patients with pre-existing headache conditions, while individualized approaches are necessary to address the potential interplay between migraine medications and erectile dysfunction treatments.

Prevalence and Factors Associated with Erectile Dysfunction in Diabetic Patients at the National University Hospital Center Hubert Koutoukou Maga in Cotonou

Erectile dysfunction was one of the most common complications in diabetic patients. According to several studies, its prevalence was two to three times higher in diabetics than in the general population. But it has often been overlooked despite the fact that it seriously affects the quality of life. The aim of this study was to determine the prevalence of erectile dysfunction and its associated factors in diabetics’ patients. This was a cross-sectional analysis study of 76 male diabetic patients who consulted by the Department of Endocrinology from June 22, 2019 to September 25, 2019. Erectile dysfunction was diagnosed by calculating the IIEF score. Statistical comparisons were made between patients without and with Erectile dysfunction chi-square test with a significance level p Conclusion: This study showed a high prevalence of erectile dysfunction in diabetics. Significant concomitant factors were hypertension, diabetes imbalance and the duration of diabetes. It was, therefore, important to include systematic screening for erectile dysfunction at least annually, as well as other complications of diabetes.

Stem cell therapy and diabetic erectile dysfunction:A critical review

Erectile dysfunction(ED)has been identified as one of the most frequent chronic complications of diabetes mellitus(DM).The prevalence of ED is estimated to be about 67.4%in all DM cases worldwide.The pathophysiological process leading to ED involves endothelial,neurological,hormonal,and psychological factors.In DM,endothelial and neurological factors play a crucial role.Damages in the blood vessels and erectile tissue due to insulin resistance are the hallmark of ED in DM.The current treatments for ED include phosphodiesterase-5 inhibitors and penile prosthesis surgery.However,these treatments are limited in terms of just relieving the symptoms,but not resolving the cause of the problem.The use of stem cells for treating ED is currently being studied mostly in experimental animals.The stem cells used are derived from adipose tissue,bone,or human urine.Most of the studies observed an improvement in erectile quality in the experimental animals as well as an improvement in erectile tissue.However,research on stem cell therapy for ED in humans remains to be limited.Nevertheless,significant findings from studies using animal models indicate a potential use of stem cells in the treatment of ED.

Progress and prospect of stem cell therapy for diabetic erectile dysfunction

Diabetic erectile dysfunction(DED)is a common complication of diabetes mellitus,significantly impairing the quality of life of patients.The conventional clinical treatment still has limitations.Stem cells(SCs),as a type of cells with multidirectional or directional differentiation capability and sustainable selfrenewal potential,are widely used in regenerative medicine and tissue engineering.With the continuous update of regenerative medicine theory and the success of animal experiments,SCs as a treatment for male erectile dysfunction,especially DED,have attracted widespread attention because of curable possibility.This review focus on the current progress in the clinical application of SC treatment for DED.Moreover,we summarize the development prospects of SCs in the field of DMED therapy.

In vitro and in vivo investigation of natural compounds from seed extract of Mucuna pruriens lacking L-DOPA for treatment of erectile dysfunction

Objective:To investigate the biological effects of the Mucuna pruriens(M.pruriens)seed extracts that lacked of L-DOPA,which was formerly reported as the active ingredient,on erectile dysfunction(ED)both in vitro and in vivo.Methods:Seed of M.pruriens plant that cultivated in Mae Taeng District,Chiang Mai Province,Thailand,was collected.Component of its seeds were extracted and isolated into 2 fractions using methanol,polar and nonpolar.Each fraction was investigated for phytochemicals using GC/MS and was screened for biological activity In vitro using three different cell lines.The most biological active fraction was used to treat to both steptozotocin(STZ)-induced diabetes mellitus-erectile dysfunction(DM-ED)male wistar rats and normal rats(n=6 per groups)to compare the effect on sexual behaviour parameters,including number of intromission,mounting and ejaculation,with that of rats given Sildenafil by individually pairing with their female counterparts.Penile tissues and serums were collected to determine histological structure,related gene expression and biomolecules.Results:The phytochemicals of the polar fraction were possibly catechol and its derivatives plus polyphenols,whereas the nonpolar fraction consisted of lipid derivatives.L-DOPA was not detected in either of the extracts.The polar fraction was able to up-regulate the expression of ED-related genes including e NOS and n NOS in vitro which subsequently promotes NO production and maintains intracellular cG MP levels.When administrated to DM-ED rats,the polar extract significantly improved all sexual behaviour parameters in DM-ED rats compare to untreated group(18.3±1.8 to 10.8±2.9 for intromission,9.8±2.2 to 5.7±1.3 for mounting,and 1.8±0.6 to 0.2±0.4 for ejaculation).That effect might due to the ability of the extract to stimulate the expression of eN OS and nN OS which results in NO production and subsequently maintains cG MP levels in penile tissue.Moreover,this extract may also prevent penile tissue deterioration due to diabetes.Conclusions:The polar extract of M.pruriens seed can be used for ED therapy,especially in patients with metabolic diseases including diabetes.The action of the extract might be due to catechol and its derivatives and polyphenols.

