The Experts below are selected from a list of 84 Experts worldwide ranked by ideXlab platform
Carlo Foresta - One of the best experts on this subject based on the ideXlab platform.
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efficacy of penile low intensity shockwave treatment for erectile dysfunction correlation with the severity of Cavernous Artery disease
Asian Journal of Andrology, 2021Co-Authors: N Caretta, Pierfrancesco Palego, Maurizio De Rocco Ponce, Nadia Minicuci, Ilaria De Santis, Andrea Garolla, Carlo ForestaAbstract:We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction (ED) combined with Cavernous Artery disease (CAD). ED was evaluated by the International Index of Erectile Function, subdividing patients into mild and moderate/severe forms. CAD was assessed using penile color Doppler ultrasonography. Patients (n = 111) with a positive outcome after treatment, based upon the minimal clinically important difference of the International Index of ED, were followed up for 3 months and 6 months. We found a significant mean increase in the index of erectile function, with an overall improvement in hemodynamic parameters of the Cavernous Artery. In particular, 93.9% of the patients with mild ED without CAD responded to treatment and 72.7% resumed normal erectile function. Only 31.2% of the patients with moderate/severe ED and CAD responded to treatment, and none resumed normal erectile function. All patients with mild ED and no CAD maintained the effects of therapy after 3 months, while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months. Thus, patients with mild ED and no CAD have better and longer lasting responses to such treatment, with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.
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Cavernous Artery intima media thickness a new parameter in the diagnosis of vascular erectile dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: N Caretta, Pierfrancesco Palego, Mirko Schipilliti, Alberto Ferlin, Antonella Di Mambro, Carlo ForestaAbstract:ABSTRACT Introduction A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved. Although Cavernous peak systolic velocity (PSV) is generally considered a major parameter, it has many false positives and negatives because of anatomic variations of the Cavernous Artery course, challenging site of sampling, insufficient caracterization of an early phase of vascular disease, and significant influence of adrenergic tone. Aim We performed a high magnification ultrasonographic study in order to compare functional and morphological parameters of the Cavernous Artery to PSV and their relation with penile and systemic atherosclerosis. Methods A total of 109 subjects (84 ED patients and 25 controls) evaluated in our andrological center from March 2007 to January 2008 were enrolled in the study. Main Outcome Measures All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution echo color doppler evaluation of carotid, femoral and penile districts (acceleration time, intima media thickness [IMT], intima adventitia thickness, caliper before and after intraCavernous alprostadil injection [Δ-Cavernous calliper]). Results Cavernous parameters were significantly different between ED and controls. Multivariate model showed that IMT was the only predicting parameter for ED of vascular origin. Cavernous IMT showed a strong direct correlation with carotid and femoral IMT. ED patients with two or more cardiovascular risk factors had a significantly higher Cavernous IMT. Conclusions An increased Cavernous IMT (≥0.3 mm) might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase. Caretta N, Palego P, Schipilliti M, Ferlin A, Di Mambro A, and Foresta C. Cavernous Artery intima-media thickness: A new parameter in the diagnosis of vascular erectile dysfunction. J Sex Med **;**:**–**.
N Caretta - One of the best experts on this subject based on the ideXlab platform.
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efficacy of penile low intensity shockwave treatment for erectile dysfunction correlation with the severity of Cavernous Artery disease
Asian Journal of Andrology, 2021Co-Authors: N Caretta, Pierfrancesco Palego, Maurizio De Rocco Ponce, Nadia Minicuci, Ilaria De Santis, Andrea Garolla, Carlo ForestaAbstract:We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction (ED) combined with Cavernous Artery disease (CAD). ED was evaluated by the International Index of Erectile Function, subdividing patients into mild and moderate/severe forms. CAD was assessed using penile color Doppler ultrasonography. Patients (n = 111) with a positive outcome after treatment, based upon the minimal clinically important difference of the International Index of ED, were followed up for 3 months and 6 months. We found a significant mean increase in the index of erectile function, with an overall improvement in hemodynamic parameters of the Cavernous Artery. In particular, 93.9% of the patients with mild ED without CAD responded to treatment and 72.7% resumed normal erectile function. Only 31.2% of the patients with moderate/severe ED and CAD responded to treatment, and none resumed normal erectile function. All patients with mild ED and no CAD maintained the effects of therapy after 3 months, while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months. Thus, patients with mild ED and no CAD have better and longer lasting responses to such treatment, with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.
