Modern methods of diagnosis and treatment of vasculogenic erectile dysfunction

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Abstract

A review of modern methods of diagnosis and treatment of vasculogenic erectile dysfunction is presented. Data regarding the diagnostic value of noninvasive and invasive diagnostic techniques are displayed: stamp test, Snap-Gauge test, use of the RigiScan and Androscan-MIT systems, intracavernous injections of vasoactive drugs, Doppler ultrasound of penile vessels, penile angiography, and magnetic resonance arteriography. The advantages and disadvantages of each of these tests are shown. The main directions of conservative and surgical treatment of vasculogenic erectile dysfunction are presented. Notably, early detection of erectile dysfunction with the prescription of appropriate treatment can improve the quality of life of patients and prevent life-threatening complications of cardiovascular conditions.

About the authors

Ruslan R. Aliev

Altai State Medical University

Author for correspondence.
Email: ruslanaliev@bk.ru
ORCID iD: 0000-0003-4464-9162

MD

Russian Federation, Barnaul

Alexandr I. Neymark

Altai State Medical University

Email: neimark.a@mail.ru
ORCID iD: 0000-0002-5741-6408
SPIN-code: 4528-7765
Scopus Author ID: 7102411541

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Barnaul

Andrei V. Davydov

Altai State Medical University

Email: andre1763@mail.ru
ORCID iD: 0000-0001-8212-2623
SPIN-code: 2423-1090

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Barnaul

References

  1. Kapsargin FP, Volkova GA, Zukov RA, et al. Analysis of publicly available rehabilitation of erectile dysfunction in young men. In: Proceedings of the scientific and practical conference of urologists of Western Siberia: “Issues of diagnostics and treatment of urological diseases”; 2004 May 12–13, 2004; Biysk. (In Russ.)
  2. Pushkar DYu, Kamalov AA, Al-Shukri SHh, et al. Epidemiological study of the prevalence of erectile dysfunction in the Russian Federation. RMJ. 2012;20(3):112–115. (In Russ.) EDN: PACUHF
  3. Efremov EA, Shekhovtsov SYu, Kastrikin YuV, et al. Diagnosis of erectile dysfunction. current state of the problem. Effective pharmacotherapy. 2019;15(16):38–44. EDN: ZKWQHB doi: 10.33978/2307-3586-2019-15-16-38-44
  4. Meisel RL, Sachs BD. The physiology of male sexual behavior. In: Knobil E, Neil J, editors. The physiology of reproduction. New York: Raven Press; 1994. P. 3–96.
  5. Saenz de Tejada IS, Angulo J, Cellek S, et al Physiology of erectile function and pathophysiology of erectile dysfunction. J Sex Med. 2005;2(1):29–36. doi: 10.1111/j.1743-6109.04038.x
  6. Andersson KE, Wagner G. Physiology of penile erection. Physiol Rev. 1995;75(1):191–236. doi: 10.1152/physrev.1995.75.1.191
  7. Duncan C, Omran GJ, The J, et al. Erectile dysfunction: A global review of intracavernosal injectables. World J Urol. 2019;37: 1007–1014. doi: 10.1007/s00345-019-02727-5
  8. Ghanem H, Raheem AA, Abdel Rahman IFS, et al. Botulinum neurotoxin and its potential role in the treatment of erectile dysfunction. Sex Med Rev. 2018;6(1):135–142. doi: 10.1016/j.sxmr.2017.07.008
  9. Goldstein I, McCullough AR, Jones LA, et al. A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. J Sex Med. 2012;9(4):1122–1133. doi: 10.1111/j.1743-6109.2011.02629.x
  10. Madeira CR, Tonin FS, Fachi MM, et al. Efficacy and safety of oral phosphodiesterase 5 inhibitors for erectile dysfunction: a network meta-analysis and multicriteria decision analysis. World J Urol. 2021;39(3):953–962. doi: 10.1007/s00345-020-03233-9
  11. Kang SG, Kim JJ. Udenafil: Efficacy and tolerability in the management of erectile dysfunction. Ther Adv Urol. 2013;5(2):101–110. doi: 10.1177/1756287212470019
  12. Andersson K-E. Mechanisms of penile erection and basis for pharmacological treatment of erectile dysfunction. Pharmacol Rev. 2011;63(4):811–859. doi: 10.1124/pr.111.004515
