T07-O-06 The benefit of testosterone administration to men not responding to PDE-5 inhibitors: state of the art - 27/06/08
Résumé |
Introduction |
Delivery of the phosphodiesterase type 5 inhibitors (PDE 5-inhibitors) has been a step forward in the treatment of erectile dysfunction. The success of the PDE 5-inhibitors rendered androgens as treatment for erectile problems in the average patient as something of the past.
Methods |
Over the last 15 years the age-related decline of circulating testosterone in men has received serious attention. Moreover, new research has presented convincing evidence that testosterone has profound effects on tissues of the penis involved in the mechanism of erection and that testosterone deficiency impairs the anatomical and physiological substrate of erectile capacity, at least in part reversible upon androgen replacement.
Results |
There are androgen receptors in the human corpus cavernosum. The expression of nitric oxide (NO) synthesis is regulated by androgens. Several studies show that androgen plays a critical role in restoring and maintaining the penile trabecular smooth muscle structure and function as well as regulating the cell apoptosis. Testosterone deficiency induces both biological and structural/functional changes in the trabecular cavernosal tissues. Adipocyte accumulation in penile subtunical area of the corpus cavernosum emphasized the potential mechanism for veno-occlusive dysfunction in androgen deficiency.
Conclusion |
So, in androgen-deficient men, testosterone may restore the anatomical/biochemical substrate on which the PDE-5 inhibitors act. The above argues for measurement of testosterone in men with complaints of erectile dysfunction. Several studies, including our own, show that testosterone treatment alone, or in addition to PDE-5 inhibitors, may restore erections in these men.
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Vol 17 - N° S1
P. 102-103 - janvier-mars 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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