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  1. Article: Pathophysiology and treatment of diabetic erectile dysfunction.

    Moore, Charles R / Wang, Run

    Asian journal of andrology

    2006  Volume 8, Issue 6, Page(s) 675–684

    Abstract: The pathophysiology of diabetes is multifactorial and no single etiology is at the forefront ... cGMP)-dependent kinase-1 (PKG-1). The treatment of diabetic ED is multimodal. Treatment ... The proposed mechanisms of erectile dysfunction (ED) in diabetic patients includes elevated ...

    Abstract The pathophysiology of diabetes is multifactorial and no single etiology is at the forefront. The proposed mechanisms of erectile dysfunction (ED) in diabetic patients includes elevated advanced glycation end-products (AGEs) and increased levels of oxygen free radicals, impaired nitric oxide (NO) synthesis, increased endothelin B receptor binding sites and ultrastructural changes, upregulated RhoA/Rho-kinase pathway, NO-dependent selective nitrergic nerve degeneration and impaired cyclic guanosine monophosphate (cGMP)-dependent kinase-1 (PKG-1). The treatment of diabetic ED is multimodal. Treatment of the underlying hyperglycemia and comorbidities is of utmost importance to prevent or halt the progression of the disease. The peripherally acting oral phosphodiesterase type 5 (PDE5) inhibitors are the mainstay of oral medical treatment of ED in diabetics. Vacuum erection devices are an additional treatment as a non-invasive treatment option. Local administration of vasoactive medication via urethral suppository or intracorporal injection can be effective with minimal side-effects. Patients with irreversible damage of the erectile mechanism are candidates for penile implantation. Future strategies in the evolution of the treatment of ED are aimed at correcting or treating the underlying mechanisms of ED. With an appropriate vector, researchers have been able to transfect diabetic animals with agents such as neurotrophic factors and nitric oxide synthase (NOS). Further studies in gene therapy are needed to fully ascertain its safety and utility in humans.
    MeSH term(s) Alprostadil/administration & dosage ; Alprostadil/therapeutic use ; Cyclic GMP-Dependent Protein Kinases/physiology ; Diabetes Complications/physiopathology ; Diabetic Neuropathies/physiopathology ; Erectile Dysfunction/etiology ; Erectile Dysfunction/physiopathology ; Erectile Dysfunction/therapy ; Glycation End Products, Advanced/physiology ; Humans ; Male ; Nitric Oxide/physiology ; Penile Erection ; Penile Prosthesis ; Penis/blood supply ; Phosphodiesterase Inhibitors/therapeutic use ; Receptor, Endothelin B/physiology ; Suppositories ; Vacuum
    Chemical Substances Glycation End Products, Advanced ; Phosphodiesterase Inhibitors ; Receptor, Endothelin B ; Suppositories ; Nitric Oxide (31C4KY9ESH) ; Cyclic GMP-Dependent Protein Kinases (EC 2.7.11.12) ; Alprostadil (F5TD010360)
    Language English
    Publishing date 2006-11
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2075824-8
    ISSN 1745-7262 ; 1008-682X
    ISSN (online) 1745-7262
    ISSN 1008-682X
    DOI 10.1111/j.1745-7262.2006.00223.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Testosterone deficiency in men with Type 2 diabetes: pathophysiology and treatment.

    Gianatti, E J / Grossmann, M

    Diabetic medicine : a journal of the British Diabetic Association

    2019  Volume 37, Issue 2, Page(s) 174–186

    Abstract: ... Exogenous testosterone treatment consistently reduces fat mass, increases muscle mass and improves ... on androgen deficiency-like clinical features are inconsistent, and effects on sexual dysfunction may be ... in men with established Type 2 diabetes, but also predicts future diabetic risks and increased mortality ...