  13. Argiolas A. Male erectile dysfunction: Chemical pharmacology of penile erection. Drugs Discov Today Ther Strateg. 2005;2(1):31–36. doi: 10.1016/j.ddstr.2005.05.005
  14. Glina S, Fonseca GN, Bertero EB, et al. Efficacy and tolerability of lodenafil carbonate for oral therapy of erectile dysfunction: A phase III clinical trial. J Sex Med. 2010;7(5):1928–1936. doi: 10.1111/j.1743-6109.2010.01711.x
  15. Azadzoi KM, Saenz de Tejada I. Diabetes mellitus impairs neurogenic and endothelium-dependent relaxation of rabbit corpuscavernosum smooth muscle. J Urol. 1992;148(5–1):1587–1591. doi: 10.1016/S0022-5347(17)36975-6
  16. Azadzoi KM, Kim N, Brown ML, et al. Endothelium-derived nitric oxide and cyclooxygenase products modulate corpus cavernosum smooth muscle tone. J Urol. 1992;147(1):220–225. doi: 10.1016/S0022-5347(17)37201-4
  17. Angulo J, Cuevas P, Fernández A, et al. Enhancedthromboxane receptor-mediated responses and impaired endothelium-dependent relaxation in human corpus cavernosum fromdiabetic impotent men: Role of protein kinase C activity. J Pharmacol Exp Ther. 2006;319(1):783–789. doi: 10.1124/jpet.106.108597
  18. Mitidieri E, Cirino G, d’Emmanuele di Villa Bianca R, Sorrentino R. Pharmacology and perspectives in erectile dysfunction in man. Pharmacol Ther. 2020;208:107493. doi: 10.1016/j.pharmthera.2020.107493
  19. Erkovich AA, Aliev RT, Nasedkina TV, et al. Monitoring of nocturnal penile tumescence in healthy volunteers by the “Androscan MIT” registrar to establish reliable normal physiological values in a multicenter study. Urologiia. 2021;(4):61–67. EDN: LJWKEU doi: 10.18565/urology.2021.4.61-67
  20. Belew D, Klaassen Z, Lewis RW. Intracavernosal injection for the diagnosis, evaluation, and treatment of erectile dysfunction: A review. Sex Med Rev. 2015;3(1):11-23. doi: 10.1002/smrj.35
  21. Virag R. Intracavernous injection of papaverine for erectile failure. Lancet. 1982;320(8304):938. doi: 10.1016/s0140-6736(82)90910-2
  22. Delcour C, Wespes E, Vandenbosch G, et al. The effect of papaverine on arterial and venous hemodynamics of erection. J Urol. 1987;138(1):187–189. doi: 10.1016/s0022-5347(17)43041-29
  23. Juenemann K-P, Lue TF, Fournier GR Jr, Tanangho EA. Hemodynamics of papaverine- and phentolamine-induced penile erection. J Urol. 1986;136(1–1):158–161. doi: 10.1016/s0022-5347(17)44763-x
  24. Montorsi F, Salonia A, Zanoni M, et al. Current status of local penile therapy. Int J Impot Res. 2002;14(1):S70–81. doi: 10.1038/sj.ijir.3900808
  25. Wespes E, Delcour C, Rondeux C, et al. The erectile angle: objective criterion to evaluate the papaverine test in impotence. J Urol. 1987;138(5):1171–1173. doi: 10.1016/s0022-5347(17)43539-7
  26. Brindley GS. Cavernous alpha-blockade: a new technique for investigating and treating erectile impotence. Br J Psychiatry. 1983;143(4):332–337. doi: 10.1192/bjp.143.4.332
  27. Nelson CJ, Hsiao W, Balk E, et al. Injection anxiety and pain in men using intracavernosal injection therapy after radical pelvic surgery. J Sex Med. 2013;10(10):2559–2265. doi: 10.1111/jsm.12271
  28. Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633–641. doi: 10.1016/j.juro.2018.05.004
  29. El-Sakka AI. What is the current role of intracavernosal injection in management of erectile dysfunction? Int J Impot Res. 2016;28(3):88–95. doi: 10.1038/ijir.2016.14
  30. Hackett G, Kirby M, Wylie K, et al. British society for sexual medicine guidelines on the management of erectile dysfunction in men-2017. J Sex Med. 2018;15(4):430–457. doi: 10.1016/j.jsxm.2018.01.023
  31. Hatzimouratidis K, Salonia A, Adaikan G, et al. Pharmacotherapy for erectile dysfunction: recommendations from the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med. 2016;13(4):465–488. doi: 10.1016/j.jsxm.2016.01.016
  32. Velcek D, Sniderman KW, Vaughan ED, et al. Penile flow index utilizing a Doppler pulse wave analysis to identify penile vascular insufficiency. J Urol. 1980;123(5):669–673. doi: 10.1016/s0022-5347(17)56082-6
