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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
The mechanisms and potential of stem cell therapy for penile fibrosis
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<blockquote data-quote="madman" data-source="post: 207588" data-attributes="member: 13851"><p><strong>Fig. 2 | <u>Penile fibrosis</u>. Peyronie’s disease, urethral stricture, and corpora cavernosa fibrosis are fibrotic disorders of the penile connective tissues that are characterized by changes in the collagen composition (formation of a fibrous plaque) of the tunica albuginea, the urethral corpus spongiosum, and the penile corpora cavernosa, respectively8,11.<u> Corpora cavernosa fibrosis is characterized by generalized fibrosis in the erectile tissue of the penis</u>. <u>When the expansion of corporal spongy tissue is compromised as a result of fibrosis, rapid filling of the sinusoids will no longer occur, leading to a subsequent lack of compression of the subtunical venules94, rendering the penis incapable of becoming completely rigid (corporal Veno-occlusive dysfunction)</u>. <u>The most important aetiological factors for corpora cavernosa fibrosis include atherosclerosis (owing to chronic penile hypoxia), diabetes mellitus (owing to endothelial dysfunction, nerve damage, impaired arterial flow, reactive oxygen species and advanced glycation end-products (AGEs)), and iatrogenic causes (damage of the neurovascular bundle during prostatectomy in patients with prostate cancer)</u>94–96. Peyronie’s disease is a localized fibrotic disorder situated on the tunica albuginea of the penis. Peyronie’s disease is associated with erectile dysfunction (veno-occlusive dysfunction), curvatures of up to 90° or more (which impair sexual intercourse) and up to 50% of patients experience clinically significant depression and/or relationship problems175. <u>The leading hypothesis states that Peyronie’s disease is caused by repetitive microtrauma as a result of buckling of the penis during intercourse176. Patients experience an acute phase with a painful penis (usually during erections), no palpable plaque, and a progressive curvature. After 12–24 months, the disease evolves into a chronic, stable plaque and curvature that is painless</u>. Currently, available treatment options include surgery and intratunical injections of collagenase in stable disease. Other (medical) treatment options have proven unsuccessful177. Urethral strictures are characterized by an abnormal narrowing of the urethra that functionally causes a bladder outlet disorder, which can negatively affect a patient’s quality of life by leading to genitourinary infection (epididymitis, prostatitis, cystitis, or pyelonephritis), impairing voiding and causing secondary bladder overactivity (with complaints of urgency and urgency incontinence)9. Several aetiologies have been proposed and are categorized as iatrogenic, traumatic, inflammatory, and idiopathic9. Since the advent of endourological surgical techniques and urine catheters, the iatrogenic factors have been the most important causes of urethral strictures</strong></p><p><strong>[ATTACH=full]16298[/ATTACH]</strong></p></blockquote><p></p>
[QUOTE="madman, post: 207588, member: 13851"] [B]Fig. 2 | [U]Penile fibrosis[/U]. Peyronie’s disease, urethral stricture, and corpora cavernosa fibrosis are fibrotic disorders of the penile connective tissues that are characterized by changes in the collagen composition (formation of a fibrous plaque) of the tunica albuginea, the urethral corpus spongiosum, and the penile corpora cavernosa, respectively8,11.[U] Corpora cavernosa fibrosis is characterized by generalized fibrosis in the erectile tissue of the penis[/U]. [U]When the expansion of corporal spongy tissue is compromised as a result of fibrosis, rapid filling of the sinusoids will no longer occur, leading to a subsequent lack of compression of the subtunical venules94, rendering the penis incapable of becoming completely rigid (corporal Veno-occlusive dysfunction)[/U]. [U]The most important aetiological factors for corpora cavernosa fibrosis include atherosclerosis (owing to chronic penile hypoxia), diabetes mellitus (owing to endothelial dysfunction, nerve damage, impaired arterial flow, reactive oxygen species and advanced glycation end-products (AGEs)), and iatrogenic causes (damage of the neurovascular bundle during prostatectomy in patients with prostate cancer)[/U]94–96. Peyronie’s disease is a localized fibrotic disorder situated on the tunica albuginea of the penis. Peyronie’s disease is associated with erectile dysfunction (veno-occlusive dysfunction), curvatures of up to 90° or more (which impair sexual intercourse) and up to 50% of patients experience clinically significant depression and/or relationship problems175. [U]The leading hypothesis states that Peyronie’s disease is caused by repetitive microtrauma as a result of buckling of the penis during intercourse176. Patients experience an acute phase with a painful penis (usually during erections), no palpable plaque, and a progressive curvature. After 12–24 months, the disease evolves into a chronic, stable plaque and curvature that is painless[/U]. Currently, available treatment options include surgery and intratunical injections of collagenase in stable disease. Other (medical) treatment options have proven unsuccessful177. Urethral strictures are characterized by an abnormal narrowing of the urethra that functionally causes a bladder outlet disorder, which can negatively affect a patient’s quality of life by leading to genitourinary infection (epididymitis, prostatitis, cystitis, or pyelonephritis), impairing voiding and causing secondary bladder overactivity (with complaints of urgency and urgency incontinence)9. Several aetiologies have been proposed and are categorized as iatrogenic, traumatic, inflammatory, and idiopathic9. Since the advent of endourological surgical techniques and urine catheters, the iatrogenic factors have been the most important causes of urethral strictures [ATTACH type="full" alt="Screenshot (6914).png"]16298[/ATTACH][/B] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
The mechanisms and potential of stem cell therapy for penile fibrosis
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