Dirk Schultheiss

Central effects of sildenafil (Viagra) on auditory selective attention and verbal recognition memory in humans: a study with event-related brain potentials

Abstract The purpose of this study was to assess possible central side-effects of sildenafil (Viagra) on attention and memory functions. Sildenafil and placebo were administered in young male subjects in a double-blind balanced cross-over design. Behavioral patterns and event-related brain potentials (ERP) were recorded in a spatial auditory attention and a visual word recognition task. While behavioral patterns did not reveal any overt effects of sildenafil, auditory ERPs were indicative of an enhanced ability to focus attention (amplitude enhancement of Nd-effect) and to select relevant target stimuli in the sildenafil condition (P3 component). In the memory task, CNS-effects of sildenafil were evident in a reduction of a negativity in the 150–250 ms range. No overt effects on behavior were observed. Nevertheless, the data reveal CNS-effects of sildenafil necessitating further studies.

Tissue engineering from Adam to the zygote: historical reflections.

Abstract Tissue engineering, long a matter of myth and dream throughout the history of medicine, is now a practical reality. A wide spectrum of biological materials are used in the field of urology to treat disease and to overcome human disabilities, including tissue grafts and organ transplantation. Laboratory-engineered bioproducts for the off-the-shelf replacement and reconstruction of tissue is now almost at hand. This article presents a glimpse into the past by highlighting a number of early pioneering works in the field of tissue transplantation and cell culture technologies.

The history of endocrine therapy of benign and malignant diseases of the prostate.

Abstract The discovery of endocrine therapy of diseases of the prostate can be regarded as one of the most important events in the history of medicine and in urology in particular. This article delivers an overview about scientists and clinicians involved in this work during the last 200 years. A close historical relation between the endocrine therapy of benign prostatic hyperplasia and prostate cancer can be recognized. The historical framework between the work of John Hunter in the late eighteenth century, that of Charles Brenton Huggins in the late 1930s, and that of Andrew Schally in the 1970s has been assembled herein. With respect to all the other men who contributed greatly to this medical achievement, e.g., Edward L. Keyes and Russell S. Ferguson, with their first report on radioorchiectomy for the treatment of metastatic prostate cancer in 1936, this historical vignette is intended to make them part of the historical record.

G. Frank Lydston (1858–1923) revisited: androgen therapy by testicular implantation in the early twentieth century

At the beginning of the twentieth century the transplantation or implantation of either human or animal testicular tissue was an appealing form of androgen therapy in hypogonadal and aging males. This article on the history of medicine discusses the work of the American urologist G. Frank Lydston from Chicago, who was a well-known and respected surgeon in the academic world and was involved in the early clinical trials of this procedure.

Acute epididymitis induces alterations in sperm protein composition

OBJECTIVE To use a proteomic approach to evaluate possible postinflammatory alterations in the protein composition of motile sperm in patients 3 months after acute epididymitis. DESIGN Prospective case-control study. SETTING University medical school research laboratory. PATIENT(S) Eight patients 3 months after acute unilateral epididymitis and 10 healthy controls. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Proteome analysis of sperm samples collected by swim-up from control and acute epididymitis patients analyzed by two-dimensional gel electrophoresis and subsequent protein identification by matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) mass spectrometry; immunofluorescence staining for mitochondrial ATP synthase subunit β (ATP5B), α-tubulin (TUBA1A), and tubulin-β2c (TUBB4B) for validation purposes. RESULT(S) Proteome analysis identified 35 proteins in sperm from epididymitis patients that were down-regulated, irrespective of subcellular localization and biologic function. Furthermore, immunofluorescence microscopy confirmed ATP5B, TUBA1A, and TUBB4B were less abundantly expressed in epididymitis samples compared with controls. CONCLUSION(S) Despite normal semen parameters observed by conventional semen analysis in patients after epididymitis, significant changes to sperm protein composition were observed. These changes may be implicated as additional factors contributing to subfertility/infertility in men after episodes of epididymitis.

