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http://www.ucdenver.edu/academics/colleges/pharmacy/Departments/ClinicalPharmacy/DOCPFaculty/Q-Z/Pages/Paul-Reynolds,-PharmD.aspx
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Erectile licensed prostaglandin preparation for use in erectile dysfunction, sildenafil and cardiovascular risk. Can self-directed pelvic floor after medical therapy for prolactin and adrenocorticotropic exercises improve erectile function?. Nature Clinical hormone co-producing pituitary macroadenoma without Practice Urology 2005;2(3):128-129. Effect of sildenafil on renin secretion in safety of sildenafil citrate in the treatment of erectile human subjects. Experimental biology and medicine (Maywood, dysfunction in patients with ischemic heart disease. Intralesional acetate, nocturnal penile tumescence, laboratory arousal, and interferon-alpha-2B injections for the treatment of sexual acting out in a male with schizophrenia. Kans Med of prolonged erection after diagnostic pharmacological 1990;91(12):325-326. Cyclodextrin-based structured interview for the screening of hypogonadism in pharmaceutics: Past, present and future. Lecture 6: restoration of male sexual function receptor antagonists as potential agents for the following spinal cord injury. Ann Pharmacother sildenafil citrate (Viagra) on renal arteries: An 2004;38(1):77-85. Time/duration effectiveness of sildenafil versus tadalafil in the treatment of erectile dysfunction in Culha M, Mutlu N, Acar O et al. Proc Annu Clin with intracavernous medication supported with oral agents in Spinal Cord Inj Conf 2004;42(11):643-648. Malaysian researchers bet big on home-grown Derby C A, Araujo A B, Johannes C B et al. Nat Med 2005;11(9):912 Measurement of erectile dysfunction in population- based studies: the use of a single question self- Czuriga I, Riecansky I, Bodnar J et al. Cardioselective Beta-Blocker Nebivolol with Bisoprolol in Int J Impot Res 2000;12(4):197-204. Penile paraffinoma: the prevalence of erectile dysfunction in the Massachusetts Male delayed presentation. The role of intracavernosal vasoactive agents to overcome Desouza C, Parulkar A, Lumpkin D et al. Paraplegia effects of sildenafil on brachial artery flow-mediated dilatation 1992;30(4):273-276. Complications of intracavernous incidence and management of priapism in Western injections and penile prostheses in spinal cord injured men. Int J Impot Res Archives of Physical Medicine & Rehabilitation 2003;15(4):272-276. Medical treatment of impotence with time, and refractory period: placebo-controlled, papaverine and phentolamine intracavernosal injection. Effect on sexual function predominantly nonpsychogenic erectile dysfunction with of long-term treatment with selective serotonin intracavernosal vasoactive intestinal polypeptide and reuptake inhibitors in depressed patients treated in phentolamine mesylate in a novel auto-injector system: a primary care. Comparison of clinical trials with sildenafil, Effect of the use of internal iliac artery for renal vardenafil and tadalafil in erectile dysfunction. Expert Opin transplantation on penile vascularity and erectile Pharmacother 2005;6(1):75-84. Multiple sclerosis and sexual functioning: A in Central & Peripheral Nervous System review. Acupuncture in the Fazeli-Matin S, Montague D K, Angermeier K W et treatment of psychogenic erectile dysfunction: first results of a al. Penile fracture after intracavernous injection prospective randomized placebo-controlled study. Effects of megestrol of erectile dysfunction in diabetic subjects: results acetate therapy on body composition and circulating testosterone from a survey of 400 diabetes centres in Italy. Experience with Current and future strategies in the treatment of erectile sildenafil in diabetes. International Metabolism - Clinical & Experimental 2002;15(1):49 Journal of Clinical Pharmacology & Therapeutics 52. Sildenafil Focus on Alternative & Complementary Therapies for male erectile dysfunction: a systematic review and 2005;10(2):94-97. Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical Fink H A, MacDonald R, Rutks I R et al. Impact of sildenafil on male erectile dysfunction in men with the metabolic syndrome. Cardiovascular safety of in patients with benign prostatic hyperplasia, sublingual apomorphine in patients on stable doses of oral hypertension, or both. Primary Psychiatry 2003;10(2):23 Postmarketing Surveillance of Ocular Adverse Drug Reactions. Phase I Study of supplementation in hypogonadal men: our personal Replication-Competent Adenovirus-Mediated Double-Suicide experience. Arch Ital Urol Androl 2005;77(4):191 Gene Therapy in Combination with Conventional-Dose Three- 193. Dimensional Conformal Radiation Therapy for the Treatment of Newly Diagnosed, Intermediate- to High-Risk Prostate Cancer. Pro-erectile effect of systemic apomorphine: Existence of a spinal Fugl-Meyer A R, Lodnert G, Branholm I B et al. Randomized trial of sildenafil for the treatment of Fulgram P F, Cochran J S, Denman J L et al. Sildenafil initial results with transurethral alprostadil for erectile Study Group. Efficacy results and quality-of-life measures in men receiving Gallo L, Perdona S, Autorino R et al. Recovery of erection after sildenafil citrate for the treatment of erectile pelvic urologic surgery: our experience. Giuliano Francois, Pena Beatrice, Mishra Avanish et Gerstenbluth R E, Maniam P N, Corty E W et al. Quality of Life Research: An International Journal of Quality of Life Ghezzi A, Malvestiti G M, Baldini S et al. Erectile impotence in Aspects of Treatment, Care & Rehabilitation multiple sclerosis: A neurophysiological study. Cardiology Review hypothalamic-pituitary-testicular interaction in diabetic males. Safety and efficacy of sildenafil citrate in the Grunwald J E, Jacob S S, Siu K et al. Oral phentolamine: an alpha-1, alpha-2 adrenergic antagonist for the treatment of erectile dysfunction. A prospective evaluation of efficacy and compliance with a multistep treatment approach Guay A T, Sabharwal P, Varma S et al. Delayed for erectile dysfunction in patients after non-nerve sparing diagnosis of psychological erectile dysfunction radical prostatectomy. American Journal Geriatric Pharmacotherapy Govier F E, McClure R D, Kramer-Levien D. Dose-dependent of oral sildenafil in the treatment of erectile effects of testosterone on sexual function, mood, and dysfunction.
Int J Radiat oncol Biol Phys After External Beam Radiotherapy for Prostate Cancer. Androgen diation received by the bulb of the penis correlates with deprivation with radiation therapy compared with radiation risk of impotence after three-dimensional conformal ra-- therapy alone for locally advanced prostatic carcinoma: diotherapy for prostate cancer. Complications after and radiation dose to penile base structures: a lack of treatment with external-beam irradiation in early-stage correlation. In J Radiat Oncol Biol Phys 2004;59:1039- prostate cancer patients: a prospective multiinstitutional 1046. Three-dimensional stereotactic posterior citrate (Viagra) and erectile dysfunction following external- ischiorectal space computerized tomography guided beam radiotherapy for prostate cancer. Eficacy of sildenail in an of life and sequelae in patients treated with brachytherapy open-label study as a continuation of a double-blind study and external beam irradiation for localized prostate cancer. Minimally invasive double-blind, placebo-controlled, cross-over study to treatment for localized adenocarcinoma of the prostate: re-- assess the eficacy of tadalail (Cialis®) in the treatment of view of 1048 patients treated with ultrasound-guided Pal-- erectile dysfunction following three-dimensional conformal ladium-103 brachytherapy. Tadalail (Cialis) and erectile of life after interstitial radiation therapy for prostate cancer. The current state of hormonal ther-- analysis of conformal high-dose-rate brachytherapy boost apy for prostate cancer. Minimally invasive with observation after radical prostatectomy and pelvic treatment for localized adenocarcinoma of the prostate: lymphadenectomy in men with node-positive prostate review of 1048 patients treated with ultrasound-guided cancer. Managing Complications of Androgen implantation for patients with localized prostate cancer. Skeletal Potency after permanent prostate brachytherapy for fracture associated with androgen suppression induced localized prostate cancer. Int J Radiat oncol Biol Phys osteoporosis: the clinical incidence and risk factors for 2001;50:1235-1242. Changes in bone permanent radioactive seed implantation for treatment of mineral density, lean body mass and fat content as mea-- prostate cancer. Risk of new- injection for men with sexual dysfunction following onset diabetes mellitus and worsening glycaemic variables irradiation: a preliminary report. Int J Radiat oncol Biol for established diabetes in men undergoing androgen- Phys 1991;21:1311-1314. Patterns of oral sildenail in patients with erectile dysfunction after sexual and erectile dysfunction and response to treatment radiotherapy for carcinoma of the prostate. Penile cancer: review of the recent functioning after treatment for testicular cancer – review literature. Treatment of testicular cancer: life after partial penectomy for penile carcinoma. Gonadal intravesical instillation and erectile function: is there a hormones in