Sindrome Metabolico y funcion-disfuncion Sexual

1: J Sex Med. 2009 Aug 12. Links

Metabolic Syndrome and Sexual (Dys)function.

Borges R, Temido P, Sousa L, Azinhais P, Conceição P, Pereira B, Leão R, Retroz E,Brandão A, Cristo L, Sobral F.

Centro Hospitalar de Coimbra-Urology Department, Coimbra, Portugal.

Introduction. The general worldwide increase in metabolic syndrome (MS) among most populations may result in more individuals with sexual dysfunction. Aim. To provide an update on clinical and experimental evidence regarding sexual dysfunction in patients with MS from both sexes and treatment modalities. Methods. A comprehensive literature review was performed using MEDLINE with the MeSH terms and keywords for "metabolic syndrome,""obesity,""female sexual dysfunction,""erectile dysfunction,""androgen deficiency,""weight loss," and "bariatric surgery." Main Outcome Measures. To examine the data relating to sexual function in both men and women with MS, its relationship and the impact of treatment. Results. The MS is strongly correlated with erectile dysfunction, hypogonadism (predictors of future development of MS), and female sexual dysfunction. Few studies have been addressed in the treatment of these dysfunctions in the special setting of MS, other than the observational effects on sexual function of individual risk factors correction. This can be a result of their understudied etiopathogeny. Nonsurgical weight loss has been shown to improve sexual function (with the mainstay on sedentarism prevention), whereas the efficacy of bariatric surgery in this respect, which has been suggested by some preliminary evidence, needs to be further confirmed by adequate clinical trials. Conclusion. As the global incidence of MS increases, more individuals may experience sexual dysfunction and a systematic evaluation should be emphasized in this patient population, in order to identify those who are in need of intervention.

PMID: 19678882 [PubMed - as supplied by publisher]

rol de de las immunophilinas en la recuperacion de la funcion erectil luego de la injuria del nervio cavernoso

1: J Sex Med. 2009 Mar;6 Suppl 3:340-6. Links

Role of immunophilins in recovery of erectile function after cavernous nerve injury.

Sezen SF, Lagoda G, Burnett AL.

James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Department of Urology, Baltimore, MD 21287, USA. ssezen1@jhmi.edu

INTRODUCTION: Immunophilin ligands provide potentially new alternatives for the treatment of erectile dysfunction (ED), which occurs after injury of the cavernous nerves (CNs). AIM: To review and update current knowledge of the neurotrophic effects and likely mechanism of action of immunophilin proteins with emphasis on the FK506-binding protein (FKBP) subfamily and the role of immunophilin ligands for the treatment of CN injury-induced ED. METHODS: Review of available reports of studies investigating the effects and neurotrophic mechanisms of immunophilin ligands involved in erectile function recovery in rodent models of CN injury. MAIN OUTCOME MEASURES: Erection parameters and molecular correlations associated with CN injury and functional recovery. RESULTS: Treatment with prototype immunosuppressive immunophilin ligands FK506 (FK) and rapamycin (Rapa) improve erectile function in animal models of CN injury. Similarly, non-immunosuppressive analogs such as GPI-1046 and FK1706 are effective in recovery of erections after CN injury. Neuronal nitric oxide may influence the erection recovery effects of immunophilin ligands after CN injury. FKBPs 38 and 65 expression changes in the penis and its innervation coincide with the neurotrophic effects of immunophilin ligands. Antioxidative actions of immunophilin ligands contribute to their neurotrophic effects. Immunophilins are localized to nerves coursing in human prostate and penile tissue. CONCLUSIONS: The findings support the hypothesis that immunophilin ligands, working through specific receptor mechanisms that are specific to injured CN, are potentially useful to sustain erectile function in men following radical prostatectomy.

PMID: 19267858 [PubMed - indexed for MEDLINE]

Reporte del comportamiento de la funcion erectil luego del tratamiento del cáncer de próstata clinicamente localizado.

1: J Urol. 2007 Aug;178(2):597-601. Epub 2007 Jun 13. Links

Erectile function outcome reporting after clinically localized prostate cancer treatment.

Burnett AL, Aus G, Canby-Hagino ED, Cookson MS, D'Amico AV, Dmochowski RR, Eton DT,Forman JD, Goldenberg SL, Hernandez J, Higano CS, Kraus S, Liebert M, Moul JW, Tangen C, Thrasher JB, Thompson I; American Urological Association Prostate Cancer Guideline Update Panel.

The Johns Hopkins Hospital, 600 North Wolfe St., Marburg 407, Baltimore, Maryland 21287-2411, USA. aburnett@jhmi.edu

PURPOSE: In conjunction with the assignment to update the Guidelines for Management of Clinically Localized Prostate Cancer, the American Urological Association Prostate Cancer Guideline Update Panel performed a side analysis of the reporting of erectile function outcomes in this clinical context as published in the medical literature. MATERIALS AND METHODS: Four National Library of Medicine PubMed(R) Services literature searches targeting articles published from 1991 through early 2004 were done to derive outcome reporting (efficacy or side effects) for the treatment of clinical stage T1 or T2 N0M0 prostate cancer. A database was constructed containing descriptions relating to erectile function as well as numerical frequency rates of complete erectile dysfunction, and partial and intact erectile function for various treatments. A literature review was also done, consisting of a PubMed Services search of current measures and protocols used for assessing erectile function outcomes and a survey of consensus opinion sources on the management of male sexual dysfunctions. RESULTS: Based on inclusion criteria 436 articles were selected. Of these articles database extraction from 100 pertaining to radical prostatectomy garnered various characterizations of erectile function, including qualitative descriptions, generic terminology and rating systems. Database extraction from 31 articles, in which results for at least 50 patients were reported, yielded ranges of rates for complete erectile dysfunction, partial erectile function and intact erectile function that were 26% to 100%, 16% to 48% and 9% to 86% for radical prostatectomy, 8% to 85%, 21% to 47% and 36% to 63% for external beam radiation, and 14% to 61%, 21% and 18% for interstitial radiation, respectively. The literature review showed an evolution in standards for studying and reporting erectile function outcomes. CONCLUSIONS: Clinical studies reporting erectile function outcomes after localized prostate cancer treatment often demonstrate poorly interpretable and inconsistent manners of assessment as well as widely disparate rates of erectile dysfunction and erectile function. Future studies must apply scientifically rigorous methodology and standard outcomes measures to advance this field of study.

PMID: 17570435 [PubMed - indexed for MEDLINE]