    Abstract Epidemiological studies consistently demonstrate that lowered serum testosterone is not only common in men with established Type 2 diabetes, but also predicts future diabetic risks and increased mortality. Preclinical studies report plausible mechanisms by which low testosterone could mediate dysglycaemia. Exogenous testosterone treatment consistently reduces fat mass, increases muscle mass and improves insulin resistance in some studies, but the majority of currently available randomized controlled trials (RCTs) do not report a consistent glycaemic benefit. In men with diabetes, testosterone treatment effects on androgen deficiency-like clinical features are inconsistent, and effects on sexual dysfunction may be attenuated compared with men without diabetes. The long-term risks of testosterone treatment in older men without medical disease of the hypothalamic-pituitary-testicular axis are not known. Current RCTs are not definitive, owing to their small size, short duration and enrolment of men with mostly relatively good baseline glycaemic control not specifically selected for the presence of androgen deficiency symptoms. Although large, well-designed clinical trials are needed, given the benefit-risk ratio of testosterone treatment is not well understood, routine serum testosterone testing or testosterone treatment of asymptomatic men with Type 2 diabetes is currently not recommended. Carefully selected, symptomatic men with low testosterone who are informed of the lack of high-level evidence regarding the long-term benefits and risks of this approach may be offered a trial of testosterone treatment in combination with lifestyle measures, weight loss and optimization of comorbidities.
    MeSH term(s) Adipose Tissue/metabolism ; Androgens/therapeutic use ; Blood Glucose/metabolism ; Body Composition ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/metabolism ; Erectile Dysfunction/complications ; Erectile Dysfunction/drug therapy ; Erectile Dysfunction/metabolism ; Hormone Replacement Therapy ; Humans ; Hypoglycemic Agents/therapeutic use ; Hypogonadism/complications ; Hypogonadism/drug therapy ; Hypogonadism/metabolism ; Insulin Resistance ; Libido ; Male ; Obesity/complications ; Obesity/metabolism ; Risk Assessment ; Testosterone/deficiency ; Testosterone/therapeutic use ; Treatment Outcome
    Chemical Substances Androgens ; Blood Glucose ; Hypoglycemic Agents ; Testosterone (3XMK78S47O)
    Language English
    Publishing date 2019-06-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 605769-x
    ISSN 1464-5491 ; 0742-3071 ; 1466-5468
    ISSN (online) 1464-5491
    ISSN 0742-3071 ; 1466-5468
    DOI 10.1111/dme.13977
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Erectile dysfunction and coronary atherothrombosis in diabetic patients: pathophysiology, clinical features and treatment.

    Gazzaruso, Carmine

    Expert review of cardiovascular therapy

    2006  Volume 4, Issue 2, Page(s) 173–180

    Abstract: ... In particular, the role of endothelial dysfunction in the pathophysiology of erectile dysfunction and ... coronary artery disease have been outlined. Finally, recent guidelines on the treatment of erectile dysfunction ... of erectile dysfunction and the association of erectile dysfunction with overt and silent coronary artery disease ...

    Abstract The current review reports recent data available in the literature on the prevalence of erectile dysfunction and the association of erectile dysfunction with overt and silent coronary artery disease in patients with diabetes mellitus. The mechanisms by which erectile dysfunction is associated with coronary artery disease and potential clinical implications of this association have been extensively analysed. In particular, the role of endothelial dysfunction in the pathophysiology of erectile dysfunction and the potential clinical usefulness of erectile dysfunction to identify diabetic patients with silent coronary artery disease have been outlined. Finally, recent guidelines on the treatment of erectile dysfunction with phosphodiesterase-5 inhibitors in diabetic patients with and without coronary artery disease have been reported and discussed.
    MeSH term(s) 3',5'-Cyclic-GMP Phosphodiesterases ; Coitus/physiology ; Coronary Artery Disease/complications ; Coronary Artery Disease/epidemiology ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Diabetes Mellitus/epidemiology ; Diabetic Angiopathies/complications ; Diabetic Angiopathies/epidemiology ; Erectile Dysfunction/complications ; Erectile Dysfunction/epidemiology ; Erectile Dysfunction/physiopathology ; Humans ; Male ; Myocardial Ischemia/epidemiology ; Phosphodiesterase Inhibitors/therapeutic use ; Phosphoric Diester Hydrolases ; Practice Guidelines as Topic ; Prevalence ; Risk Factors
    Chemical Substances Phosphodiesterase Inhibitors ; Phosphoric Diester Hydrolases (EC 3.1.4.-) ; 3',5'-Cyclic-GMP Phosphodiesterases (EC 3.1.4.35) ; Cyclic Nucleotide Phosphodiesterases, Type 5 (EC 3.1.4.35) ; PDE5A protein, human (EC 3.1.4.35)
    Language English
    Publishing date 2006-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2192343-7
    ISSN 1744-8344 ; 1477-9072
    ISSN (online) 1744-8344
    ISSN 1477-9072
    DOI 10.1586/14779072.4.2.173
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Diabetes-induced erectile dysfunction: epidemiology, pathophysiology and management.

