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

A retrospective multi-institutional study was performed to document and characterize the arterial vascular disease in the hypogastric-cavernous arterial bed and/or veno-occlusive dysfunction of the corpora cavernosa in patients with end stage renal disease. We evaluated 20 impotent patients (mean age 40 +/- 9 years) with chronic renal failure using pharmaco-cavernosometry and pharmacocavernosography (4 also underwent pharmaco-arteriography). Patients were divided into groups based on the treatment (14 with renal transplantation and 6 with hemodialysis or peritoneal dialysis), as well as by history of vascular risk factors (16 with and 4 without risk factors). Of the patients 19 revealed abnormal intracavernous pressure responses to repeated intracavenous injections of vasoactive agents implying vascular disease of the penis. Cavernous artery occlusive disease was found in 78% of the patients. All patients who underwent arteriography had diffuse atherosclerotic disease of the distal penile arteries. Corporeal veno-occlusive dysfunction was found in 90% of the patients, of whom 60% had diffuse pan-cavernous leakage involving the dorsal, cavernous and crural veins, glans penis and corpus spongiosum. This renal failure-associated vascular disease of the penis was found to occur independently of the presence of known systemic atherosclerotic vascular risk factors. Patients who underwent early treatment of the uremia by renal transplantation had vasculogenic impotence only in the case of rejection of the renal transplant, suggesting that early renal transplantation may delay or prevent the development of the penile vasculopathy. The most likely pathophysiology of the vascular impairment includes renal failure-associated atherosclerosis, and renal failure-associated hypoxia changes of the contractile (smooth muscle) and structural (collagen/elastin) components of the erectile tissue. Strategies for future research and clinical therapies are suggested.
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PMID:Impotence and chronic renal failure: a study of the hemodynamic pathophysiology. 830 70

Impotence affects an estimated 10 million American men. The cause is usually organic in men over age 50; psychogenic impotence is more common in younger men. Vascular disease is the most common cause of impotence. Evaluation in patients with impotence includes thorough history taking and diagnostic testing. Once the cause of impotence is determined, appropriate management can be chosen. Current therapeutic options include vacuum tumescence devices, self-injection, oral therapy, psychotherapy, and penile prostheses.
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PMID:Management of impotence. Diagnostic considerations and therapeutic options. 844 27

The etiological diagnosis of an erectile dysfunction usually requires a study of penis vascularization. The arterial origin involves a high percentage of erectile dysfunctions. The eco-doppler allows to perform the study in a fast, non-invasive and effective way, providing information on the morphological aspects of arteries and flow parameters. This paper reports on a study conducted in 151 subjects, aged 27-80 years, where the cause of impotence was arterial; the existence of clinical signs of vascular deficit in other domains had already suggested the condition in a group (36 subjects), while the another group (115) had no clinical symptoms and was diagnosed through eco-doppler. 75.5% were smokers and 83.1% hypertensive. All subjects underwent a baseline study, repeated in 148 after intracavitary injection (ICI). The arteries were difficult to identify at rest, but easier after ICI, presenting morphological features which were suggestive of disease: twisted course, irregular lumen, thickened walls. Flow parameters at rest presented no differences between groups, both speed (p < 0.001) and flow time (p < 0.05) being lower than in subjects with no vascular disease. Only 25.7% reached full erection with ICI, beats being noticed in 44 (91.9%). After administration of the drug there was a significant increase in systolic speed (p < 0.001), rising to 16 +/- 4.9 cm/s vs 34.7 +/- 9.3 cm/s in subjects with no vascular disease (p < 0.001). Flow time increases after ICI, reaching 345 +/- 215 msec, less than in healthy subjects (p < 0.001). RI, highly variable at rest, does not change significantly after ICI, 0.71 +/- 0.11, lower than subjects with no disease (p < 0.001). The increases seen in flow speed are greater in subjects with no ischaemic symptomatology (p < 0.01), same as RI (p < 0.05), and reveals a better arterial response. Those who obtain full erection reach greater RI (0.77 +/- 0.13) than those without full erection (0.68 +/- 0.08) (p < 0.001).
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PMID:[Erectile dysfunction of arterial origin. Vascular study of the penis with Doppler ultrasonography]. 876 99

The negative role of smoking on circulation is widespread knowledge and it has been rated as a vascular risk factor. This paper evaluates the influence of smoking on the arterial supply to the erectile tissue, establishing the flow speed parameters in cavernous arteries with eco-doppler both at rest and after intracavernous PgE1 injection. Four groups were studied: non-smokers, without arterial disease and with arterial disease of non-smoking etiology; smokers with vascular disease, and another group where smoking was the only verified etiological factor. No significant differences were detected in flow speed parameters at rest among smokers and non smokers both in individuals with preserved erectile potency or with erectile dysfunction. Following drug therapy, impotent smokers showed the worse erectile response. With regard to flow speed parameters, although the differences were not significant, it can be seen that smokers, whether potent or not, show less differential speed, flow time, and acceleration, exhibiting a certain degree of arterial rigidity. That flow speed parameters, in cases with erectile dysfunction, can be superposed in individuals with arterial-origin impotence and those where smoking is the sole risk factor, indicates that this is a factor which causes erectile dysfunction due to vascular damage, as severe as any other caused by other factors such as arteriosclerosis, diabetes, or hypertension.
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PMID:[Assessment of tobacco impact on penile vascularization with echo-Doppler and intracavernous injection]. 880 98

