Review of erectile dysfunction in diabetic animal models

Erectile dysfunction (ED) is a common, male sexual disorder that has a negative impact on the quality of life of men and their sexual partners. The prevalence of ED in diabetic men is ≥ 50%. Animal models provide a valuable perspective in the investigation of ED. Most basic science studies have utilized the rodent model of type 1 diabetes. However, an animal model for type 2 diabetes-associated ED requires verification. The streptozotocin (STZ) induced type 1 diabetic model has contributed to significant advancement in the study of ED. A Medline search using the keywords "diabetic animals and ED" was performed, and available peer-reviewed English articles between 2007-2013 were evaluated. The proposed mechanisms for developing ED in diabetics include: hyperglycemia, impaired nitric oxide (NO) synthesis, cyclic guanosine monophosphate (cGMP) pathway dysfunction, increased levels of reactive free-radicals, up-regulation of the RhoA/Rho-kinase pathway, and neuropathic damage. The current treatment regimen of diabetes-induced ED is multimodal. Modification of comorbidities and, specifically, rectifying the underlying hyperglycemia is vital to prevent or halt progression of the disease. Further research on the basic mechanisms of ED and additional studies using better animal models of ED associated with type 1 and 2 diabetes are needed. Preclinical studies using the diabetic animal model will likely provide further insight for intervention and prevention strategies for diabetic ED treatment.