الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The aim of our study is to compare the safety, efficacy and durability of different doses of BTX-A (50 and 100 unit) in the treatment of Vasculogenic Erectile Dysfunction after failure of other ICI therapy. ED is predicted to affect more than 300 million men worldwide by 2025. ED is classified as psychogenic, organic, or mixed psychogenic and organic, 80% of cases are now considered to be organic in origin, but the final common pathway in the majority of subjects with organic ED is endothelial dysfunction with vasculogenic ED.Various forms of therapy have been developed to treat ED, including oral pharmacotherapy, transurethral suppositories, vacuum constriction devices, intracavernosal injection (ICI) therapy, and implantation of penile prosthesis.It is important to re-evaluate ED therapeutic strategies and mandates robust steps to validate the innovative dugs and technologies that may revolutionise ED treatment. Over the past half century, ED treatment has rapidly evolved and continues to change with more available novel methods of treatment.It is well known that BoNT is derived from the Gram-positive rod shaped anaerobic bacteria, Clostridium botulinum. There are seven serotypes of BoNT (A-G) out of which only types A and B have been available to commercial use, the doses are expressed in Units of activity and are not interchangeable in doses. BoNT enters the neurons by binding to the synaptic vesicle protein 2 (SV2), during exocytosis of the neurotransmitter. With endocytosis of this toxin, it combines with synaptosomal-associated proteins (SNAP 25) protein and inhibits exocytosis of the neurotransmitters within the vesicles. Hence the affected neuromuscular junctions become paralyzed. The affected neurotransmitters include acetylcholine, noradrenaline and sensory neuropeptides such as adenosine triphosphate (ATP), substance P, neurokinin A, nitric oxide etc.