Radiological methods in the diagnosis of cavernous hemodynamic disorders in men with diabetes mellitus and erectile dysfunction
Background. Cardiovascular diseases and diabetes mellitus (DM) remain the main comorbidities in erectile dysfunction (ED), and endothelial dysfunction plays an extremely important role in the mechanisms of ED development. The purpose of the study is to investigate the role of the vascular factor in the pathogenesis of ED in men with DM and the possibility of early diagnosis of vascular disorders. Materials and methods. To study the blood flow, 45 men with DM and ED aged 22–58 years were examined. Penile Doppler ultrasonography was carried out using AlokaSSD 5000 ProSound (Japan) device at rest and in dynamics of transition to a rigid erection after administration of a vasoactive drug at the 5, 15, and 30th minutes. Results. Reduction of peak systolic blood flow velocity with increased indices of arterial wall tone and peripheral resistance is a consequence of microcirculatory disorders, tissue permeability observed in patients with DM. Decreased blood supply to the penis and slowing the washout of tracer in men with DM and ED established during the radionuclide angiography of the penis indicate microcirculation disorders in the cavernous bodies (microangiopathy). Conclusions. Minimally invasive specialized methods for the examination of patients with DM and ED allow us to obtain a physiologically adequate assessment of the overall degree of vascularization of cavernous bodies in the dynamics of erection, complement each other and make it possible to evaluate the phenomenon of erection by various objective indicators.
Full Text:PDF (Українська)
Fonseca V, Jawa A. Endothelial and erectile dysfunction, diabetes mellitus, and the metabolic syndrome: Common pathways and treatments? Am J Cardiol. 2005 Dec 26;96(12B):13M-18M. doi: 10.1016/j.amjcard.2005.07.005.
Corona G, Mannucci E, Forti G, Maggi M. Hypogonadism, ED, metabolic syndrome and obesity: A pathological link supporting cardiovascular disease. Int J Androl. 2009 Dec;32(6):587-98. doi: 10.1111/j.1365-2605.2008.00951.x.
Demir O, Aykut-Kefi MS, Abdurrahman-Comleksi SY, et al. Can Doppler ultrasonografy show endothelial dysfunction and erectile dysfunction patients with metabolic syndrome? J Sex Med. 2006;3(Suppl 3):239. doi: 10.1111/j.1743-6109.2006.00188_4.x.
Wu FC, Tayar A, Pye SR, et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: The European Male Aging Study. J Clin Endocrinol Metab. 2008 Jul;93(7):2737-45. doi: 10.1210/jc.2007-1972.
Kaplan SA, Meehan AG, Shah A. The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? J Urol. 2006 Oct;176(4 Pt 1):1524-7; discussion 1527-8. doi: 10.1016/j.juro.2006.06.003.
Corona G, Mannucci E, Petrone L, et al. NCEP-ATPIII-defined metabolic syndrome, type 2 diabetes mellitus, and prevalence of hypogonadism in male patients with sexual dysfunction. J Sex Med. 2007 Jul;4(4 Pt 1):1038-45. doi: 10.1111/j.1743-6109.2007.00529.x.
Antonio L, Wu FC, O’Neil TW, et al. Associations between sex steroids and the development of metabolic syndrome: a longitudinal study in European men. J Clin Endocrinol Metab. 2015 Apr;100(4):1396-404. doi: 10.1210/jc.2014-4184.
Shabsigh R, Kaufman J, Magee M, Creanga D, Russell D, Budhwani M. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction. BMC Urol. 2010 Nov 5;10:18. doi: 10.1186/1471-2490-10-18.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2019