Influencing Factors for Erectile Dysfunction of Young Adults with No Response to PDE5i

Erectile dysfunction(ED)is a common male disorder.Although orally-administered phosphodiesterase type 5 inhibitors(PDE5 inhibitors)are now recognized as the primary pharmacological treatment method for ED,20%-30%of the patients treated with PDE5 inhibitors exhibit no significant effects.This study aims to investigate the influencing factors of ED in young adults with no response to PDE5 inhibitors.ED patients who would take PDE5 inhibitors were included and investigated with a questionnaire.Patients with no response to PDE5 inhibitors(tadalafil and sildenafil)served as study group,and those with response to PDE5 inhibitors as control group.Then Chi square test and logistic regression analysis were applied to find the potential influencing factors.In total,378 ED patients were included.Ninety-three(24.6%)cases were non-responsive to PDE5 inhibitors,and the remaining 285(75.4%)responded to PDE5 inhibitors.In multiple logistic regression analysis,we found that history of drinking(OR=3.152;95%CI 1.672-6.975),spousal noncooperation(OR=2.994;95%CI 1.589-5.638),number of fixed sex partners(OR=0.358;95%CI 0.132-0.651),duration of ED(OR=3.356;95%CI 1.352-8.333),and depression(OR=3.689;95%CI 1.579-8.979)could be the influencing factors for ED patients’non-response to PDE5 inhibitors.In conclusion,history of drinking,spousal noncooperation,number of fixed sex partner,long duration of ED,and depression could be the influencing factors for ED patients'non-response to PDE5 inhibitors.Patients and doctors should pay attention to these factors.

Impact of Radical Prostatectomy on Urinary Incontinence, Erectile Dysfunction and General Quality of Life

The aims of this study were to evaluate the impact of radical retropubic prostatectomy on patient’s quality of life. Patients undergoing radical retropubic prostatectomy were followed for six months after surgery. We used quality of life questionnaires to study specific urinary symptoms and general health. WHOQOL-Bref (World Health Organization for Quality of Life) questionnaire was used to evaluate general health aspects, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form), OABq (Overactive Bladder) and IPSS (International Prostatic Symptom Score) to evaluate incontinence and overactive bladder symptoms and Male Sexual Quotient to assess postoperative sexual dysfunctions. The questionnaires were scheduled before surgery, one, three and six months after surgery. Regarding the OAB-q scores, I-PSS and WHOQOL-Bref (physical, psychological, environmental, general, Question 1 and Question 2), symptoms worsened after one month if compared to preoperative symptoms. After six months, the WHOQOL’s social domain, the ICIQ-SF and QS-M scores remained worse if compared to preoperative evaluation. The incidence of sexual dysfunctions after six months was 0.83. In conclusion, urinary incontinence affects patient’s quality of life with gradual recovery after six months postoperatively. The social domain was the most common aspect affected by urinary incontinence. Our sexual dysfunction incidence was higher than other studies and this fact could be explained by many surgeries having been done by residents.

Correlates of Erectile Dysfunction in Nigerian Men with Type 2 Diabetes Mellitus: Experience from a Tertiary Health Center

Introduction: Erectile dysfunction (ED) is a common complication of diabetes mellitus (DM) that is associated with poor quality of life and can be present in type 2 diabetics at the time of diagnosis. There are common risk factors associated with erectile dysfunction in type 2 diabetic subjects. Some of these are potentially treatable or reversible. The risk factors evaluated by this study included glycaemic control, duration of diabetes, obesity, peripheral artery disease (PAD), hypertension and antihypertensive medications use. Materials and Methods: This study was a cross sectional one carried out over a period of six months (June-November, 2016) at the diabetes clinic of the Nnamdi Azikiwe University Teaching Hospital, Nnewi and involved 124 subjects with type 2 diabetes mellitus. A convenience sampling method was used. A detailed physical examination, blood pressure and anthropometric measurements and vascular assessment with a hand-held doppler ultrasound were carried out. Data was collected using a study proforma. Erectile dysfunction was diagnosed with the International Index of Erectile Function questionnaire while anxiety and depression were diagnosed with the Hospital Anxiety and Depression questionnaires. Subjects that had anxiety/depression or hypogonadism were excluded from the study. Results: A total of 124 subjects were studied, 48.4% of whom had erectile dysfunction. Glycaemic control was significantly associated with ED among the subjects (OR = 0.198, 95% CI = 0.081 - 0.483, P < 0.001). Similarly, peripheral artery disease (PAD) was significantly associated with ED in the subjects (OR = 2.867, 95% CI = 1.360 - 6.044, P = 0.006). However, no significant correlation was found between ED and obesity, duration of diabetes mellitus, antihypertensive medications use and duration of hypertension among the subjects (P > 0.05). Conclusion: Poor glycaemic control and presence of PAD significantly increase the risk of ED in male subjects with type 2 DM, thus underscoring the need for an early screening and treatment of these predictors of erectile dysfunction.