long term survivors 10 years after treatment concern. The impact of chemotherapy on Leydid cell function outcomes in bladder cancer patients using the bladder in long term survivors of germ cell tumors. Distressful symptoms after radical tomy and othotopic bladder substitution compared with radiotherapy for urinary bladder cancer. Urethrectomy following experience with an ileal orthotopic low pressure bladder cystectomy for bladder cancer in men: practice patterns substitute—lessons to be learned. Radical prostatectomy and of life in patients operated on with radical cystectomy and cystoprostatectomy with preservation of potency. Female sexual dysfunction ing cystectomy with intrafascial prostatectomy for high risk after radical cystectomy: A new outcome measure. Increased proximal outcomes after sexuality preserving cystectomy and urethral sensory threshold after radical pelvic surgery in neobladder (prostate sparing cystectomy) in 44 patients. Neurovascular preservation in orthotopic cystectomy is an eficacious and safe treatment for cystectomy: Impact on female sexual function Urology selected bladder cancer patients. Urol oncol: Seminars and original ileal neobladder: the impact on female sexuality. Sexual function after male radical Restrictions in quality of life in colorectal cancer patients cystectomy in a sexually active population. Prevalence of male and female sexual cystectomy patients: Subjective and objective evaluations. Total or partial prostate sparing cystectomy Adjuvant radiotherapy is associated with increased sexual for invasive bladder cancer: long-term implications on dysfunction in male patients undergoing resection for rectal erectile function. The long-term voiding function and sexual non-nerve-sparing radical retropubic prostatectomy or function after pelvic nerve-sparing radical surgery for cystectomy—results of a randomized prospective study. Urinary diversion: evidence-based cancer treated by preoperative radiotherapy: A longitudinal outcomes assessment and integration into patient prospective study. Total mesorectal excision preserves male 469 DiFabio F, Koller M, Nasccimbeni R, Talarico C, Salerni genital function compared with conventional rectal cancer B. Patients’ self-reported quality of life, sexual dysfunction 487 Bohm C, Kirschner-Hermanns R, Decius A, Heussen N, and surgeons’ awareness of patients’ needs. 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Avoiding long-term disturbance to bladder and sexual 497 Piketty C, Selinger-Leneman H, Grabar S, Duvivier function in pelvic surgery, particularly with rectal cancer. C,Bonmarchand M, Abramowitz L, Costagliola D, Mary- Sem Surg Oncol 2000;18:235-243. A prospective study on radical and nerve- with combination antiretroviral therapy. Twenty years of unrelated donor hematopoietic abdominoperineal resection for rectal cancer. Eur J Surg cell transplantation for adult recipients facilitated by the Oncol 2005;31:735-742 National Marrow Donor program. Sem Surg Oncol 19:321-328,2000 isolation of hematopoietic stem cells, and their capability 485 Bonnel C, Parc yR, Pocard M,Dehni N, Caplin S, Parc to induce donor-speciic transplantation tolerance and R, Tiret E. The use of growth factors in transplantation: a longitudinal study Bone Marrow hematopoietic stem cell transplantation. Malesexual Late effects of hematopoietic cell transplantation among function after autologous blood or marrow transplantation. Sexual function changes during the 5 years after high- dysfunction by combination therapy with testostereone dose treatment and hematopoietic cell transplantation for and sildenail in recipients of high-dose therapy for malignancy, with case-matched controls at 5 years. Female genital tracet graft-versus-host consequences: vasomotor symptoms, sexuality, and disease: incidence, risk factors and recommendations for fertility. Altered sexual health and quality of life in women prior 524 Monti M, Rosti G, De Giorgi U, Cavallari G, Severini to hematopoietic cell transplantation. Bone Marrow Transplant survivors of childhood acute lymphoblastic leukemia: a 2008;41:S43-48. Vincristine-induced acute neurotoxicity versus Guillain- Marriage in the survivors of childhood cancer: A preliminary Barre syndrome: a diagnostic dilemma. Long-term population-based marriage rates among adult Radiother Oncol 2007;84:107-13. Severe adverse impact on sexual clinical trials for adolescents and young adults with cancer. Psychosexual functioning of transplantation with partially T-cell-depleted grafts and childhood cancer survivors. A pilot intervention to Women Treated for Cervical Cancer: Characteristics and enhance psychosexual development in adolescents Correlates.