It is well known that diabetes mellitus is accompanied by complications of sexual dysfunction and it is believed that diabetic neuropathy may cause impotence. In our study, we found that not all the patients who visited our center with the chief complaint of diabetic impotence were suffering from organic impotence, and diabetes mellitus per se served as a means of psychological stress in a substantial number of cases. Probably because no method has been available to provide precise information on the state of the penile-controlling nerves, we found that a larger number of patients than expected were suffering from a vascular disorder.
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PMID:Is diabetic neuropathy responsible for diabetic impotence? 918 40

Erectile dysfunction or impotence is a very common complication in diabetic male patients; the prevalence of which may be more than that of retinopathy. The cause of diabetic impotence has been thought to be neuropathy or angiopathy or both of them. The diagnosis of diabetic impotence is based on the exclusion of other causes of impotence including psychological, iatrogenic, endocrinological impotence. The treatment options for diabetic impotence such as vacuum device, intracavernous self-injection or surgical procedures are available and useful at present. In this article, other sexual dysfunction; retrograde ejaculation and female sexual dysfunction in diabetes mellitus are also discussed.
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PMID:[Sexual dysfunction in diabetes mellitus]. 939 1

Erectile dysfunction (ED, formerly referred to as impotence, is a common (especially in diabetic and older men) and distressing condition. Several risk factors have been identified; among these are smoking, hyperlipidaemia, hypertension and diabetes mellitus. These risk factors are shared with atherosclerotic vascular disease (e.g. ischaemic heart disease). This observation underlies a common vascular pathology. Smoking may cause ED by several mechanisms, including adversely affecting intrapenile blood flow. It is important to be aware of the link between smoking and ED since this information may motivate some male smokers to quit. In this context, it is important to be aware of the link between smoking and ED since this information may motivate smokers to quit. In this context, it is relevant that there is evidence that quitting may restore/improve erectile function.
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PMID:Cigarette smoking and erectile dysfunction. 1007 52

Therapy for erectile dysfunction (ED) may be specific to the cause of ED or it may be nonspecific. There are only three causes of ED which have specific therapy: psychogenic, endocrine and certain types of reversible vasculogenic ED. In the era of oral therapy for ED, treatment is not cause-specific in the great majority of patients. For this great majority, only the basic evaluation of ED is needed. Only when there is a strong suspicion that the cause of a patient's ED is endocrine, psychogenic or reversible vascular disease are additional diagnostic tests indicated. In these three categories of patients, specific treatment of the cause of ED can produce a permanent and dramatic improvement in sexual function and satisfaction. International Journal of Impotence Research (2000) 12, Suppl 4, S12-S14.
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PMID:Diagnostic evaluation of erectile dysfunction in the era of oral therapy. 1103 81

Erectile dysfunction is a recognized complication of prostate and bladder radical surgery, although there is significant variation in the reported risk, much of this variability is related to the retrospective nature of most previous studies. Undoubtedly, the quality of life of bladder and prostate cancer patients would be much improved if both normal micturition and potency are preserved, which is the subject of this article. Quality of life studies can delineate sexual function after radical prostatectomy, including the use of sexual aids. Penile erection is a neurovascular event modulated by neurotransmitters and hormonal status. The penis is innervated by autonomic and somatic nerves. Both surgery and radiation therapy appear to affect such a mechanism. Radiation is thought to produce Erectile Dysfunction (ED) by accelerating microvascular angiopathy causing cavernosal fibrosis or stenosis of the pelvic arteries and by accelerating existing arteriosclerosis, leading to vascular impotence. Years may elapse before clinically significant ED occurs. Criteria that influence recovery of erections after surgery include younger patient age, stronger erections before operation, preservation of the neurovascular bundles, and attention to fine details in the surgical technique. Recovery of erections occurs in 68% of preoperatively potent men treated with bilateral nerve-sparing surgery and in 47% of those treated with unilateral nerve-sparing surgery.
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PMID:Erectile dysfunction after surgical treatment. 1275 91

The purpose was to assess health-related quality of life (HRQOL) in long-term survivors of thoracoabdominal aneurysm repair. Between 1983 and 2001, 43 patients underwent thoracoabdominal aneurysm repair. Long-term survivors (13) were investigated. Two were lost to follow-up. The mean follow-up period was 6.2 years. HRQOL was measured by Short Form (SF)-36, constructed of 36 items grouped into eight scales measuring physical functioning, role limitations caused by physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations caused by emotional problems, and mental health. Additional questions specific for vascular disease were ascribed. The patients' relatives received corresponding questions, responding on behalf of the patients. Patient data scores were compared with a selection of individuals from the general population. The patients' SF-36 scores were generally poorer than that of the healthy population in both physical and mental dimensions. Patients who had a complicated postoperative course generally scored lowest in physical dimensions. Comparing patients' scores with relatives scoring on behalf of the patients showed no statistical differences. According to disease-specific questions, impotence and pain were reported as major long-term postoperative problems. Patients with uncomplicated postoperative courses all reported improved health status (six) compared with the preoperative status, whereas five patients with complicated postoperative courses reported poorer health status. Nine of 11 patients experienced the same or improved HRQOL, and two patients reported reduced HRQOL after surgery. Ten of 11 patients evaluated the operation as successful. Although the sample size in this study is small, those who had postoperative complications or reported a decreased physical function in the years after surgery generally had low scores in almost all dimensions of the SF-36. When disease-specific questions were related to thoracoabdominal aneurysm surgery, most patients reported an acceptable HRQOL.
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PMID:Health-related quality of life in long term-survivors of thoracoabdominal aortic aneurysm repair. 1612 32


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