Historical Aspects of the Treatment of Urinary Incontinence

Ancient reports on urinary incontinence are rather rare and mainly address cases of extraurethral incontinence, e.g. due to a fistula acquired during childbirth or overflow incontinence, e.g. in males with urinary retention or after spinal cord injury. In modern times several authors dealt with the problem of postoperative incontinence after perineal lithotomy. Surgical techniques for the cure of urinary incontinence were not introduced before the 19th century. First this was limited to fistula repair but at the turn of the century new procedures for stress incontinence were introduced and became standard clinical procedures. Other modern techniques, e.g. artificial sphincters or electrostimulation, were alternatives developed in urology during the second half of our century. This article from the history of medicine outlines early reports on urinary incontinence and reveals a more detailed review of the different treatment options including conservative therapies, incontinence devices, electrotherapy and surgical procedures, including injection therapies and artificial sphincters.

Urodynamics in the anatomical work of Leonardo da Vinci (1452-1519)

Abstract Leonardo da Vinci (1452–1519) incorporates the symbiosis of art and medicine and can be adressed as the founder of medical illustration in the time of the Renaissance. His anatomy studies were not published in his time, which explains why Leonardos outstanding knowledge of anatomy, physiology, and medicine had no impact on his scientific contemporaries and is therefore primarily of retrospective importance in the history of medicine. The collection of anatomical illustrations remained unknown until their rediscovery in the eighteenth century and their wide publication at the beginning of our century. This article systematically reviews Leonardos genitourinary drawings with regard to urodynamic aspects of the upper and lower urinary tract, highlighting topics such as vesicoureteral reflux and urinary sphincter mechanisms.

In vitro viability of human cavernosal endothelial and fibroblastic cells after exposure to papaverine/phentolamine and prostaglandin E1

To investigate the influence of commercially available vasoactive drugs on human cavernosal endothelial and fibroblastic cells in vitro, as although corporal fibrosis is a well known side‐effect of intracavernosal injection therapy for erectile dysfunction, the possible detrimental effect of these agents on the endothelium lining the cavernosal vascular spaces is uncertain.

Erectile dysfunction and anejaculation

Key issues in the physiology of erection are central nervous control, peripheral autonomic neurotransmission, cavernous smooth muscle relaxation and intracellular signal transmission. Modern therapy of erectile dysfunction is based on this increased knowledge, resulting in new options for oral pharmacotherapy such as sildenafil or apomorphine. In addition this article pays particular attention to the topics of anejaculation, age-related changes in sexuality and testosterone substitution therapy.

Androgen therapy: Quo vadis?

Androgens play an essential role in men s health. Testosterone is needed for normal male development, sexual and reproductive functions, muscle strength, bone mineralisation, cognitive functions and general well being. Besides the various andrological disturbances, a lack of androgens can result in such important general deficits as anaemia, immune deficiency, osteoporosis, increase in organ fat and cardiovascular accidents. This topic issue of the World Journal of Urology gives an update of the variety of new treatment options that are already available on the market or will be at hand in the near future. Among these improved androgen formulations are new oral and buccal forms, long-acting injectables and implants as well as improved transdermal systems. Life expectancy has grown over 50% in the past 100 years and the number of ageing men is increasing rapidly. With age, the number of disorders, including ageing of the endocrine system and late onset hypogonadism, also increases and quality of life, including sexual functioning, becomes an important issue. The question has been raised whether low levels of testosterone and the physical side effects of hypogonadism can be regarded as an inevitable consequence of ageing or should be considered a disease that needs treatment, i.e. hormonal replacement therapy. This issue s first article discusses this problem, giving reasonable guidelines for androgen therapy in the ageing male. Also, what are the potential risks and side effects of androgen supplementation? Recently, it was shown that men with low testosterone have an increased risk for developing prostate cancer, especially of the more aggressive type [1]. This problem is also addressed separately in this topic issue. Furthermore, hypogonadism is associated with increased levels of LDL-cholesterol and insulin resistance, thus increasing the risk for coronary artery disease and diabetes [2]. Moreover, other androgens, like dehydroepiandrosterone (DHEA), have been discussed controversially for supplementation therapy and should be looked at carefully, especially as they can be purchased freely in some countries [3].