The neo-cortex is increasingly involved in the sexual response in human erectile dysfunction causes yahoo generic sildigra 120mg free shipping, first as final target of sensory inputs which arrive from the different sensory organs erectile dysfunction caused by high blood pressure medication order sildigra cheap. Different smells top erectile dysfunction doctor cheap sildigra 25 mg visa, tastes erectile dysfunction medication for sale buy cheap sildigra 50 mg on line, words, sights or touch stimuli may activate both the pertinent sensory cortex and the limbix sexual cortex when the signal is ”coded” as sexual. Cognitive factors are also in play in evaluating the sexual stimulus and modulate the ”judgmemt” of concomitant risks and wishes before engaging, or not, in a specific sexual behaviour [1,10,12]. Regional and quantitative differences in neurotransmitter’s activities 1 Graziottin A. Sexual dimorphisms Many aspects of adult sexual life, both functional and dysfunctional, can claim their origins in the very earliest steps of “sexual dimorphism” [1,5,6,9,14] The gene sequences of chromosomes have two functions: the ability to replicate, termed the “template” function, and the expression of genes, called “transcription. Interestingly, the “default” phenotypic expression for the human organism, including its brain, is female [1]. The neurons of men and women share all the basic anatomic and functional characteristics. Similarly, neurotransmitters, neurohormones, neuropeptides and neurotrophins have exactly the same structure and roles in both men and women, with some quantitative differences as well as some variability in regional distribution [1,5-7,9,14]. It appears, then, that the major neurologic differences between men and women lie mainly in their respective degrees of brain dimorphism, i. Quite interestingly, many of the central nervous system effects of testosterone are mediated by estrogen, as a result of the aromatization of testosterone by the enzyme aromatase [1,5,6]. Sexually dimorphic variations in overall brain weight (which is higher, on average, in men) do not appear to be of importance in human sexuality. Quality of brain functioning, sexual and non- sexual, depends on the complex pattern of connections between cells, their continuous plasticity, and the intensity by which they are stimulated through affective events, educational level, and environmental challenges (8-10). Clinical relevance of brain dimorphism Hemispheric asymmetry and brain dimorphism have manifest implications in male and female sexual function. For example, the most important sexual cues in women for increasing mental arousal—as well as the mental awareness of that arousal—typically involve verbal intimacy, such as having her partner’s receptive and attentive ear, or having affectionate or erotic words spoken to her. Men, on the other hand, rely much more strongly on visual stimulation, either in reality or fantasy, for mental and genital arousal. Much disappointment and frustration results when these two primary sexual cues are polarized in a couple; the consequent mental dissatisfaction may then potentially contribute to sexual dysfunction and even to sexual avoidance [9, 12,15]. Another main neuroanatomical difference between men and women lies in the medial preoptic area of the hypothalamus, the key center of the autonomic nervous system in both sexes [1,6]. This variability has many important consequences on brain function and sexual behavior as well as many other somatic effects. These hypothalamic detectors are typically switched on and off by different hypothalamic regions. Prefrontal connections also influence the hypothalamic detectors, typically to inhibit the basic drives [1,4, 5,10,11]. Many additional cognitive and perceptual inputs and cues serve to regulate the basic emotional command systems, as well. The hypothalamic dimorphisms correlates with gender related reproductive and sexual behaviours. For example, male sexual behavior is typically stable over the entire adult male lifespan; this may potentially be explained by a typical male’s lifelong production of testosterone at a relatively tonic, constant rate (notwithstanding the gradual decrease in serum levels that has been described from the second decade of life onwards). In contrast, the physiology of female sexuality is highly discontinuous, both during the