Radiological Evaluation of the Penis Before and After a Botox Injection

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madman

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Brief Summary:

The goal of this clinical trial is to find out if injecting Botox into men with erectile dysfunction makes their penis less stiff and gives them better erections. This will be done using a new ultrasound method. The main questions it tries to answer are: Is Botox injection safe and effective for men suffering from erectile dysfunction who failed other treatment methods? Does this new method have any radiological criteria for penile tissues? • If Botox is injected into the penis, is there a cut-off number for this technique that shows how much better things are before and after? Before and after treatment, participants will rate how much their erections have improved, and investigators will connect their answers to the findings
 
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*Multiple organ systems play a role in achieving a rigid erection, including the cardiovascular, central nervous, peripheral nervous, endocrine, and psychological systems

*
NO plays a role as a local intrapenile neurotransmitter that facilitates the relaxation of intracavernosal smooth muscle, allowing for increased blood flow into the corpora cavernosa

*
The synergy of increased arterial inflow and decreased venous outflow allows a man to attain and maintain a firm erection

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Cyclic GMP is needed to maintain nitric oxide-induced dilation of the intracavernosal smooth muscle tissue





*The hypothesis behind BoNT A's potential erectogenic effect lies in the idea of an existing balance between sympathetic and parasympathetic influences that maintain flaccidity and rigidity in the penile tissue, respectively. It is believed that BoNT A inhibits the exocytosis of norepinephrine synaptic vesicles at the postganglionic sympathetic neurons in the erectile tissue. The blunting of the sympathetic tone allows NO, which diffuses freely, to be the dominant neurotransmitter within the erectile tissue, thus increasing the overall parasympathetic tone
 
There have been a few other trials, one from Dr. Runels (invented p-shot and bocox) with a dozen participants and a larger one with 123 participants. I’ll have to find the links but it gave something like 1/2” flaccid gain, 70% success for ED in men with mild ED, but between 30-60% for more severe ED.
 
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Inclusion Criteria:

  • Men with ED not responding to oral PDE5Is.
Exclusion Criteria:

  • Patients with penile prostheses.
  • Patients diagnosed with Peyronie's disease.
  • Non-vascular erectile dysfunction.
  • Medical comorbidities that would limit the benefit of ICI such as uncontrolled diabetes mellitus, significant cardiovascular disease interfering with sexual activity, unstable psychiatric conditions, and the presence of anatomical, hormonal, or neurological abnormalities that would significantly impair erectile function.
  • Patients with a history of radical pelvic surgery.
  • Pelvic or spinal trauma
 
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