Stents Help Some Erectile Dysfunction
By medpagetoday.com
Stenting blocked arteries in the pelvis may improve sexual function for certain men with erectile dysfunction that is unresponsive to medical therapy, results of a pilot trial indicated.
Internal pudendal artery stenting boosted erectile function scores by a clinically-significant degree in 84% of the 19 men followed for 12 months after the procedure, Krishna J. Rocha-Singh, MD, of the Prairie Vascular Institute at St. John's Hospital in Springfield, Ill., and colleagues found.
Moreover, blood flow through the stented vessels remained durably improved without any safety concerns, the group reported here at the Transcatheter Cardiovascualar Therapeutics meeting.
These first-in-man results from the ZEN trial are promising for the highly-selected group of men in the pilot, Rocha-Singh suggested.
However, the approach faces a multitude of challenges, he told MedPage Today.
Not only are the pelvic vessels foreign territory that "looks like a bowl of spaghetti" on angiography to most interventionalists, but the future looks dicey for further clinical trials.
The ZEN trial sponsor, Medtronic, dropped their involvement and cancelled further planned studies.
The financial return on investment for any individual stent manufacturer may not be deemed sufficient for the small population of men with vascular erectile dysfunction when clinicians could use any competitor's coronary stent for the procedure, Rocha-Singh suggested.
Fully 92% of the men screened for the trial weren't candidates for the intervention -- primarily because the vascular disease was so advanced that there was nothing to open up, Rocha-Singh pointed out.
Angiographic or penile duplex ultrasound characteristics required for inclusion criteria were 70% or more stenosis in one side or 50% or more on both sides.
The 30 men who were included were typically older (average age 60), with a substantial proportion having cardiovascular risk factors such as a history of tobacco use (70%) or coronary events (20% prior heart attack, 13% prior stroke, and 7% prior unstable angina).
Catching men earlier may be key, Rocha-Singh proposed.
"It was all about the simple fact that we get men too late," he said. "Instead of stenting men in their 60s who've had bypass or carotid endarterectomy or femoral popliteal bypass, we need to ask them the first time they get on a phosphodiesterase inhibitor and ask them on a regular basis how is it working."
Half of men develop a suboptimal response to these drugs within 3 years and the options for those men aren't great, often leading to penile implants, he pointed out.
In previously reported results from the trial, the primary endpoints showed no major adverse events at 30 days (deaths, perineal gangrene or necrosis, or perineal, penile, or anal surgery) and a 59% rate of a clinically-meaningful improvement in the gold-standard measure of erectile function.
Among the 23 patients who stayed in the trial to 6 month follow-up reported by Rocha-Singh, the rate of four-point or greater improvement in the International Index of Erectile Function (IIEF) was 67%.
That rate was 84% at 12 months, though Rocha-Singh pointed out that the patient numbers had fallen off to just 19 of the original 30, suggesting the possibility of survival bias.
"I can't absolutely tell you that the patients didn't come back because they were happy they were having erections or if they were unhappy because they were already having penile implants," he told attendees at the session.
Absolute IIEF scores rose from a mean of 40 at baseline to 60 at 12 months.
Peak blood flow velocity in the cavernosal arteries through the penis showed improvements through 12 months, though, from a mean baseline of 16 cm/s to 32 cm/s.
No major adverse events were seen through 12 months.
While device companies haven't shown interest in further developing this indication for stents currently approved in the coronary heart disease setting, "that doesn't mean it's going to go away," Rocha-Singh noted, pointing to a research consortium that's getting organized in Europe around the procedure.
Source: http://www.medpagetoday.com/meetingcoverage/tct/35494
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Sunday, May 31, 2026
Robaxin Methocarbamol Article
Methocarbamol, known by brand Robaxin, is muscle relaxant used for short-term relief of painful musculoskeletal spasm. It is usually adjunct to rest, physical therapy, and non-drug recovery measures rather than stand-alone long-term solution. Drug can reduce discomfort associated with acute back strain, neck spasm, and soft-tissue injury by depressing central nervous system activity related to muscle tension perception. Benefit is mainly symptom relief, not correction of underlying structural cause. Common side effects include drowsiness, dizziness, slowed reaction time, and blurred vision. Because of these effects, caution with driving, machinery, and combined sedatives is essential, especially in first days of treatment. Methocarbamol is often used for limited duration during acute flare periods. If pain persists, clinicians usually reassess diagnosis and broader rehabilitation strategy rather than extending relaxant indefinitely. Medication interactions matter. Combining methocarbamol with alcohol, opioids, benzodiazepines, sedating antihistamines, or sleep medications can amplify sedation and fall risk. These factors explain why robaxin-methocarbamol for muscle and pain management should be used with clear timing instructions and safety counseling. Excessive sleepiness, confusion, breathing concerns, or persistent neurologic symptoms require prompt review. Non-drug support remains key: gradual mobility, posture correction, heat therapy, hydration, and sleep optimization. These reduce recurrence and dependence on rescue medication. Patients should track function outcomes such as standing tolerance, sleep interruption from spasm, and ability to return to activity. Function change guides treatment more reliably than pain score alone. For broader comparison of spasm-treatment options and recovery planning, patients can review muscle relaxants care resources before follow-up visits. Patients should receive explicit daytime-versus-bedtime dosing guidance to reduce work and driving impairment. Short reassessment windows help determine whether medication is still needed or taper can begin. Clear stop plan lowers prolonged sedative exposure. Consistency with physical rehab improves long-term results. Early mobility progression reduces repeat spasm episodes. Sustainability.
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