regular menstrual cycle as well as during major reproductive life events such as pregnancy, puerperium, abortion, and menopause [9,15,16-18]. Interestingly, it has also been shown that while receptivity to pheromones remains relatively stable over life in men, there is a peak in pheromone receptivity during ovulation in women, as well as an overall greater level of odor discrimination ability during the years of fertility. After menopause, odor discrimination ability in women decreases significantly and much resembles physiologic male levels [19]. Pheromones may be responsible for mediating interactions in the mid-cycle variations observed in women, which may in turn be triggered by the ovulatory androgen peak, promoting the atresia of non-dominant follicles in the ovary as well as a mental and physical peak in sexual desire, arousability and receptivity [20]. The biologic ramification of these relationships is to increase female sexual responsiveness when the likelihood of conception is at its highest. Human pheromones and their role in sexual attraction and reproduction has been recently reviewed [20]. Central nervous system dimorphisms may well represent the biological basis for the differences in sexual desire, perception, and expression experienced by men and women, including the disparities in the frequency, content, and intensity of erotic fantasies, nocturnal erotic dreams, and sexual daydreams; the perception of central arousal; the quality and quantity of expression of the sexual response, and the likelihood and emotional resonance of orgasm [1, 6-9, 12, 15-18, 21-27]. A more dynamic understanding of the continuous interactions between the somatic body and the psychic mind and how these processes differ between men and women will help to clarify the similarities that are neglected by the polarized focus on contextual factors in women and on biological factors in men. Neural pathways At the level of the spine, the neural pathways of sympathetic and parasympathetic sexual responses in both genders follow the same anatomic distributions until their termination in different male and female target sexual organs [1,2,3,9,28]. These pathways involve: the superior hypogastric plexus, the middle hypogastric plexus (which gives rise to the hypogastric nerves joining the testicular or ovarian plexus), the ureteric plexus, the internal iliac arterial plexus, the inferior hypogastric plexus (which receives mostly sympathetic afferent and efferent fibers from the hypogastric nerves, the postganglionic sympathetic fibers derived from the sacral splanchnic nerves, and the parasympathetic fibers derived from pelvic splanchnic nerves—the 3 Graziottin A. The uterovaginal plexus is simply the terminal ramifications of the lower part of the inferior hypogastric plexus. In women, the uterovaginal plexus supplies the uterus, salpinges, ovaries, vagina, erectile tissue of the clitoris and vestibular bulbs (via the cavernous nerves of the clitoris), urethra, and greater vestibular glands [2,28] In both genders, the perineum receives its primary somatic innervation from the pudendal nerve (derived from S2, S3, and S4) and its sympathetic innervation from the sacral portion of the sympathetic chain [2, 28, 30-32]. The anatomic pathway of the pudendal nerve is very similar in both men and women, forming a single trunk that runs approximately 1 cm posterior to the ischial spine through the greater sciatic foramen inferior to the piriformis muscle. It then re- enters the pelvic cavity through the lesser sciatic foramen and proceeds anteriorly through Alcock’s canal, passing posterior to the junction between the ischial spine and sacrospinous ligament and anterior to the sacrotuberous ligament and medial to the internal pudendal vessels. At this point, the pudendal nerve branches in to its three main pathways: the inferior hemorrhoidal nerve, the perineal nerve, and the dorsal nerve of the clitoris in women, or penis, in men. These similarities in neural pathways have important implications for oncologic surgeries, in which the sparing of the vesical nerve plexus fibers that accompany the vesical artery to the bladder may significantly reduce sexual and urinary morbidity in both men and women [9]. They may as well help explain the equal risks of numbness, reduced sensibility, and arousal difficulties of the external genitalia secondary to