    Thorve, Vrushali S / Kshirsagar, Ajay D / Vyawahare, Neeraj S / Joshi, Vipin S / Ingale, Kundan G / Mohite, Reshma J

    Journal of diabetes and its complications

    2011  Volume 25, Issue 2, Page(s) 129–136

    Abstract: ... 50%. The pathophysiology of diabetes-induced erectile dysfunction (DIED) is multifactorial and no ... The treatment of DIED is multimodal. Treatment of the underlying hyperglycemia and comorbidities is of utmost ... Erectile dysfunction (ED) is defined as the inability of the male to attain and maintain ...

    Abstract Erectile dysfunction (ED) is defined as the inability of the male to attain and maintain erection of penis sufficient to permit satisfactory sexual intercourse. Prevalence of impotence in diabetic men is ≥50%. The pathophysiology of diabetes-induced erectile dysfunction (DIED) is multifactorial and no single etiology is at the forefront. The proposed mechanisms of erectile dysfunction in diabetic patients includes elevated advanced glycation end-products, increased levels of oxygen free radicals, impaired nitric oxide synthesis, increased endothelin B receptor binding sites and up-regulated RhoA/Rho-kinase pathway, neuropathic damage and impaired cyclic guanosine monophosphate (cGMP)-dependent protein kinase-1. The treatment of DIED is multimodal. Treatment of the underlying hyperglycemia and comorbidities is of utmost importance to prevent or halt the progression of disease. Oral medications are considered as the first line therapy for management of DIED. If oral agents cannot be used or have insufficient efficacy despite appropriate dosing and education, second-line treatments should be addressed. When there is lack of efficacy or when there is dissatisfaction with other modalities, penile prostheses are often the best alternative for ED and are considered as the third line therapy for DIED. Future strategies in the evolution of the treatment of DIED are aimed at correcting or treating the underlying mechanisms of DIED.
    MeSH term(s) Animals ; Diabetes Complications/epidemiology ; Diabetes Complications/etiology ; Diabetes Complications/metabolism ; Diabetes Complications/therapy ; Diabetic Neuropathies/complications ; Diabetic Neuropathies/epidemiology ; Diabetic Neuropathies/metabolism ; Diabetic Neuropathies/therapy ; Erectile Dysfunction/epidemiology ; Erectile Dysfunction/etiology ; Erectile Dysfunction/metabolism ; Erectile Dysfunction/therapy ; Glycation End Products, Advanced/adverse effects ; Glycation End Products, Advanced/metabolism ; Health ; Humans ; Male ; Nitric Oxide/biosynthesis ; Sexuality/physiology
    Chemical Substances Glycation End Products, Advanced ; Nitric Oxide (31C4KY9ESH)
    Language English
    Publishing date 2011-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1105840-7
    ISSN 1873-460X ; 1056-8727
    ISSN (online) 1873-460X
    ISSN 1056-8727
    DOI 10.1016/j.jdiacomp.2010.03.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Pathophysiology of diabetic erectile dysfunction: potential contribution of vasa nervorum and advanced glycation endproducts.