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Cavernous Artery intima media thickness a new parameter in the diagnosis of vascular erectile dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: N Caretta, Pierfrancesco Palego, Mirko Schipilliti, Alberto Ferlin, Antonella Di Mambro, Carlo ForestaAbstract:ABSTRACT Introduction A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved. Although Cavernous peak systolic velocity (PSV) is generally considered a major parameter, it has many false positives and negatives because of anatomic variations of the Cavernous Artery course, challenging site of sampling, insufficient caracterization of an early phase of vascular disease, and significant influence of adrenergic tone. Aim We performed a high magnification ultrasonographic study in order to compare functional and morphological parameters of the Cavernous Artery to PSV and their relation with penile and systemic atherosclerosis. Methods A total of 109 subjects (84 ED patients and 25 controls) evaluated in our andrological center from March 2007 to January 2008 were enrolled in the study. Main Outcome Measures All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution echo color doppler evaluation of carotid, femoral and penile districts (acceleration time, intima media thickness [IMT], intima adventitia thickness, caliper before and after intraCavernous alprostadil injection [Δ-Cavernous calliper]). Results Cavernous parameters were significantly different between ED and controls. Multivariate model showed that IMT was the only predicting parameter for ED of vascular origin. Cavernous IMT showed a strong direct correlation with carotid and femoral IMT. ED patients with two or more cardiovascular risk factors had a significantly higher Cavernous IMT. Conclusions An increased Cavernous IMT (≥0.3 mm) might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase. Caretta N, Palego P, Schipilliti M, Ferlin A, Di Mambro A, and Foresta C. Cavernous Artery intima-media thickness: A new parameter in the diagnosis of vascular erectile dysfunction. J Sex Med **;**:**–**.
K E Andersson - One of the best experts on this subject based on the ideXlab platform.
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effects of nicorandil on human isolated corpus cavernosum and Cavernous Artery
The Journal of Urology, 1994Co-Authors: Petter Hedlund, F Holmquist, H Hedlund, K E AnderssonAbstract:Nitric oxide (NO) released from nonadrenergic-noncholinergic (NANC) nerves seems to be a principal mediator of the relaxation of penile erectile tissue necessary for erection, and drugs acting by release of NO have been shown to produce erection when injected intracorporeally into impotent patients. By producing hyperpolarization, K+ channel openers are effective in relaxing isolated penile erectile tissue from rabbit and man, and can produce tumescence and erection when injected intracorporeally into animals. Nicorandil is classified as a K+ channel opener, but it also acts as a donor of NO. In the present study, the effects of nicorandil on isolated preparations from human corpus cavernosum (CC) and deep Cavernous Artery (Acc) were compared with those of cromakalim (K+ channel opener) and SIN-1 (NO donor). Nicorandil produced a concentration-dependent relaxation of CC and Acc preparations. The relaxations obtained at the highest nicorandil concentration used (10(-4) M.) were 75 +/- 3% and 66 +/- 4% in CC preparations contracted by noradrenaline and endothelin-1, respectively. The corresponding effects in Acc preparations were 70 +/- 14% and 73 +/- 5%. Glibenclamide (blocking ATP-dependent K+ channels) significantly reduced the nicorandil-induced relaxation in CC, but not in Acc. Methylene blue (believed to block soluble guanylate cyclase) reduced nicorandil's relaxant effect in CC, although statistical significance was not obtained. NG-nitro-L-arginine 10(-4) M. (NO synthase inhibitor) did not significantly influence the effect of nicorandil on precontracted preparations in either tissue. In CC preparations contracted by electrical field stimulation, nicorandil and cromakalim concentration dependently inhibited the responses. This effect was significantly counteracted by glibenclamide. It is concluded that nicorandil is effective in relaxing human CC chiefly by its K+ channel opening action, and to some extent by its ability to release NO. For nicorandil's relaxing effect on Acc, ATP dependent K+ channels seem to be of limited importance. If effective in impotent patients, the drug may represent a new, interesting approach to the treatment of erectile dysfunction.
Kevin T. Mcvary - One of the best experts on this subject based on the ideXlab platform.
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papaverine topical gel for treatment of erectile dysfunction
The Journal of Urology, 1995Co-Authors: Ragab Elrashidy, Kevin T. McvaryAbstract:ABSTRACTIntraCavernous injection of vasoactive substances has been shown to be an effective means of treatment of organic erectile dysfunction. However, up to 50% of men eventually discontinue treatment often because of lack of spontaneity and needle phobia. This study was done as a phase I, placebo controlled, nonblinded investigation of the safety and efficacy of a topical papaverine gel in the treatment of erectile dysfunction. Of 20 men with organic impotence 17 completed the trial and 13 of these patients had spinal cord injuries. After application of a 15% and 20% papaverine base gel to the scrotum, perineum and penis, Cavernous Artery diameter was significantly increased (36%, p <0.001) as assessed by color flow Doppler ultrasound. Peak systolic flow velocity increased 26%. Only 3 of 14 patients achieved an increase in Cavernous Artery diameter of 75% or more and 2 of 14 had a peak systolic flow velocity of 25 cm. per second or more after application of a topical base gel. Similar findings were pre...