compression of the pudendal nerve experienced by both men and women who ride bicycles for long periods of time without adequate protection or frequent position changes [29]. Finally, knowledge of similarities and differences between male and female basic anatomic structures and neurological pathways may contribute to a parallel thinking of pathophysiology of male and female sexual disorders, which could be useful in the clinical practice [2, 9, 28, 30-32]. The external female genitalia Accurate examination of the female external and internal genitalia is often disregarded in the sexual consultation, particularly when sexual disorders are complained of. Opposite to that, the physical examination can be extremely informative not only on the close interaction between biological and psychosexual factors, but also on the variety of critical information a clinician can get. The vulva includes mons pubis, clitoris and labia majora and minora, which are the structures that are surrounding the urogenital cleft (the external genitals) [2,28]. Mons pubis is the hair covered area over the pubis bone and forms the anterosuperior limit of the urogenital cleft with the labia majora on both sides and ends posteriorly at the anterior margin of the perineal body. It may be associated to acne, hypertrichosis (when excess hair maintain a female distribution) or hirsutism (when excess hair has a male distribution). These changes may be associated to body image concerns which may contribute to a feeling of sexual inadequacy, contributing to sexual disorders [15]; 2) loss of pubic hair may anticipate the menopausal changes; it may be perceived as a sign of inadequate sexual aging and may be associated to vulvar dystrophy, loss of sexual desire and/or of genital arousal [33]. They meet anteriorly, creating the anterior commissure in front of the glans of the clitoris; and posteriorly forming the posterior commissure. The internal surface has multiple sebaceous follicles which keep the surface lubricated. The labia minora are smaller, composed of supple elastic skin without subcutaneous fat, but rich in sebaceous glands. The clitoris is a 7-13 cm cylindral structure composed of glans clitoris, corpus clitoris (which is comprised of the paired corpora) and the crura, the deep extensions of the corpora, which diverge under the pubic arch [2,28,34]. It consists of cavernous tissue with trabecular smooth muscle and collagen connective tissue [34,35], encircled by a thin fibrous capsule surrounded by large nerve trunks [36]. The vestibular bulbs are paired organs of erectile tissue structure located directly beneath the skin of the labia minora. The vulvar vestibule includes the vulvar area comprised between the inferior part of the clitoris, the medial part of labia minora and the fourchette. The central part includes the external side of the hymen, that marks the limit between the vagina, which has a mullerian origin, and the introitus, which has a cloacal origin. Clinical relevance: 1) Shape of external genitalia and clitoral dimension can vary until the frank anomaly of the intersexual states which may contribute to sexual identity problems and body image concerns [37]; 2) Clitoromegaly may be spontaneous or iatrogenic, as consequence of topical and/or systemic treatment with androgens, or with corticosteroids with androgenic activity. It may be associated with a number of clinical conditions, which include the above, plus avoidance of physical contact if the bigger size is perceived as a marker of pathology. When associated to spontaneous or iatrogenic hyperandrogenism, clitoromegaly may be associated to unwanted excess of genital arousal. Priapism of the clitoris, when the glands and the shaft are engorged and painful, is a rear conditions which should be considered in women complaining of “clitoralgia” [9]. Priapism may cause or be associated with pain in the clitoris in non sexual conditions (i. In this condition, the labia minora may disappear and be conglutinated in a unique tissue involution (Fig.
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Diseases
- Hypertrophic myocardiopathy
- Peripheral neuroectodermal tumor
- 47, XXX syndrome
- Leisti Hollister Rimoin syndrome
- Thyroid carcinoma, papillary (TPC)
- Brachydactyly mesomelia mental retardation heart defects
- Cutaneous vascularitis
- Warburg Thomsen syndrome
- Intrauterine infections