Aversa Antonio, Bruzziches Roberto, Vitale Cristiana, Marazzi Giuseppe, Francomano Davide, Barbaro Giuseppe, Spera Giovanni, Rosano Giuseppe M C
University of Rome La Sapienza, Dept of Medical Pathophysiology, Viale Policlinico 155 - 00161 Rome, Italy.
Expert Opin Drug Metab Toxicol. 2007 Jun;3(3):451-64. doi: 10.1517/17425255.3.3.451.
Erectile dysfunction frequently represents a neurovascular complication of diabetes mellitus, and it has been calculated that almost 50% of diabetic men will have erectile dysfunction within 6 years after diagnosis. Penile endothelial and smooth muscle cell dysfunction are due to molecular pathway abnormalities (i.e., activation of PKC, increased oxidative stress and overproduction of advanced-glycosylation end products). The response rate to oral drug therapies, such as sildenafil, is lower than in most other groups. Because therapeutic alternatives (i.e., intracavernous injections with vasoactive agents) are not curative, clinical trials aimed to demonstrate rehabilitative effects with daily phosphodiesterase type-5 inhibitors are ongoing. If this approach proves successful, it will determine many advantages over the intracavernosal treatment and potentially induce sexual rehabilitation.
