Introduction The use of antidepressant medications has transformed modern psychiatry, offering millions of patients effective relief from the disabling symptoms of major depressive disorder and related conditions. Yet this therapeutic revolution has come at a cost. Alongside improvements in mood…
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Introduction Traumatic wounds represent one of the most persistent challenges in clinical practice. From minor cuts to deep surgical injuries, wound management remains central to surgery, emergency medicine, and long-term rehabilitation. Despite centuries of progress, the “ideal” wound healing agent—fast,…
Introduction Sexual health remains one of the most sensitive yet fundamental aspects of human well-being. Disorders that interfere with this dimension of life often carry not only medical but also psychological and social consequences. Among them, erectile dysfunction (ED) stands…
Introduction Prostate cancer remains one of the most prevalent malignancies among men, particularly in the aging population. Advances in screening, diagnosis, and treatment have led to steadily improving survival rates. Yet, as survival improves, a paradox emerges: long-term therapies designed…
Introduction Testicular torsion remains one of the most feared emergencies in andrology and urology. When a testis twists upon the spermatic cord, it creates an acute ischemic state that rapidly endangers tissue viability. Prompt detorsion is often lifesaving for the…
Radical cystectomy remains the cornerstone treatment for muscle-invasive bladder cancer and selected cases of high-risk non–muscle-invasive disease. Despite refinements in surgical technique, perioperative care, and the use of enhanced recovery pathways, the procedure carries a significant burden of morbidity. Patients…
Functional hypogonadism is increasingly recognized as one of the silent medical epidemics of the 21st century. Unlike classical hypogonadism caused by irreversible testicular or pituitary failure, functional hypogonadism reflects a state of reversible testosterone deficiency often driven by lifestyle and…
Introduction Infertility remains one of the most emotionally taxing conditions in reproductive medicine, and the role of endometrial receptivity is central to both natural conception and assisted reproductive technologies (ART). Among the many determinants of endometrial receptivity, endometrial thickness occupies…
Erectile dysfunction (ED) has transitioned in the last few decades from being a socially whispered embarrassment to a condition that is openly discussed in the clinic and vigorously investigated in the laboratory. The reason for this shift is straightforward: ED…
Introduction Sildenafil citrate, known worldwide under its brand name Viagra, revolutionized the management of male erectile dysfunction when it entered clinical practice in the late 1990s. Its mechanism of action is well established: inhibition of phosphodiesterase type 5 (PDE5) leads…
Introduction Organic erectile dysfunction (ED) has long been a clinical puzzle that stretches beyond the limits of oral pharmacotherapy. Although phosphodiesterase type 5 inhibitors (PDE5is) such as sildenafil and tadalafil revolutionized sexual medicine, their effectiveness is highly dependent on intact…
Introduction Few medical topics are as misunderstood—and as surrounded by silence—as female sexual dysfunction. Among its subcategories, Female Sexual Interest/Arousal Disorder (FSIAD) stands out, not because it is rare, but because it is so common and yet so undertreated. At…
Erectile dysfunction (ED) remains one of the most distressing complications for men with type 2 diabetes mellitus (T2DM). While pharmacological treatments such as phosphodiesterase-5 inhibitors (PDE5i) are widely prescribed, they do not always yield satisfactory results, nor are they appropriate…
Introduction Cardiovascular disease remains the leading cause of death in individuals with diabetes, and among its many manifestations, diabetic cardiomyopathy holds a particularly sinister reputation. Defined as structural and functional abnormalities of the myocardium in the absence of overt ischemia…
Introduction Medicine advances in curious cycles. For decades, the prevailing paradigm has been “bench to bedside”—a straight highway where discoveries in basic science are transported into the clinical realm. Yet, as physicians and patients alike know, highways are prone to…
Introduction The medical sciences have long struggled with one deceptively simple problem: how to know exactly what is present in a biological system, and in what quantity. Drugs, metabolites, and biochemical markers often share overlapping chemical signatures, making their detection…
