Understanding and targeting the Rho kinase pathway in erectile dysfunction
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Updated: Apr 22, 2026

Intracavernosal Pressure Recording to Evaluate Erectile Function in Rodents
Published on: June 6, 2018
Nikolai A Sopko1, Johanna L Hannan1, Trinity J Bivalacqua1
1James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, 1800 Orleans Street/Marburg 134, Baltimore, MD 21287, USA.
Abstract:
Erectile dysfunction (ED) is a common disorder that affects a quarter of US men, and has many causes, including endothelial impairment, low testosterone levels, prior surgical manipulation, and/or psychogenic components. Penile erection is a complex process requiring neurally mediated relaxation of arteriolar smooth muscle and engorgement of cavernosal tissues, mediated by nitric oxide (NO). Current medical therapies for ED largely seek to maximize endogenous NO signalling. Certain aetiologies, including diabetes, are difficult to treat with current modalities, emphasizing the need for new molecular targets. Research has demonstrated the importance of RhoA-Rho-associated protein kinase (ROCK) signalling in maintaining a flaccid penile state, and inhibition of RhoA-ROCK signalling potentiates smooth-muscle relaxation in an NO-independent manner. The mechanisms and effects of RhoA-ROCK signalling and inhibition suggest that the RhoA-ROCK pathway could prove to be a new therapeutic target for the treatment of ED.
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