title: Seminal vesicles and diabetic neuropathy: ultrasound evaluation after prolonged treatment with a selective phosphodiesterase-5 inhibitor.
abstract: We have previously reported that infertile patients with diabetes mellitus (DM) have a particular ultrasound features of the seminal vesicles (SV) characterized by higher fundus-to-body ratio and lower pre- and post-ejaculatory difference in body antero-posterior diameter (APD). Based on these premises the aim of the present study was to investigate possible ultrasound SV changes in infertile patients with DM and diabetic neuropathy (DN), after prolonged administration of tadalafil (TAD) (a specific phosphodiesterase-5 inhibitor). To accomplish this, 20 infertile patients with symptomatic DN and erectile dysfunction were selected and arbitrarily divided into two groups which were assigned to: daily administration of 5 mg TAD for 3 months (Group A) (n = 10) and administration of placebo (Group B) (n = 10). All patients underwent to scrotal and prostate-vesicular transrectal ultrasound evaluation and semen analysis (Laboratory Manual for the Examination and Processing of Human Semen, WHO, 2010) before and after treatment. The following SV US parameters were recorded: (i) body APD; (ii) fundus APD; (iii) parietal thickness of the right and left SVs; and (iv) number of polycyclic areas within both SVs. We then calculated the following parameters: (i) fundus/body (F/B) ratio; (ii) difference of the parietal thickness between the right and the left SV and (iii) pre- and post-ejaculatory APD difference. In addition, we also evaluated the SV ejection fraction. Group A patients showed a significant reduction in F/B ratio and higher pre- and post-ejaculatory body SV APD difference compared with baseline or Group B after 3 months. These patients showed also a significant increase in SV ejection fraction and a significant improvement of the total sperm count, progressive motility, seminal levels of fructose, leucocytes and ejaculate volume. In conclusion, these results suggest that infertile DM patients with DN and erectile dysfunction had an improvement of ultrasound features suggestive of diabetic neuropathy after daily treatment with low doses of TAD.
authors: Section of Endocrinology, Andrology and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy. sandrolavignera@email.it
authors: S
authors: S
authors: La Vignera
authors: R A
authors: RA
authors: Condorelli
authors: E
authors: E
authors: Vicari
authors: F
authors: F
authors: Lotti
authors: V
authors: V
authors: Favilla
authors: G
authors: G
authors: Morgia
authors: M
authors: M
authors: Maggi
authors: A E
authors: AE
authors: Calogero
mesh_terms: D000328:Adult; D002243:Carbolines / Q000009:adverse effects / Q000627:therapeutic use*; D003920:Diabetes Mellitus; D003929:Diabetic Neuropathies / Q000150:complications*; D004542:Ejaculation / Q000187:drug effects; D007172:Erectile Dysfunction / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007248:Infertility, Male / Q000000981:diagnostic imaging; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D055101:Semen Analysis; D012669:Seminal Vesicles / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D000068581:Tadalafil; D014463:Ultrasonography
chemical_list: D002243:Carbolines; D058986:Phosphodiesterase 5 Inhibitors; D000068581:Tadalafil