A Cross-Sectional Study According to Risk Factors Associated with Erectile Dysfunction in Men

Background: Erectile dysfunction (ED) is a common condition in general population. It has a negative impact on the couple’s quality of life. In 1995, it was estimated that it affected 152 million people worldwide, and that it would affect more than 322 million people in 2025 with a large increase in developing countries. Several studies have suggested a causal link between ED and cardiovascular disease. In the Democratic Republic of Congo, no studies exist on this subject. Nonetheless, we are seeing increased promotion on the management of sexual disorders in our media, which could testify to the extent of this problem. Objective: To assess the extent of cardiovascular risk factors for ED in Kinshasa. Material and Methods: This is a cross-sectional study for analytical purposes. It collected several categories of individuals from May 1 to October 31, 2018. The severity of ED was assessed by the IIEF-5 score and the associated risk factors sought via logistic regression. Results: The mean age of the respondents was 59.9 ± 19.2 years, more than half of the respondents were over the age of 60 years old (60%). The ED proportion was 78.8%, and 75% of respondents had at least moderate ED. This anomaly was significantly elevated among respondents aged over 60 years (94.8%), diabetics (87.5%), hypertensive patients (92.3%) and stroke victims (86%). The independently associated risk factors were: age > 60 years [ORa: 9.87;95% CI: 6.42 - 10.48, p < 0.001], diabetes mellitus [ORa: 2.99;95% CI: 1.80 - 4.95, p = 0.013] and the stroke [ORa: 2.1;95% CI: 1.36 - 3.39;p = 0.012%]. The age threshold predicting ED was 67 years. Conclusion: ED is a frequent disorder in our environment and likely to affect the quality of life of men who suffer from it. There is an ED and cardiovascular risk factors correlation. A proactive attitude of the caregiver in current practice would allow early detection of ED with a view to early and optimal management.

The mechanism of Xuefu Zhuyu decoction in treating erectile dysfunction based on Arrowsmith tool

Arrowsmith,a literature retrieval tool,was used to explore the theoretical pharmacological mechanism of action of Xuefu Zhuyu decoction and its single herb against erectile dysfunction.Cytoscape 3.6.1 software was used to analyze the correlation between the components of Xuefu Zhuyu decoction and the identified mechanism of action.Different herbs in Xuefu Zhuyu decoction may play a therapeutic role by regulating iNOS,COX-2,mTOR,Wnt,AMPK,Nrf2,TLR4,CYP2D6,BDNF,MAPK,Akt,STAT3,PI3K,ERK1,P38MAPK,JNK,VEGF,and other targets.The treatment of erectile dysfunction with Xuefu Zhuyu decoction embodied the multicomponent,multitarget,and multipathway.The Arrowsmith tool retrieval and analysis provided a scientific basis for further elucidation of the mechanism of Xuefu Zhuyu decoction against erectile dysfunction.

Safety and Efficacy of Oral Mirodenafil in Mexican with Erectile Dysfunction

Erectile dysfunction is treated with 5-phospodiesterase inhibitors as Mirodenafil, which has shown its efficacy and safety in Koreans, however;no information in other populations is available. An open clinical trial study was designed to evaluate the efficacy and safety in real life of a fixed-dose of Mirodenafil in Mexican patients with erectile dysfunction. Forty-seven male patients received a 100 mg tablet of Mirodenafil, during 12 weeks. Primary outcome efficacy measure was the percentage of male patients with successful intercourse. Secondary outcomes measures included patient satisfaction, mood and self-esteem level. Safety assessments included laboratory tests, vital signs, physical examination, 12-lead electrocardiogram recordings, and incidence of adverse events by patients. Oral administration of Mirodenafil improved in an 80% - 90% the number of successful intercourses from 7 to 84 days of treatment. Moreover, patients reported a significant increment in their sexual satisfaction, mood and self-esteem. Mirodenafil treatment did not modify vital signs nor anthropometric parameters during 84 days. Mild headache was the most frequent adverse event (17.0%) and there were no severe adverse events during pharmacological treatment. Data suggest that oral Mirodenafil is safety, well tolerated and effective in the Mexican population with erectile dysfunction.

