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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examined prospectively the prevalence and type of sexual dysfunction in a well-characterized group of 160 insulin-treated (Type 1) diabetics during a 6-year period. Of the original sample, 101(76%) participated in the follow-up study and were considered representative of the original consecutive sample. In this study each patient was his/her own control. Prevalence and type of sexual dysfunction was similar to reports from the first investigation and similar to prevalences from other studies. At both examinations a significantly higher prevalence of sexual dysfunction was recorded among diabetic men with signs of peripheral neuropathy. A group of diabetic patients had recovered from their sexual problems in the intervening period without any therapeutic procedures and without any changes in their diabetic status. Psychosocial events seemed to be major factors. Recovery was seen even in patients having peripheral and/or autonomic neuropathy. Although a significant correlation of peripheral neuropathy and erectile dysfunction in diabetic men was demonstrated, many patients with peripheral and/or autonomic neuropathy were without any sexual concerns. Reported sexual dysfunction was significantly correlated to clinical assessment of disease-acceptance and prevalence of somatopsychological reactions to the disease. Of importance in optimal diabetes therapy and in sexual dysfunction research in diabetics is the integration of emotional and behavioral aspects without forsaking the somatic factors. In routine diabetes control sexual aspects should be incorporated in the overall counseling of the diabetic patient or the diabetic couple.
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PMID:Sexual dysfunction in insulin-treated diabetics: a six-year follow-up study of 101 patients. 374 Oct 87

Sexual dysfunction was studied in 50 patients who had had a myocardial infarction (MI) matched with 50 control patients who were comparable in terms of age, hypertension, diabetes, and smoking. The MI group revealed sexual dysfunction in 76%, with erectile dysfunction in 42%. In the control group there was sexual dysfunction in 68% and erectile dysfunction in 48%. There was no statistically significant difference observed between the two groups. However, there was a significant influence of sex counseling on subsequent sexual functioning. Patients who received information as to when it was safe for them to resume sexual activity showed a lesser degree of apprehension in the post-MI period. The need of sexual rehabilitation for these patients and more thorough epidemiological comparative studies are suggested.
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PMID:Myocardial infarction and its influence on male sexual function. 380 Jun 40

Careful evaluation was carried out in 93 men older than 50 with erectile dysfunction. Their mean age was 61 years and the disorder had been present for a mean of 4.5 years. While 14 men (15%) had psychosocial factors that may have been pertinent, only 2 scored poorly on an Affect Balance Scale and 3 were receiving psychoactive medications. Results of nocturnal penile tumescence were abnormal in 91%. In 39% penile-brachial pressure indices were suggestive of pelvic vascular disease and in 9% were consistent with a pelvic "steal syndrome." Pelvic or peripheral nerve conduction disorders were also commonly seen in 54%. Endocrinopathy may have contributed to the dysfunction in 35%. Twenty-one men had diabetes mellitus, two new cases of hypothyroidism were discovered and hypogonadism was diagnosed definitely in four and considered likely in five others. Coexisting medical conditions were found in more than 90% of the men, especially hypertension, use of antihypertensive medications and atherosclerotic disease. Previous prostatectomies (19%) and vasectomies (30%) were common in the surgical histories. Given the wide range of disorders uncovered in older men complaining of impotence, diagnostic study of potential causes may lead to a more rational approach for the evaluation and management of these men.
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PMID:Evaluation of impotence in older men. 401 64

By direct interrogation and specific questions, the erectile function of 1,128 male adults, aged sixteen to eighty years and over, was elicited. The erectile function was based on ability to develop an erectile angle of 90 degrees and more, and this was used for classification purposes. Three hundred seventeen consecutive, unselected male diabetics and 117 nondiabetic male hypertensives were compared with 635 consecutive adult males with neither diabetes nor hypertension. Our results indicate that erectile dysfunction, partial or complete, is more prevalent in diabetics compared with nondiabetics of the same age groups. An unexpected finding was a meager relationship between hypertension and erectile disability. Antihypertensive drugs were responsible for only 2 cases of erectile dysfunction in our male hypertensive patients. The negative impact of age was noted in all age groups and in those with or without diabetes or hypertension.
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PMID:Erectile dysfunction in diabetes and hypertension. 402 3