Introduction The science of medicine has always been a dialogue between observation and measurement. For centuries, physicians relied on symptoms, physical signs, and intuition to guide therapy. But the past few decades have ushered in a profound transformation—one that leans…
Introduction Erectile dysfunction (ED) is a subject that simultaneously carries enormous clinical significance and a weight of cultural stigma. Defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, ED is not a trivial…
Introduction Ureteral stents are among the most frequently used devices in modern urology. They are indispensable in restoring urine flow, preserving renal function, and facilitating healing after ureteral surgery. Yet, despite their benefits, they have one notorious downside: stent-related discomfort…
Introduction Female sexual dysfunction (FSD) is a broad, multifaceted condition that challenges both clinicians and patients. It is not a singular disease but rather a constellation of disorders encompassing reduced desire, impaired arousal, orgasmic difficulties, and pain. Unlike male sexual…
Introduction Erectile dysfunction (ED) is more than a private inconvenience; it is a public health issue with significant psychological, relational, and medical consequences. Globally, it affects millions of men, and its prevalence is steadily rising due to aging populations, increasing…
Introduction Pulmonary hypertension (PH) remains one of the most formidable challenges in modern cardiology. Defined by abnormally elevated pulmonary arterial pressures, it is both a disease in itself and a complication of diverse cardiovascular and respiratory conditions. Patients with PH…
Introduction For as long as humanity has recorded its desires, aphrodisiacs have occupied an exalted—and sometimes suspicious—place in culture. From oysters consumed by Roman nobles to ginseng brewed in traditional Chinese medicine, the quest for enhanced sexual vitality transcends geography,…
Erectile dysfunction (ED) is often framed as a quality-of-life issue—awkward to discuss, easy to postpone, and, regrettably, frequently labeled “just stress.” That framing is dangerously incomplete. In many men, ED is an early clinical manifestation of systemic vascular disease, sometimes…
Introduction Erectile dysfunction (ED) has long since outgrown its reputation as a whispering taboo of the bedroom. Once shrouded in embarrassment, it is now recognized as a major public health issue affecting physical, psychological, and relational well-being. Estimates suggest that…
Introduction Sildenafil citrate, commonly known under its commercial name Viagra, has been hailed for revolutionizing the management of erectile dysfunction since its unexpected discovery in the 1990s. Originally developed as an anti-anginal agent, its unforeseen ability to enhance penile erection…
Infertility is not merely a biological limitation; it is an emotional storm that reshapes intimate partnerships and burdens individual identity. For male patients, sexual dysfunction often represents both a cause and a consequence of infertility. Erectile difficulties, ejaculatory disorders, and…
Introduction Pulmonary arterial hypertension (PAH) is a devastating condition characterized by progressive increases in pulmonary vascular resistance, ultimately leading to right ventricular failure and premature death. When PAH develops secondary to chronic obstructive pulmonary disease (COPD), the prognosis becomes even…
Introduction When sildenafil citrate entered the medical stage in the late 1990s, its fame rested firmly on its ability to rescue erections through selective inhibition of phosphodiesterase type 5 (PDE5). Yet pharmacology often writes richer stories than the ones drug…
Introduction Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) represent a double burden for aging men. The obstruction of urinary outflow caused by prostatic enlargement combines with storage and voiding symptoms, making routine activities—from sleeping through the night…
Introduction The intersection between hormones, sexual health, and psychology has always been a fertile ground for both science and speculation. Testosterone, long heralded as the quintessential “male hormone,” is often portrayed as the biochemical key not only to virility but…
Introduction Among the many challenges in colorectal surgery, anastomotic leak remains one of the most dreaded complications. Despite meticulous surgical technique, leaks can occur, leading to prolonged hospitalization, reoperations, sepsis, and increased mortality. The rectal anastomosis, in particular, is prone…
Introduction When sildenafil citrate first entered clinical practice in 1998, it revolutionized the management of erectile dysfunction. The story of a failed antihypertensive drug becoming the world’s most famous “blue pill” is often retold as a triumph of serendipity. Yet,…