    Cellek, S / Cameron, N E / Cotter, M A / Muneer, A

    International journal of impotence research

    2013  Volume 25, Issue 1, Page(s) 1–6

    Abstract: ... on the pathophysiology, in order to understand the cellular and molecular mechanisms leading to ED in diabetes. Diabetes ... Erectile dysfunction (ED) due to diabetes mellitus remains difficult to treat medically despite ... induced ED is often resistant to PDE5 inhibitor treatment, thus there is a need to discover targets ...

    Abstract Erectile dysfunction (ED) due to diabetes mellitus remains difficult to treat medically despite advances in pharmacotherapeutic approaches in the field. This unmet need has resulted in a recent re-focus on the pathophysiology, in order to understand the cellular and molecular mechanisms leading to ED in diabetes. Diabetes-induced ED is often resistant to PDE5 inhibitor treatment, thus there is a need to discover targets that may lead to novel approaches for a successful treatment. The aim of this brief review is to update the reader in some of the latest development on that front, with a particular focus on the role of impaired neuronal blood flow and the formation of advanced glycation endproducts.
    MeSH term(s) Diabetic Neuropathies/metabolism ; Diabetic Neuropathies/physiopathology ; Erectile Dysfunction/drug therapy ; Erectile Dysfunction/metabolism ; Erectile Dysfunction/physiopathology ; Glycation End Products, Advanced/metabolism ; Humans ; Male ; Phosphodiesterase 5 Inhibitors/therapeutic use ; Vasa Nervorum/metabolism ; Vasa Nervorum/physiopathology
    Chemical Substances Glycation End Products, Advanced ; Phosphodiesterase 5 Inhibitors
    Language English
    Publishing date 2013-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1034295-3
    ISSN 1476-5489 ; 0955-9930
    ISSN (online) 1476-5489
    ISSN 0955-9930
    DOI 10.1038/ijir.2012.30
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Diabetes-induced erectile dysfunction: epidemiology, pathophysiology and management

    Thorve, Vrushali S / Kshirsagar, Ajay D / Vyawahare, Neeraj S / Joshi, Vipin S / Ingale, Kundan G / Mohite, Reshma J

    Journal of diabetes and its complications. 2011 , v. 25, no. 2

    2011  

    Abstract: ... 50%. The pathophysiology of diabetes-induced erectile dysfunction (DIED) is multifactorial and no ... The treatment of DIED is multimodal. Treatment of the underlying hyperglycemia and comorbidities is of utmost ... Erectile dysfunction (ED) is defined as the inability of the male to attain and maintain ...

    Abstract Erectile dysfunction (ED) is defined as the inability of the male to attain and maintain erection of penis sufficient to permit satisfactory sexual intercourse. Prevalence of impotence in diabetic men is ≥50%. The pathophysiology of diabetes-induced erectile dysfunction (DIED) is multifactorial and no single etiology is at the forefront. The proposed mechanisms of erectile dysfunction in diabetic patients includes elevated advanced glycation end-products, increased levels of oxygen free radicals, impaired nitric oxide synthesis, increased endothelin B receptor binding sites and up-regulated RhoA/Rho-kinase pathway, neuropathic damage and impaired cyclic guanosine monophosphate (cGMP)-dependent protein kinase-1. The treatment of DIED is multimodal. Treatment of the underlying hyperglycemia and comorbidities is of utmost importance to prevent or halt the progression of disease. Oral medications are considered as the first line therapy for management of DIED. If oral agents cannot be used or have insufficient efficacy despite appropriate dosing and education, second-line treatments should be addressed. When there is lack of efficacy or when there is dissatisfaction with other modalities, penile prostheses are often the best alternative for ED and are considered as the third line therapy for DIED. Future strategies in the evolution of the treatment of DIED are aimed at correcting or treating the underlying mechanisms of DIED.
    Keywords advanced glycation end products ; binding sites ; comorbidity ; cyclic GMP ; disease course ; epidemiology ; etiology ; free radicals ; hyperglycemia ; males ; men ; nitric oxide ; oxygen ; pathophysiology ; patients ; penis ; prostheses ; therapeutics
    Language English
    Dates of publication 2011-03
    Size p. 129-136.
    Publishing place Elsevier Inc.
    Document type Article
    ZDB-ID 1105840-7
    ISSN 1056-8727
    ISSN 1056-8727
    DOI 10.1016/j.jdiacomp.2010.03.003
    Database NAL-Catalogue (AGRICOLA)

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  7. Article: The role of endothelial dysfunction in the pathophysiology of erectile dysfunction in diabetes and in determining response to treatment.

