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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The isotope phallogram is an investigation which uses radioisotope-labelled red cells in the imaging of penile arterial blood flow. In a preliminary series of 12 impotent patients undergoing both internal iliac arteriography and isotope phallography, the penogram index described by Fannous et al. (1982) has been modified to derive an accurate indicator of vascular disease.
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PMID:Isotope phallogram: preliminary communication. 400 69

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

Three hundred impotent patients were evaluated by a general and sexual questionnaire, clinical examination, hormonal assay, penile blood pressure measurements, erectiometry, urodynamic studies and ultrasonography of the corpus cavernosum. The patients were classified according to the cause of the impotence; 44% had a psychogenic basis, 13% a neuropathy, 39% a vasculogenic cause and 4% a combination of neuropathy and angiopathy. Psychogenically impotent patients were referred for further treatment. Twenty penile prostheses were implanted in the organic group; 19 patients were satisfied with the result. This diagnostic approach to impotence classification and treatment according to the cause and the careful selection of patients for surgery improved the success rate.
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PMID:[The evaluation, classification and management of 300 impotent patients]. 407 40

Pulse volume recordings were obtained in 60 normal subjects and 74 patients with a history of impotence using a technique that is simple, reliable, inexpensive, reproducible and capable of standardisation. It measures the contributions of all vessels in the penis. The components of the electronic package are described. The pulse volume amplitudes, pulse contours and other measurements in normal subjects are defined. The results give a reliable index of penile blood flow. Pulse volume recordings were also found to correlate with the severity of pelvic angiographic patterns of occlusive disease. Further investigation is necessary to determine the precision with which the method can detect penile blood flow in patients with early vascular disease.
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PMID:Vasculogenic impotence: diagnosis and objective evaluation using quantitative segmental pulse volume recorder. 653 56

The experience with 100 consecutive patients in whom an inflatable penile prosthesis was implanted for the treatment of chronic erectile impotence over a two-year period is reported. Each patient was thoroughly evaluated by history, physical examination psychologic investigation, and appropriate laboratory testing. Of these patients, the most common indication for prosthesis implantation was diabetes mellitus of adult onset, followed by vascular disease and radical pelvic surgery. Restoration of erectile function was accomplished in 99 patients. Mechanical complications and malfunction occurred in 12 patients; all such complications were surgically corrected in subsequent operative procedures. One diabetic patient experienced infection of the prosthesis, requiring its removal. The implantation of an inflatable penile prosthesis in properly selected patients, with careful surgical technique by a skilled and experienced surgeon, can produce excellent functional results and return of normal sexual activity.
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PMID:Inflatable penile prosthesis: experience with 100 patients. 661 93

The injection of 80 mg of Papaverine into one of the corpora cavernosa of the penis produces an erectile response which is proportional to the local haemodynamic conditions. On the basis of this test, the investigation of penile rigidity coupled with Doppler velocity studies permit cases of impotence due to vascular disease to be differentiated from other abnormalities of erection. The intensity of the response is proportional to the quality of the local vascular reaction. The intense vaso-dilatation of the cavernous arteries leads the author to propose the use of this drug and this route of administration in the treatment of certain cases of poor erection due to arterial disease.
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PMID:[Trial of intracavernous papaverine in the treatment of impotence. Therapeutic prospects]. 666 98

Sixty patients undergoing surgical reconstruction by classical or modified methods for aorto-iliac vascular disease were studied as to postoperative sexual function. Preoperative impotence was present in approximately half of the patients with abdominal aortic occlusion. Although internal iliac arterial blood flow was regarded as an important factor in sexual function, only a slight correlation was noted between circulatory insufficiency and postoperative sexual dysfunction. Preservation of both trunks or the left trunk of the hypogastric nerve led to a marked decrease in the incidence of ejaculation disturbances. We concluded preservation of the hypogastric nerve was more beneficial than maintenance of internal iliac arterial blood flow.
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PMID:Sexual function after aorto-iliac vascular reconstruction. Which is more important, the internal iliac artery or hypogastric nerve? 670 71

A Doppler ultrasound probe was used in 42 men to evaluate penile circulation. Twenty-six patients had confirmation of vascular anatomy by pelvic arteriography. The average penile acceleration (peak velocity over pulse rise time) relative to the radial artery acceleration was expressed as the penile flow index. Eleven potent men had a penile flow index of 3.4 plus or minus 0.4 standard error, while 13 impotent men with vascular disease on arteriography had a penile flow index of 21.7 plus or minus 5 standard error (p less than 0.01). Patients with intermediate penile flow index values had variable degrees of erectile failure. This relatively simple, non-invasive technique identifies a vascular component of impotence, thus aiding in the selection of appropriate management.
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PMID:Penile flow index utilizing a Doppler pulse wave analysis to identify penile vascular insufficiency. 742 May 53

Penile blood pressure studies and pudendal artery angiograms indicate that vascular disease may be a frequent cause of erectile failure in men. Attempts to correct this form of impotence with revascularization of the corpus cavernosum have been satisfactory in a minority of patients.
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PMID:Diagnosis and therapy of vasculogenic impotence. 742 May 54

The response to the intracavernosal injection of differing doses of prostaglandin E1 (PGE1)(10, 20 and 30 micrograms) was compared in a randomized prospective manner in 283 men with chronic impotence, in an attempt to identify the optimal drug dose for pharmacological diagnosis. The mean age of patients studied was 63.1 years, and comprised 90 men with arteriogenic impotence, 133 men with either pure venogenic impotence or venous leakage associated with arteriogenic impotence, and 60 men with psychogenic impotence. Erectile responses were quantified using real-time RigiScan monitoring and were compared to a diagnosis based on the patient history, examination findings and all subsequent investigations. In patients with arteriogenic impotence, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1, was made in 71, 89 and 90% of patients respectively. In patients with venous leakage, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1 was made in 95, 95 and 93% of patients respectively. In patients with psychogenic impotence, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1 was made in 72, 95 and 98% of patients respectively. This study indicates that pharmacological diagnosis with PGE1, is a useful screening test to differentiate penile vascular disease from psychogenic impotence and arteriogenic impotence from cavernosal venous leakage, achieves optimal sensitivity and specificity with doses of 20 micrograms or greater, but is associated with a high false diagnosis rate of diagnosis of penile vascular disease if doses of less than 20 micrograms are used.
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PMID:An attempt to standardize the pharmacological diagnostic screening of vasculogenic impotence with prostaglandin E1. 749 45


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