Since 1974, 900 patients with erectile dysfunction from various causes underwent implantation of a semi-flexible prosthesis, generally of the Small-Carrion type. The largest group had arteriosclerotic or hypertensive cardiovascular disease. The second largest group was composed of patients with diabetes mellitus. Those in the third group had undergone prostatectomy, cystectomy, or abdominal-perineal resection. For a large number of patients a diagnosis of psychogenic impotence was reached, mainly from the results of the history questionnaire and the Minnesota Multiphasic Personality Inventory. Complications were rare (8.1%). Preoperative, intraoperative, and postoperative considerations include correct selection of prosthesis, rigorous antibiotic coverage, prevention or care of perforation, and possible need for reoperation. The results were almost uniformly successful. Psychogenic cases and instances of infertility related to the impotence are reviewed.
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PMID:Surgical treatment of impotence with Small-Carrion prosthesis. Preoperative, intraoperative, and postoperative considerations. 671 88

One thousand one hundred eighty men in a medical outpatient clinic were screened as to the presence of impotence. Four hundred one men (34%) were impotent, and of those, 188 (47%) chose to be examined for their problem. After a comprehensive evaluation the following diagnoses were obtained: medication effect, 25%; psychogenic, 14%; neurological, 7%; urologic, 6%; primary hypogonadism, 10%; secondary hypogonadism, 9%; diabetes mellitus, 9%; hypothyroidism, 5%; hyperthyroidism, 1%; hyperprolactinemia, 4%; miscellaneous, 4%; and unknown causes, 7%. The mean age of the impotent patients was 59.4 years, and the prevalence of alcoholism was 7%. Luteinizing hormone, follicle-stimulating hormone, testosterone, thyroxine, triiodothyronine (T3), T3 resin uptake, and prolactin studies were necessary to diagnose individual cases. We conclude that erectile dysfunction is a common and often overlooked problem in middle-aged men followed in a medical clinic.
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PMID:Impotence in medical clinic outpatients. 682 62

Organic causes of erectile dysfunction with androgen deficiency may be associated with aging, systemic illness, and a number of specific endocrine disorders stemming from pituitary, thyroid, and adrenal dysfunction. Central hypogonadism is the main mechanism in the majority. Erectile dysfunction in diabetes mellitus is caused by chronic complications due to poor metabolic control. Diagnosis and management of these disorders are discussed, as is the need for tight glycemic control in men with diabetes.
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PMID:Diagnosis and management of endocrine disorders of erectile dysfunction. 748 29

One hundred and fifty-nine men with erectile dysfunction were assessed with Rigiscan monitoring of nocturnal penile tumescence (NPT) and response to intracavernosal injections (ICI) of papaverine or prostaglandin E1. A satisfactory NPT, suggestive of psychogenic causation, was recorded in 58%, whereas 15% had clearly impaired NPT. There was a significant association between presence of vascular disease, diabetes and impairment of NPT. For ICI, only 32% showed a satisfactory response, with 48% clearly impaired. Of the 92 men with satisfactory NPT, 40% HAD clearly impaired and 41% satisfactory ICI response. Of the 51 men with satisfactory ICI response, 8% had clearly impaired and 74.5% satisfactory NPT. There was no association between ICI response and history of vascular disease. We conclude that monitoring of NPT by Rigiscan, and without sleep monitoring, is a valuable diagnostic procedure. In contrast, because of the high proportion of false negative results. ICI monitoring is of very limited diagnostic value. The explanation for false negative ICI responses, however, could prove to be of considerable theoretical and clinical importance.
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PMID:The clinical assessment of erectile dysfunction: a comparison of nocturnal penile tumescence monitoring and intracavernosal injections. 749 41

