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Erectile dysfunction: expectations beyond phosphodiesterase type 5 inhibition.
1Department of Medical Phisiopathology, University La Sapienza, Rome, Italy. antonio.aversa1@fastwebnet.it
Journal of Endocrinological Investigation
|May 8, 2004
Summary
Understanding erectile dysfunction (ED) involves exploring the vascular and molecular basis of penile erection. New therapies target local factors for patients unresponsive to phosphodiesterase Type 5 inhibitors.
Area of Science:
- Urology
- Molecular Biology
- Pharmacology
Background:
- Erection is a vascular event dependent on penile endothelium.
- Penile tumescence relies on a balance of contracting and relaxing factors affecting smooth muscle cells.
- Erectile dysfunction (ED) is increasingly recognized as a symptom, not a disease.
Purpose of the Study:
- To review the pathophysiological mechanisms of erection.
- To discuss novel therapeutic approaches for ED.
- To provide clinicians with basic concepts relevant to clinical practice.
Main Methods:
- Literature review of recent studies on erection pathophysiology.
- Investigation of molecular machinery in corpus cavernosum (CC) cells.
- Analysis of local factors like phosphodiesterases, rho-kinases, and endothelins.
Main Results:
- Partial clarification of erection pathophysiology and CC cellular mechanisms.
- Identification of key local factors regulating penile tumescence.
- Availability of pharmacological agents targeting these mediators.
Conclusions:
- An intact endothelium is crucial for erection.
- Newer therapeutic strategies are emerging for ED.
- Clinicians need to integrate sexual medicine into practice for ED management.