Treatment of Vasculogenic Erectile Dysfunction with Piezowave2 Device. Application of Low Intensity Shockwaves Using Novel Linear Shockwave Tissue Coverage (LSTC-ED®) Technique. A Prospective, Multicentric, Placebo-Controlled Study

Low intensity shockwave (LiSW) treatment is known to improve revascularization. The method has been evaluated and is used to treat vasculogenic erectile dysfunction (ED). The present study aimed to demonstrate the efficacy of a linear focused piezoelectric shockwave device (Richard Wolf/ELvationPiezowave2) to treat patients with vasculogenic ED using a novel linear shockwave tissue coverage LSTC-ED® technique. A total of 75 patients were treated using the Piezowave2 device and the LSTC-ED® technique. Patients’ erectile function was evaluated using the modified IIEF-5 (International Index of Erectile Function) scale at the beginning of treatment and at 1 month post treatment;patients were additionally questioned using our own Treatment Satisfaction Questionnaire (TSQ). The study also included a group of 50 patients treated by placebo;the outcomes of both groups were compared. The average IIEF-5 score of patients in the treatment group increased from 14.4 at baseline to 18.6 at 1 month post treatment. According to the IIEF-5 scale, treatment was successful in 81.33% of patients (61/75). According to the Treatment Satisfaction Questionnaire (answers 1 to 3 of the TSQ), treatment was successful in 77.3% of patients (58/75). In the placebo group of 50 patients only 5 patients showed an improvement based on IIEF score, and 8 reported an improvement based on their answers to the TSQ. No significant adverse effects were observed during treatment or in the follow-up period. The Piezowave2 device and the LSTC-ED® technique proved to be suitable and effective to treat erectile dysfunction.

Erectile Dysfunction in Hemodialysis in Togo

Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%);01 case (2.6%) between 11 and 16 points;06 cases (15.4%) between 17 to 21 points;08 cases (20.5%) between 22 and 25 points;and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P 0.001). Conclusion: The prevalence of ED is very high in Togo.

Magnitude and Factors Contributing to Erectile Dysfunction among Diabetic Men Attending the Diabetic Clinic at Debre Tabor Comprehensive and Specialized, Hospital in North West, Ethiopia 2020, Institutional Based Cross-Sectional Study

Background: Erectile dysfunction, which is defined as difficult to attain and maintain an erectile function enough to permit sufficient sexual performance, is accepted to be a big problem especially among diabetic patients. Objective To assess the Magnitude and factors contributing to Erectile Dysfunction Among Diabetic men attending the diabetic clinic in Debre Tabor Comprehensive and Specialized hospital, North West Ethiopia. Methods: Hospital based cross-sectional study was conducted on 362 participants in Debre Tabor Comprehensive and Specialized Hospital from August - December 2020 using systematic random sampling technique. Data were analyzed with SPSS Version 23. Binary and multivariable logistic regressions were done to identify factors which were contributing to erectile dysfunction. P-value < 0.05 and the corresponding 95% CI of odds ratios were considered to declare the result as statistically significant. Results: Three hundred sixty-two diabetes patients participating in the study with the mean age being 44.4 ± 14.47 (range: 18 - 78) years were interviewed. The majority (59.7% with CI: 54.4:64.6) of the diabetes patients suffered from erectile dysfunction and 13.3% (95% CI 17.8% - 26.8%) were found to have severe erectile dysfunction. Bi-variable analysis showed duration of diabetes (>10 years), type of diabetes (type II), physical exercise, drinking alcohol, BMI, blood glucose, and blood pressure were associated with erectile dysfunction at 5% level (p ≤ 0.05). Multiple logistic regression analysis revealed that duration of diabetes 10 years (AOR = 6.2, 95% CI: 2.78 - 13.85, p = 0.001), co-existing hypertension (AOR: 3.59, 95% CI: 1.58 - 8.19, p = 0.002), physically inactive (AOR = 2.87, 95% CI: 1.53 - 8.31, p = 0.003), unsafe level alcohol intake (AOR: 3.09;95% CI 1.45 - 6.59*, p = 0.003) and raised blood glucose (AOR: 15.26, 95% CI: 7.82 - 29.77, p = 0.004) were independent risk factors but no association was found with other variables. Conclusion: The magnitude of erectile dysfunction in this study population was 59.7% and associated with the type of diabetes;duration of diabetic, physical exercise, alcohol drinking, increase in blood pressure, and elevated blood glucose level were independently correlated with erectile dysfunction.