Erectile dysfunction occurs frequently in human diabetes, and it is sometimes associated with hypogonadism. These conditions also develop in a model of insulin-dependent (type I) diabetes, the BB/WORdp (diabetic prone) rat but have not yet been investigated in the model of insulin-resistant (type II) diabetes, the BBZ/WOR rat. It is also unknown whether diabetes-related impotence is due to reduced levels of the mediator of penile erection, nitric oxide, caused by a decrease of nitric oxide synthase (NOS) in the penis. To clarify these questions, groups (n = 5-6) of diabetic BB/WORdp (insulin-maintained) and BBZ/WOR rats were age-matched with diabetic-resistant BB/WORdr and non-diabetic BB/WORdp rats and submitted to determinations of serum glucose, testosterone, and penile reflexes (cups and flips). Erectile dysfunction was found in all of type I and in most of type II diabetic animals (glycemias of 25.0 and 31.1 mM), at the selected mean ages of 310 and 180 days old, respectively. This was evidenced by over 95% decreases of erectile reflexes in both types of diabetes and was accompanied by 75% reduction of serum testosterone. Soluble NOS activity was measured in penile tissue from the diabetic rats with impaired erectile reflexes and in the corresponding controls, by the (3H)-L-arginine/citrulline conversion assay. The neuronal NOS isoform (nNOS) content was determined by a semiquantitative western blot assay. Both types of diabetes showed a marked decrease of penile NOS activity (74 and 55%, respectively), and a lower reduction of penile nNOS content (47 and 33%, respectively). No endogenous NOS inhibitor was detected in the diabetic type I penile cytosol by cross-mixing NOS activity assays. Our data support a common etiology for erectile dysfunction present in rats with types I and II diabetes mellitus and suggest that the etiology is related to a decrease of penile NOS derived in part from serum androgen deficiency.
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PMID:Reduction of penile nitric oxide synthase in diabetic BB/WORdp (type I) and BBZ/WORdp (type II) rats with erectile dysfunction. 758 27

Erectile dysfunction is a well documented complication among male hemodialysis patients. The cause has been reported to be related to multiple factors, including neurological, endocrinological and vasculogenic elements. The purpose of this study was to identify the factors which most greatly determine erectile dysfunction in hemodialysis patients. Male hemodialysis patients without diabetes mellitus and severe anemia (Hb value < 8.0 g/dl) were entered into the study. We measured nocturnal penile tumescence (NPT) values in these patients and carried out neurological studies (measurement of the penile dorsal nerve conduction velocity and the bulbocavernosus reflex (BCR) latency). a vasculogenic study (measurement of the penile blood pressure index (PBPI) and endocrinological studies (measurement of serum free testosterone levels and serum prolactin levels before hemodialysis). NPT values (maximum penile circumference changes) in hemodialysis patients decreased compared with those in healthy males. In both hemodialysis patients and healthy males, NPT values decreased with age. NPT values in hemodialysis patients were significantly lower than those in healthy males in the fifties and sixties. 32.2% of hemodialysis patients had severe penile neurological disorder. 55.6% of them showed abnormal NPT. PBPI was low in only 10.0% of hemodialysis patients. However, there was a significant correlation between PBPI and the NPT value (r = 0.387). Serum free testosterone levels in hemodialysis patients were significantly lower than those in healthy males. There was a significant correlation between the serum free testosterone level and the NPT value (r = 0.328). However, there was no correlation between the serum prolactin level and the NPT value. To identify the factors which most greatly determine erectile dysfunction in hemodialysis patients, we carried out multivariate analysis. The criterion variables in this analysis were NPT values. The coefficient of determination was highest for a neurological disorder (30.7%), followed by an endocrinological disorder (a reduction in the serum free testosterone level) (11.6%) and a vasculogenic disorder (a reduction in PBPI) (4.2%).
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PMID:[Study of sexual function in male hemodialysis patients--analysis of the cause of erectile dysfunction]. 760 52


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