University Hospital of North Tees, Hardwick Road, Stockton-on-Tees, Cleveland TS19 8PE, UK.
Nat Rev Urol. 2010 Nov;7(11):603-9. doi: 10.1038/nrurol.2010.165.
The management of erectile dysfunction (ED) has been revolutionized by the discovery of phosphodiesterase 5 (PDE5) inhibitors, which have been commercially available for more than a decade and are the first-line therapeutic option for men with ED. Sildenafil, vardenafil and tadalafil were approved by the European Medicine Agency and the US FDA for the treatment of ED on the back of their high efficacy rates and favorable safety profiles. However, despite the fact that more than 50 million patients with ED worldwide have been successfully treated with one of these PDE5 inhibitors, some men--most notably those with severe neurologic damage, diabetes mellitus or severe vascular disease--are resistant to the currently available drugs and require more-invasive treatments, such as intracavernosal injection therapy. Partly as a consequence of this, research into alternative therapeutic approaches continues, including the development of new PDE5 inhibitors, centrally acting pharmaceutical agents, and application of molecular technologies such as gene therapy and stem cell therapy.
勃起功能障碍 (ED) 的管理已经被磷酸二酯酶 5 (PDE5) 抑制剂的发现所彻底改变，这些抑制剂已经商业化十多年，是 ED 患者的一线治疗选择。西地那非、伐地那非和他达拉非因其高疗效率和有利的安全性而被欧洲药品管理局和美国食品和药物管理局批准用于治疗 ED。然而，尽管全球有超过 5000 万 ED 患者成功地接受了这些 PDE5 抑制剂中的一种治疗，但一些男性——尤其是那些有严重神经损伤、糖尿病或严重血管疾病的男性——对现有药物有抗药性，需要更具侵入性的治疗，如阴茎海绵体内注射治疗。部分由于这个原因，对替代治疗方法的研究仍在继续，包括开发新的 PDE5 抑制剂、中枢作用药物以及应用基因治疗和干细胞治疗等分子技术。
