Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite frequent erectile impotence in aged men, etiologic data are scarce. We evaluated 121 impotent male veterans (mean age, 68 +/- 5.3 years) to obtain information on potential pathophysiologic mechanisms. Subjects related a complete medical history and underwent physical examination, metabolic assessment, nocturnal penile tumescence monitoring, and vascular and neurologic assessment. The most frequent cause of impotence was the coexistence of neurologic and vascular disorders (30.3%). Other subjects had single causes, including vascular disease (21.1%), diabetic neuropathy (17.1%), nondiabetic neuropathy (10.5%), and psychopathology (9.2%). Remaining patients suffered from adverse drug effects (3.9%), hypogonadism (2.6%), and Peyronie's disease (1.3%). Five patients were objectively impotent on the basis of nocturnal penile tumescence, but otherwise normal. We conclude that geriatric impotence is primarily related to vascular or neurologic dysfunction. However, 15.7% of aged impotent men may have reversible impotence (eg, psychogenic causes or hypogonadism), and an additional 31.5% may have a treatable disorder (eg, penile neuropathy).
 ...
PMID:Why aged men become impotent. 278 97

An investigation of 37 diabetics with impotence (15) or erectile difficulties (22) is presented. On average two significant abnormalities per patient were found. Ranked in order of incidence, the causes were as follows: 1) Combination of neuropathy and psychosocial factors, 2) combination of neuropathy and vascular disease, 3) peripheral neuropathy only, 4) combination of hormonal imbalance and psychosocial factors, 5) combination of three or more defects, and 6) penile vascular disease or psychosocial problems only, or hormonal imbalance combined with peripheral neuropathy.
 ...
PMID:Etiologic aspects of impotence in diabetes. 279 92

PBI was measured in 555 patients chosen at random from those who visited our impotence clinic between October 1984 and September 1986. Of 555 patients with impotence 29 (5.2%) showed a low PBI level of less than 0.6. On the basis of carefully taken history, risk factors causing the disturbance of penile blood flow were found in 13 (44.8%) of these 29 patients. They included diabetes mellitus, hypertension, surgery of pelvic organ, vertebral injury, vascular disorder of brain and gangliosympathectomy. Although penile angiography is necessary to make the definite diagnosis of vasculogenic impotence, hospitalization is usually required to perform the examination. Measurement of PBI is useful as a screening test to detect vasculogenic impotence at an outpatient clinic, because this examination is noninvasive and technically easy.
 ...
PMID:[Measurement of penile brachial index (PBI) in patients with impotence]. 281 2

Vascular disease is a major cause of impotence in patients over the age of 40. In a prospective study of 130 impotent patients followed for 24 to 36 months, patients with a penile brachial pressure index (PBPI) of 0.65 or less had a significantly greater risk of a myocardial infarction or a cerebrovascular accident than patients with higher PBPIs. It is concluded that impotence in association with a low PBPI should be considered an indicator of a future major vascular event.
 ...
PMID:Relationship of penile brachial pressure index to myocardial infarction and cerebrovascular accidents in older men. 296 81

The incidence of erectile dysfunction in patients with long-term diabetes mellitus can be as high as 50%. Diabetic microangiopathy is regarded as the most important pathogenic factor. In this review of a group of 210 impotent patients evaluated and treated at our centre we report on the examination data (angiopathy, neuropathy, psychogenic factors) in 36 patients with diabetes in comparison with the corresponding findings in 169 non-diabetic patients. In 5 patients erectile dysfunction had actually preceded the clinical manifestations of diabetes mellitus. Autoinjection therapy was started in 62% of all the diabetic patients, since this is effective, minimally invasive and, therefore, applicable to a large group of patients. This form of therapy was accepted by 90% of our patients' partners, which is in accordance to the reports in the literature. However, treatment had to be interrupted in 2 out of the 22 patients, owing to lack of cooperation on the part of the sexual partner. No complications were attributable to autoinjection therapy.
 ...
PMID:[Disorders of erectile potency in diabetes mellitus]. 304 17

The 11-year experience with 395 consecutive patients in whom an inflatable prosthesis was implanted for the treatment of chronic erectile impotence is reported. Among these patients the most common etiology was vascular disease, followed by diabetes mellitus and radical pelvic surgery. The original American Medical Systems prosthesis with PPT cylinders shows a 61 per cent complication and revision rate with followup from 3 to 11 years. The newer inflatable prostheses manufactured since 1983 have needed revision in only 13 per cent of the patients followed to 4 years. Salvage procedures and increased product reliability have resulted in 97 per cent of the patients being satisfied. Five types of inflatable prostheses are compared and advantages are discussed.
 ...
PMID:Eleven years of experience with the inflatable penile prosthesis. 336 71

