Kedia George T, Ückert Stefan, Tsikas Dimitrios, Becker Armin J, Kuczyk Markus A, Bannowsky Andreas
Department of Urology & Urological Oncology, Division of Surgery, Hannover Medical School, 30625 Hannover, Germany.
Department of Urology, DIAKOVERE GmbH, Friederikenstft Lutheran Hospital, 30171 Hannover, Germany.
J Clin Med. 2020 Sep 16;9(9):2987. doi: 10.3390/jcm9092987.
It is widely accepted that disorders of the male (uro)genital tract, such as erectile dysfunction (ED) and benign diseases of the prostate (lower urinary tract symptomatology or benign prostatic hyperplasia), can be approached therapeutically by influencing the function of both the vascular and non-vascular smooth muscle of the penile erectile tissue or the transition zone/periurethral region of the prostate, respectively. As a result of the discovery of nitric oxide (NO) and cyclic guanosine monophosphate (GMP) as central mediators of penile smooth muscle relaxation, the use of drugs known to increase the local production of NO and/or elevate the intracellular level of the second messenger cyclic GMP have attracted broad attention in the treatment of ED of various etiologies. Specifically, the introduction of vasoactive drugs, including orally active inhibitors of the cyclic GMP-specific phosphodiesterase (PDE) 5, has offered great advantage in the pharmacotherapy of ED and other diseases of the genitourinary tract. These drugs have been proven efficacious with a fast on-set of action and an improved profile of side-effects. This review summarizes current strategies for the treatment of ED utilizing the application of vasoactive drugs via the oral, transurethral, topical, or self-injection route.
人们普遍认为，男性（泌尿）生殖道疾病，如勃起功能障碍（ED）和前列腺良性疾病（下尿路症状或良性前列腺增生），可分别通过影响阴茎勃起组织的血管和非血管平滑肌功能或前列腺的移行区/尿道周围区域的功能来进行治疗。由于一氧化氮（NO）和环磷酸鸟苷（cGMP）被发现是阴茎平滑肌舒张的核心介质，使用已知能增加局部NO生成和/或提高第二信使环磷酸鸟苷细胞内水平的药物在治疗各种病因的ED方面引起了广泛关注。具体而言，血管活性药物的引入，包括口服活性的环磷酸鸟苷特异性磷酸二酯酶（PDE）5抑制剂，在ED和其他泌尿生殖道疾病的药物治疗中具有很大优势。这些药物已被证明有效，起效快且副作用改善。本综述总结了通过口服、经尿道、局部或自我注射途径应用血管活性药物治疗ED的当前策略。