  33. Lue TF, Hricak H, Marich KW, Tanagho EA. Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology. 1985;155(3):777–781. doi: 10.1148/radiology.155.3.3890009
  34. Aversa A, Sarteschi LM. The role of penile color-duplex ultrasound for the evaluation of erectile dysfunction. J Sex Med. 2007;4(5):1437–1447. doi: 10.1111/j.1743-6109.2007.00546.x
  35. Katlowitz NM, Albano GJT, Morales P, Golimbu M. Potentiation of drug-induced erection with audiovisual sexual stimulation. Urology. 1993;41(5):431–434. doi: 10.1016/0090-4295(93)90502-2
  36. Sikka SC, Hellstrom WJG, Brock G, Morales AM. Standardization of vascular assessment of erectile dysfunction: standard operating procedures for duplex ultrasound. J Sex Med. 2013;10(1): 120–129. doi: 10.1111/j.1743-6109.2012.02825.x
  37. Cavallini G, Maretti C. Unreliability of the duplex scan in diagnosing corporeal venous occlusive disease in young healthy men with erectile deficiency. Urology. 2018;113:91–98. doi: 10.1016/j.urology.2017.11.005
  38. Golijanin D, Singer E, Davis R, et al. Doppler evaluation of erectile dysfunction — part 2. Int J Impot Res. 2007;19:43–48. doi: 10.1038/sj.ijir.3901478
  39. Hatzichristou DG, Saenz de Tejada I, Kupferman S, et al. In vivo assessment of trabecular smooth muscle tone, its application in pharmaco-cavernosometry and analysis of intracavernous pressure determinants. J Urol. 1995;153(4):1126–1135. doi: 10.1016/S0022-5347(01)67530-X
  40. Saenz de Tejada I, Moroukian P, Tessier J, et al. Trabecular smooth muscle modulates the capacitor function of the penis. Studies on a rabbit model. Am J Physiol. 1991;260(5–2):H1590–H1595. doi: 10.1152/ajpheart.1991.260.5.H1590
  41. Arafa M, Eid H, Shamloul R. Significance of phentolamine redosing during prostaglandin E1 penile color Doppler ultrasonography in diagnosis of vascular erectile dysfunction. Int J Urol. 2007;14(5): 476–477. doi: 10.1111/j.1442-2042.2006.01732.x
  42. Mulhall JP, Abdel-Moneim A, Abobakr R, Goldstein I. Improving the accuracy of vascular testing in impotent men: correcting hemodynamic alterations using a vasoactive medication re-dosing schedule. J Urol. 2001;166(3):923–926. doi: 10.1016/s0022-5347(05)65865-x
  43. Teloken PE, Park K, Parker M, et al. The false diagnosis of venous leak: prevalence and predictors. J Sex Med. 2011;8(8): 2344–2349. doi: 10.1111/j.1743-6109.2011.02298.x
  44. Povelitsa EA, Dosta NI, Bystrenkov AV, et al. Dynamic multispiral computer contrast angiography a internal pudental artery — an innovative diagnostic methodof arteriogenny erectile dysfunction. Innovative technologies in medicine. 2017;5(3):155-166. EDN: ZOKYTR
  45. Montague DK, Jarow JP, Broderick GA, et al. Chapter 1: The management of erectile dysfunction: an AUA update. J Urol. 2005;174(1):230–239. doi: 10.1097/01.ju.0000164463.19239.19
  46. Rajfer J, Canan V, Dorey FJ, Mehringer CM. Correlation between penile angiography and duplex scanning of cavernous arteries in impotent men. J Urol. 1990;143(6):1128–1130. doi: 10.1016/s0022-5347(17)40203-5
  47. Bähren W, Gall H, Scherb W, et al. Arterial anatomy and arteriographic diagnosis of arteriogenic impotence. Cardiovasc Interven Radiol. 1988;11:195–210. doi: 10.1007/BF02577004
  48. Efremov EA, Zhukov OB, Shcherbinin SN, et al. Dynamic computerised cavernosography in the diagnosis of veno-occlusive erectile dysfunction. Urology today. 2012;(4). (In Russ.)
  49. Kyzlasov PS, Kasymov BG, Al-Shukri SK, et al. Radiation diagnostics of arteriovenous erectile dysfunction: history and development. Urology reports (St. Petersburg). 2018;8(1):40–46. EDN: YWJLJI doi: 10.17816/uroved8140-46
  50. Armenakas NA, McAninch JW, Lue TF, et al. Posttraumatic impotence: magnetic resonance imaging and duplex ultrasound in diagnosis and management. J Urol. 1993;149(5–2):1272–1275. doi: 10.1016/s0022-5347(17)36365-6