    Pegge, N C / Twomey, A M / Vaughton, K / Gravenor, M B / Ramsey, M W / Price, D E

    Diabetic medicine : a journal of the British Diabetic Association

    2006  Volume 23, Issue 8, Page(s) 873–878

    Abstract: ... endothelial dysfunction. We studied the relative importance of these factors in diabetic and non-diabetic men ... in both diabetic and non-diabetic men is characterized by marked endothelial dysfunction in comparison with non ... with ED and determined if they predict responses to treatment with sildenafil.: Methods: Thirty-three ...

    Abstract Background: Erectile dysfunction (ED) in diabetes is related to autonomic neuropathy and endothelial dysfunction. We studied the relative importance of these factors in diabetic and non-diabetic men with ED and determined if they predict responses to treatment with sildenafil.
    Methods: Thirty-three men, aged 35-65 years, with ED (20 diabetic, 13 non-diabetic), 15 of whom were sildenafil responders and 18 non-responders, were compared with 30 age and risk-matched control subjects (15 diabetic, 15 non-diabetic). Subjects with ED completed the International Index of Erectile Function (IIEF) questionnaire. Endothelial function was assessed by changes in brachio-radial and femoro-tibial arterial pulse-wave velocity (pulse-wave velocity) during reactive hyperaemia, expressed as percentage endothelium-dependent dilatation. Autonomic function was assessed by heart rate variation during expiration and inspiration (E/I ratio) and during the valsalva manoeuvre.
    Results: The respective changes in pulse-wave velocity, in the arm and leg [mean (sd)] were 0.71 (6.5)% and 3.5 (6.4)% in the impotent diabetic men, 0.7 (7.6)% and 2.4 (5.9)% in the non-diabetic impotent men, -0.68 (5.7)% and -1.31 (7.2)% in the non-impotent diabetic men and 7.7 (3.7)% and 7.6 (3.4)% in the control subjects. There was a significant interaction between ED and diabetic status such that there was significantly impaired vascular response in the diabetic group (both with and without ED) and in the non-diabetic group with ED compared with the non-diabetic control group (P = 0.01 and P = 0.001 for brachio-radial and femoro-tibial measures, respectively). The E/I ratios of the diabetic men were significantly lower than those of the control subjects [1.17 (0.14) vs. 1.33 (0.16), P < 0.02), but there were no differences in the measures of autonomic neuropathy between the groups with ED and those with normal erectile function. Amongst diabetic men, the initial IIEF scores (maximum score 30, low score indicates more severe ED) were significantly higher in sildenafil-responders than non-responders [16.3 (8.4), vs. 6.8 (7 1), P < 0.02]. The rate of sildenafil response was not significantly affected by the measures of endothelial or autonomic function.
    Conclusions: ED in both diabetic and non-diabetic men is characterized by marked endothelial dysfunction in comparison with non-diabetic control subjects. Response to sildenafil is not predicted by either endothelial function or autonomic function, but in diabetic men appears to be related to the initial degree of erectile dysfunction.
    MeSH term(s) Adult ; Aged ; Case-Control Studies ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/physiopathology ; Diabetic Angiopathies/drug therapy ; Diabetic Angiopathies/etiology ; Diabetic Angiopathies/physiopathology ; Diabetic Neuropathies/drug therapy ; Diabetic Neuropathies/etiology ; Diabetic Neuropathies/physiopathology ; Endothelium, Vascular/physiopathology ; Erectile Dysfunction/drug therapy ; Erectile Dysfunction/etiology ; Erectile Dysfunction/physiopathology ; Humans ; Male ; Middle Aged ; Penile Erection/drug effects ; Piperazines/therapeutic use ; Purines/therapeutic use ; Sildenafil Citrate ; Sulfones/therapeutic use ; Treatment Outcome ; Vasodilator Agents/therapeutic use
    Chemical Substances Piperazines ; Purines ; Sulfones ; Vasodilator Agents ; Sildenafil Citrate (BW9B0ZE037)
    Language English
    Publishing date 2006-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605769-x
    ISSN 1464-5491 ; 0742-3071 ; 1466-5468
    ISSN (online) 1464-5491
    ISSN 0742-3071 ; 1466-5468
    DOI 10.1111/j.1464-5491.2006.01911.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Book ; Online: Updates and Advances in Nephrolithiasis