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post radical prostatectomy penile blood flow assessment with color flow doppler ultrasound
The Journal of Urology, 1994Co-Authors: Donna Blackburn, Kevin T. McvaryAbstract:AbstractCadaveric dissections have revealed that accessory blood vessels to the penis often arise near or through the apex of the prostate. These accessory vessels may be easily injured during radical prostatectomy. Increasing attention since the 1980s has focused on preserving potency after radical prostatectomy with a nerve sparing technique. However, many patients are impotent even after a nerve sparing procedure. An arterial, venous or psychological mechanism may be involved. A prospective study was designed to assess Cavernous Artery diameter, peak systolic flow velocity, penile blood flow, end diastolic flow velocity and resistance index preoperatively and postoperatively in patients undergoing radical prostatectomy. Ten patients with a mean age of 60 years were evaluated, of whom 8 underwent a unilateral nerve sparing procedure, 1 bilateral nerve sparing procedure and 1 bilateral nonnerve sparing procedure. Mean penile blood flow as calculated by the formula penile blood flow = peak systolic flow v...
Pierfrancesco Palego - One of the best experts on this subject based on the ideXlab platform.
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efficacy of penile low intensity shockwave treatment for erectile dysfunction correlation with the severity of Cavernous Artery disease
Asian Journal of Andrology, 2021Co-Authors: N Caretta, Pierfrancesco Palego, Maurizio De Rocco Ponce, Nadia Minicuci, Ilaria De Santis, Andrea Garolla, Carlo ForestaAbstract:We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction (ED) combined with Cavernous Artery disease (CAD). ED was evaluated by the International Index of Erectile Function, subdividing patients into mild and moderate/severe forms. CAD was assessed using penile color Doppler ultrasonography. Patients (n = 111) with a positive outcome after treatment, based upon the minimal clinically important difference of the International Index of ED, were followed up for 3 months and 6 months. We found a significant mean increase in the index of erectile function, with an overall improvement in hemodynamic parameters of the Cavernous Artery. In particular, 93.9% of the patients with mild ED without CAD responded to treatment and 72.7% resumed normal erectile function. Only 31.2% of the patients with moderate/severe ED and CAD responded to treatment, and none resumed normal erectile function. All patients with mild ED and no CAD maintained the effects of therapy after 3 months, while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months. Thus, patients with mild ED and no CAD have better and longer lasting responses to such treatment, with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.
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Cavernous Artery intima media thickness a new parameter in the diagnosis of vascular erectile dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: N Caretta, Pierfrancesco Palego, Mirko Schipilliti, Alberto Ferlin, Antonella Di Mambro, Carlo ForestaAbstract:ABSTRACT Introduction A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved. Although Cavernous peak systolic velocity (PSV) is generally considered a major parameter, it has many false positives and negatives because of anatomic variations of the Cavernous Artery course, challenging site of sampling, insufficient caracterization of an early phase of vascular disease, and significant influence of adrenergic tone. Aim We performed a high magnification ultrasonographic study in order to compare functional and morphological parameters of the Cavernous Artery to PSV and their relation with penile and systemic atherosclerosis. Methods A total of 109 subjects (84 ED patients and 25 controls) evaluated in our andrological center from March 2007 to January 2008 were enrolled in the study. Main Outcome Measures All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution echo color doppler evaluation of carotid, femoral and penile districts (acceleration time, intima media thickness [IMT], intima adventitia thickness, caliper before and after intraCavernous alprostadil injection [Δ-Cavernous calliper]). Results Cavernous parameters were significantly different between ED and controls. Multivariate model showed that IMT was the only predicting parameter for ED of vascular origin. Cavernous IMT showed a strong direct correlation with carotid and femoral IMT. ED patients with two or more cardiovascular risk factors had a significantly higher Cavernous IMT. Conclusions An increased Cavernous IMT (≥0.3 mm) might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase. Caretta N, Palego P, Schipilliti M, Ferlin A, Di Mambro A, and Foresta C. Cavernous Artery intima-media thickness: A new parameter in the diagnosis of vascular erectile dysfunction. J Sex Med **;**:**–**.