The results of investigations in 50 impotent patients with neurological disease are presented. Using intracorporeal papaverine, Doppler duplex scanning, cardiovascular reflex testing and skin thermal threshold monitoring, the vascular and neurological components were assessed in each of three clinical groups with probable or overt neuropathy. These comprised spinal injury, diabetes and pelvic trauma. Anatomical detail of the penis was well seen using these techniques. In 15 patients with spinal injuries, although the aetiology was predominantly neurological, six exhibited poor flow in the deep penile arteries following injection of papaverine. This was associated with poor erections in these patients, suggesting a vascular pathology. In 27 patients with diabetes the results showed a mixed pattern. Vascular disease was almost universal, combined with varying degrees of autonomic and peripheral neuropathy, and only three had full erections with papaverine. Those with pelvic trauma (8 patients) also had a mixed picture, although some had good erections following papaverine injection. Duplex Doppler scanning of the deep penile arteries correlated with the quality of papaverine-induced erection. Thermal testing was a highly sensitive indicator of small nerve fibre dysfunction, possibly at an earlier stage than standard autonomic testing. A vascular component to impotence was shown to be common in those with neurological impairment, and may alter management.
 ...
PMID:Results of investigation of impotence in patients with overt or probable neuropathy. 342 44

Non-insulin-dependent diabetes mellitus is predominantly a disease of aging, with more than 70 percent of non-insulin-dependent (type II) diabetic patients older than 55 years of age. The prevalence of macrovascular, microvascular, and neurologic complications in outpatients with type II diabetes between the ages of 55 and 74 was compared with that in a similarly aged nondiabetic group of patients. The association between duration of diabetes, hypertension, age, and other putative risk factors that are prevalent in this elderly diabetic population and the occurrence of complications was explored. This cross-sectional survey confirmed a significant increase in retinopathy, neuropathy, impotence, and macrovascular complications in patients with type II diabetes. Within the diabetic population, duration of disease was associated with the occurrence of retinopathy and neuropathy, but not associated with such macrovascular complications as coronary artery disease. Gender, type of therapy, and previously identified risk factors for vascular disease such as hypertension had little impact on the prevalence of complications in this population. The notion that type II diabetes in the elderly represents "mild" diabetes with regard to complications must be discarded. Further identification of risk factors within this diabetic population may suggest therapeutic approaches that will prevent or ameliorate the development of complications.
 ...
PMID:Non-insulin-dependent diabetes in older patients. Complications and risk factors. 353 94

Previous studies of the relationship of gonadal function to impotence in men with diabetes mellitus have yielded conflicting results. Pituitary-testicular function was studied in 28 impotent diabetic men and 15 normal men. Impotence was documented by clinical history and subdivided into categories of primary organic (n = 16), primary psychogenic (n = 7), and unclassified (n = 5) on the basis of nocturnal penile tumescence (NPT) testing, psychological testing, and penile vascular studies. All NPT parameters were diminished (P less than or equal to 0.001) in the impotent diabetic men compared to values in the normal men. Endocrine studies revealed increased urinary LH (P less than or equal to 0.05) and diminished serum free testosterone levels in the diabetic men with primary organic impotence. These changes were not found in normal men or diabetic men with primary psychogenic impotence. Six months of treatment in a home blood glucose-monitoring program resulted in significant improvement in metabolic control but no improvement in pituitary-testicular function, NPT, or sexual performance in the primary organic impotent group. Eight patients with primary organic impotence and no evidence of penile vascular disease had significant improvement (P less than or equal to 0.01) in NPT results as well as subjective improvement in sexual function after 6 months of parenteral testosterone administration. These studies suggest that primary gonadal dysfunction may be related to organic impotence in diabetes, and improvement in selected patients can occur with androgen therapy.
 ...
PMID:Gonadal dysfunction in diabetic men with organic impotence. 358 93

A stepwise diagnosis using objective and reproducible methods of examination makes it possible to distinguish between psychogenic and organic causes of impotence. Among 104 men who had organic disorders of erection half were due to local penile disease, the remainder to vascular disease (diabetic angiopathy, arteriosclerosis, abnormal venous drainage). Cavernosal through-flow measurements revealed differences among the various groups of disorders with regard to the flow rates required for achieving and maintaining an artificial erection and made it possible, in conjunction with other tests (Doppler perfusion measurements and papaverine response), to arrive at a precise diagnosis and plan for surgical intervention. Of 91 men who had been operated upon 79 had good results (87%). Largely noninvasive diagnostic measures thus achieved effective treatment and thus contributed to an improved feeling of self-esteem.
 ...
PMID:[Diagnosis and therapy of organic impotence]. 378 Apr 48


<< Previous 1 2 3 4 5 6 Next >>