    Long, Layron

    Pathophysiology, Genetics, and Treatment Modalities

    2017  

    Keywords Renal medicine & nephrology ; cavitation, diabetic foot, relapse, chronic wounds, food, erectile dysfunction
    Language English
    Size 1 electronic resource (130 pages)
    Publisher IntechOpen
    Document type Book ; Online
    Note English
    HBZ-ID HT030645627
    ISBN 9789535147046 ; 9535147048
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  9. Article: The effect of streptozotocin-induced diabetes on the rat seminal vesicle: A possible pathophysiological basis for disorders of ejaculation.

    Morrison, J F B / Dhanasekaran, S / Sheen, Rajan / Frampton, C M / Mensah-Brown, Eric

    Annals of the New York Academy of Sciences

    2006  Volume 1084, Page(s) 267–279

    Abstract: ... of serotonin and adrenaline, particularly around 19-26 weeks after STZ treatment. The uptake of tritiated ... In the streptozotocin (STZ)-diabetic rat major increases in noradrenaline concentration and content ... of the seminal vesicles were evident as early as 7 weeks following induction of hyperglycemia and returned toward normal ...

    Abstract In the streptozotocin (STZ)-diabetic rat major increases in noradrenaline concentration and content of the seminal vesicles were evident as early as 7 weeks following induction of hyperglycemia and returned toward normal after 34 weeks of hyperglycemia. There were significant reductions in the concentration and content of dopamine at 19-42 weeks of diabetes, and small occasionally significant reductions in the content of serotonin and adrenaline, particularly around 19-26 weeks after STZ treatment. The uptake of tritiated noradrenaline in the diabetics was increased at 12 weeks compared to the controls, and decreased to control levels with increasing age. Release of tritiated noradrenline was increased in response to electrical field stimulation and high potassium solutions, and raising calcium concentration caused increased release at rest and during electrical stimulation. Immunohistochemical demonstration of tyrosine hydroxylase was increased during the period when the noradrenaline concentration and content were elevated. It is concluded that there are significant changes in the sympathetic innervation of the seminal vesicle during the course of STZ diabetes, and that alterations in the reuptake, release, and synthesis of the neurotransmitter noradrenaline may contribute to changes in the concentration of the amine in the tissue. It is possible that the changes observed are related to the remodeling and regrowth of sympathetic nerve endings damaged in the early stages of hyperglycemia. These changes may also contribute to disorders of ejaculation in diabetes.
    MeSH term(s) Animals ; Blood Glucose/metabolism ; Diabetes Mellitus, Experimental/blood ; Diabetes Mellitus, Experimental/physiopathology ; Dopamine/blood ; Ejaculation/physiology ; Erectile Dysfunction/blood ; Erectile Dysfunction/etiology ; Erectile Dysfunction/physiopathology ; Hyperglycemia/physiopathology ; Male ; Norepinephrine/metabolism ; Rats ; Rats, Wistar ; Seminal Vesicles/physiopathology
    Chemical Substances Blood Glucose ; Dopamine (VTD58H1Z2X) ; Norepinephrine (X4W3ENH1CV)
    Language English
    Publishing date 2006-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 211003-9
    ISSN 1749-6632 ; 0077-8923
    ISSN (online) 1749-6632
    ISSN 0077-8923
    DOI 10.1196/annals.1372.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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