Introduction Erectile dysfunction (ED), once euphemistically labeled “impotence,” has moved from the shadows of taboo to the forefront of medical research and therapy. It is no longer dismissed as a psychological curiosity but recognized as a common, multifactorial disorder with…
Introduction Few drugs in modern medicine have become as iconic as sildenafil citrate. Popularly known as Viagra, this phosphodiesterase type 5 (PDE5) inhibitor has redefined the treatment of erectile dysfunction (ED) and has extended its therapeutic reach into pulmonary arterial…
Introduction Urolithiasis has long been a painful companion of humanity, afflicting men more than women, and costing health systems billions annually. Among all urinary tract stones, distal ureteric stones (DUS)—stones lodged in the lower third of the ureter—represent more than…
Introduction In pharmaceutical science, stability is not just a desirable quality; it is an absolute requirement. A drug can possess remarkable pharmacological activity, but if its physical or chemical structure refuses to remain intact under normal storage or formulation conditions,…
Introduction Lower urinary tract symptoms (LUTSs) in men are among the most common and burdensome clinical complaints in urology. They affect quality of life, disrupt sleep, interfere with daily activities, and often coexist with erectile dysfunction. For decades, management was…
Introduction Acute kidney injury (AKI) remains one of the most feared complications following cardiac surgery. Despite improvements in surgical technique, cardiopulmonary bypass (CPB) protocols, and perioperative care, up to one-third of patients undergoing major cardiac operations develop postoperative AKI. This…
Introduction Lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED) represent two of the most common and bothersome conditions affecting middle-aged and elderly men. For decades, they were treated as independent clinical entities: LUTSs as the inevitable outcome of benign…
Introduction Few hormones in human biology have sparked as much fascination, debate, and misunderstanding as testosterone. For decades, it has been celebrated as the quintessential “male hormone,” associated with virility, libido, muscle mass, and bone strength. In recent years, however,…
Introduction Kidney transplantation remains the gold standard treatment for end-stage renal disease (ESRD), offering superior survival and quality of life compared to dialysis. Yet, behind the celebratory headlines of “graft survival” and “creatinine normalization,” there lies a quieter but equally…
Introduction Modern medicine often suffers from compartmentalization: cardiologists manage the heart, endocrinologists handle hormones, and urologists concern themselves with the prostate, kidneys, and male sexual function. Yet the biological truth does not respect these professional boundaries. Erectile dysfunction (ED), once…
Introduction Erectile dysfunction (ED) remains one of the most distressing sequelae following radical prostatectomy. While surgeons have refined nerve-sparing techniques since the 1980s, the sobering truth persists: many men continue to experience compromised erectile function after surgery. Beyond its physical…
Introduction When sildenafil citrate—originally developed to treat angina—emerged as the world’s first oral therapy for erectile dysfunction, few anticipated its later identity as a pharmacological polymath. Beyond penile vascular physiology and pulmonary hypertension, sildenafil is increasingly recognized for its influence…
Introduction The physiology of penile erection represents one of the most elegant intersections between endocrinology, neurobiology, and vascular medicine. Central to this system are two principal regulators: testosterone, the quintessential androgen, and sildenafil, the archetypal phosphodiesterase type 5 (PDE5) inhibitor….
Introduction The story of sildenafil, originally introduced as a treatment for erectile dysfunction, is evolving in directions few pharmacologists anticipated. Beyond its now iconic role as a phosphodiesterase type 5 (PDE5) inhibitor for vasodilation, sildenafil has been investigated for pulmonary…
Introduction Few enzyme families embody both elegance of biochemical design and therapeutic potential as strikingly as cyclic nucleotide phosphodiesterases (PDEs). These enzymes, tasked with the hydrolysis of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), operate as molecular brakes…
Introduction Erectile dysfunction (ED) is often regarded as a disease of aging, yet an increasing body of evidence has disrupted this stereotype. Alarmingly, a growing number of young men under 40 years are presenting with ED. For a sizable proportion…
Introduction Erectile dysfunction (ED) represents one of the most common conditions encountered in men as they age. Defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, ED is far from a trivial inconvenience….