  51. Akhvlediani ND, Bernikov AN, Gvasalia BR. Erectile dysfunction. Clinical recommendations. 2021. (In Russ.)
  52. Korneyev IA. Long-term phosphodiesterase inhibition: urologic perspectives. Effective pharmacotherapy. 2013;(16):14–17. EDN: QATBGR
  53. Vardi Y, Appel B, Jacob G, et al. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol. 2010;58(2):243–248. doi: 10.1016/j.eururo.2010.04.004
  54. Rizk PJ, Krieger JR, Kohn TP, Pastuszak AW. Low-intensity shockwave therapy for erectile dysfunction. Sex Med Rev. 2018;6(4):624–630. doi: 10.1016/j.sxmr.2018.01.002
  55. Dong L, Chang D, Zhang X, et al. Effect of low-intensity extracorporeal shock wave on the treatment of erectile dysfunction: A systematic review and meta-analysis. Am J Mens Health. 2019;13(2):1557988319846749. doi: 10.1177/1557988319846749
  56. Weihs AM, Fuchs C, Teuschl AH, et al. Shock wave treatment enhances cell proliferation and improves wound healing by ATP release-coupled extracellular signal-regulated kinase (ERK) activation. J Biol Chem. 2014;289(39):27090–27104. doi: 10.1074/jbc.M114.580936
  57. Drury R, Natale C, Hellstrom WJG. Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction. Ther Adv Urol. 2021;13:17562872211002059. doi: 10.1177/17562872211002059
  58. Daeschler SC, Harhaus L, Schoenle P, et al. Ultrasound and shock-wave stimulation to promote axonal regeneration following nerve surgery: A systematic review and meta-analysis of preclinical studies. Sci Rep. 2018;8:3168. doi: 10.1038/s41598-018-21540-5
  59. Usta MF, Gabrielson AT, Bivalacqua TJ. Low-intensity extracorporeal shockwave therapy in the treatment of erectile dysfunction following radical prostatectomy: A critical review. Int J Impot Res. 2019;31:231–238. doi: 10.1038/s41443-019-0121-3
  60. Patent US No. A16H19/00/29.11.1913. Lederer O. Surgical device.
  61. Witherington R. Vacuum constriction device for management of erectile impotence. J Urol. 1989;141(2):320–322. doi: 10.1016/S0022-5347(17)40752-X
  62. Diederichs W, Kaula NF, Lue TF, Tanagho EA. The effect of subatmospheric pressure on the simian penis. J Urol. 1989;142(4): 1087–1089. doi: 10.1016/s0022-5347(17)39001-8
  63. Lin H, Wang R. The science of vacuum erectile device in penile rehabilitation after radical prostatectomy. Transl Androl Urol. 2013;2(1):61–66. doi: 10.3978/j.issn.2223-4683.2013.01.04
  64. Yuan J, Lin H, Li P, et al. Molecular mechanisms of vacuum therapy in penilerehabilitation: A novel animal study. Eur Urol. 2010;58(5):773–780. doi: 10.1016/j.eururo.2010.07.005
  65. Trost LW, Munarriz R, Wang R, et al. External mechanical devices and vascular surgery for erectile dysfunction. J Sex Med. 2016;13(11):1579–1617. doi: 10.1016/j.jsxm.2016.09.008
  66. Shauly O, Gould DJ, Patel KM. Emerging nonsurgical and surgical techniques to treat erectile dysfunction: A systematic review of treatment options and published outcomes. J Plast Reconstr Aesthet Surg. 2019;72(4):532–538. doi: 10.1016/j.bjps.2018.12.028
  67. Scott FB, Bradley WE., Timm G.W. Management of erectile impotence: Use of implantable inflatable prosthesis. Urology. 1973;2(1):80–82. doi: 10.1016/0090-4295(73)90224-0
  68. Hamilton Z, Mirza M. Post-prostatectomy erectile dysfunction: Contemporary approaches from a US perspective. Res Rep Urol. 2014;6:35–41. doi: 10.2147/RRU.S39560
  69. Wang C-M, Wu B-R, Xiang P, et al. Management of male erectile dysfunction: From the past to the future. Front Endocrinol. 2023;14:1148834. doi: 10.3389/fendo.2023.1148834
  70. Montorsi F, Rigatti P, Carmignani G, et al. AMS three-piece inflatable implants for erectile dysfunction: A long-term multi-institutional study in 200 consecutive patients. Eur Urol. 2000;37(1):50–55. doi: 10.1159/000020099
  71. La Croce G, Schifano N, Pescatori E, et al. Which patient may benefit the most from penile prosthesis implantation? Andrology. 2022;10(8):1567–1574. doi: 10.1111/andr.13294

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