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Published in: World Journal of Urology 6/2005

01-12-2005 | Topic Paper

Treating erectile dysfunction by endothelial rehabilitation with phosphodiesterase 5 inhibitors

Authors: Frank Sommer, Wolfgang Schulze

Published in: World Journal of Urology | Issue 6/2005

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Abstract

A large body of evidence has accumulated demonstrating that a common pathway in conditions such as hypertension, atherosclerosis, hypercholesterolemia, diabetes mellitus, and erectile dysfunction (ED) is endothelial dysfunction. Although a complete pharmacological cure for ED is currently unavailable, the phosphodiesterase 5 (PDE5) inhibitors sildenafil, vardenafil, and tadalafil are efficacious oral therapy for ED. Results from recent studies suggest that regular treatment with a PDE5 inhibitor may lead to enhanced erectile function (EF) beyond that observed with on-demand usage, possibly through improvement of endothelial function. Such an effect may be viewed as rehabilitation of damaged erectile tissue. The present review focuses on several recent studies which provide evidence for the beneficial effect of regular PDE5 inhibitor administration on the improvement of EF by rehabilitation of vascular endothelium.
Literature
1.
go back to reference Verma S, Buchanan MR, Anderson TJ (2003) Endothelial function as a biomarker of vascular disease. Circulation 108:2054–2059CrossRefPubMed Verma S, Buchanan MR, Anderson TJ (2003) Endothelial function as a biomarker of vascular disease. Circulation 108:2054–2059CrossRefPubMed
2.
go back to reference Kloner RA, Speakman M (2002) Erectile dysfunction and atherosclerosis. Curr Atheroscler Rep 4:397–401PubMedCrossRef Kloner RA, Speakman M (2002) Erectile dysfunction and atherosclerosis. Curr Atheroscler Rep 4:397–401PubMedCrossRef
3.
go back to reference Soloman H, Man JW, Jackson G (2003) Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 89:251–254CrossRefPubMed Soloman H, Man JW, Jackson G (2003) Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 89:251–254CrossRefPubMed
4.
go back to reference Rosen MP, Greenfield AJ, Walker TG, et al (1991) Cigarette smoking: an independent risk factor for atherosclerosis in the hypogastric-cavernous arterial bed of men with atherogenic impotence. J Urol 145:759–763PubMed Rosen MP, Greenfield AJ, Walker TG, et al (1991) Cigarette smoking: an independent risk factor for atherosclerosis in the hypogastric-cavernous arterial bed of men with atherogenic impotence. J Urol 145:759–763PubMed
5.
go back to reference Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, Mc Kinlay JB (1994) Impotence and its medical and psychological correlates: results of the Massachusetts Male Aging Study. J Urol 151:54–61PubMed Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, Mc Kinlay JB (1994) Impotence and its medical and psychological correlates: results of the Massachusetts Male Aging Study. J Urol 151:54–61PubMed
7.
go back to reference Sullivan ME, Thompson CS, Dashwood MR, Khan MA, Jeremy JY, Morgan RJ, Mikhailidis DP (1999) Nitric oxide and penile erection: is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res 43:658–665CrossRefPubMed Sullivan ME, Thompson CS, Dashwood MR, Khan MA, Jeremy JY, Morgan RJ, Mikhailidis DP (1999) Nitric oxide and penile erection: is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res 43:658–665CrossRefPubMed
8.
go back to reference Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M, Engelmann U (2000) Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’. Int J Impot Res 12(6):305–311CrossRefPubMed Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M, Engelmann U (2000) Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’. Int J Impot Res 12(6):305–311CrossRefPubMed
9.
go back to reference Jardin A, Wagner G, Khoury S et al (1999) Recommendations of the 1st International Consultation on Erectile Dysfunction. Co-sponsored by the World Health Organization (WHO), International Consultation on Urological Diseases (ICUD) and Societe Internationale d’Urologie (SIU) and held July 1–3, 1999, Paris, 2000, p 713 Jardin A, Wagner G, Khoury S et al (1999) Recommendations of the 1st International Consultation on Erectile Dysfunction. Co-sponsored by the World Health Organization (WHO), International Consultation on Urological Diseases (ICUD) and Societe Internationale d’Urologie (SIU) and held July 1–3, 1999, Paris, 2000, p 713
10.
go back to reference Aytac IA, McKinlay JB, Krane RJ (1999) The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 84:50–56CrossRefPubMed Aytac IA, McKinlay JB, Krane RJ (1999) The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 84:50–56CrossRefPubMed
11.
go back to reference Montorsi F, Briganti A, Salonia A, et al (2003) Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 44:360–365CrossRefPubMed Montorsi F, Briganti A, Salonia A, et al (2003) Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 44:360–365CrossRefPubMed
12.
go back to reference Saenz de Tejada I, Gonzales Cadavid N, Heaton JP, et al (2000) Anatomy, physiology and pathophysiology of erectile dysfunction. In: Jardin A, Wagner G, Khoury S, Giuliano F, Padma-Nathan H, Rosen RC (eds) Erectile dysfunction. Health Publications Ltd., Plymouth, pp 65–102 Saenz de Tejada I, Gonzales Cadavid N, Heaton JP, et al (2000) Anatomy, physiology and pathophysiology of erectile dysfunction. In: Jardin A, Wagner G, Khoury S, Giuliano F, Padma-Nathan H, Rosen RC (eds) Erectile dysfunction. Health Publications Ltd., Plymouth, pp 65–102
13.
go back to reference Terradas C, Levalle O, Nagelberg A, Mormandi E (2001) Sildenafil improves nocturnal penile erections in organic impotence. Int J Impot Res 13(2):125–129CrossRefPubMed Terradas C, Levalle O, Nagelberg A, Mormandi E (2001) Sildenafil improves nocturnal penile erections in organic impotence. Int J Impot Res 13(2):125–129CrossRefPubMed
14.
go back to reference Ballard SA, Gingell CJ, Tang K, Turner LA, Price ME, Naylor AM (1998) Effects of sildenafil on the relaxation of human corpus cavernosum tissue in vitro and on the activities of cyclic nucleotide phosphodiesterase isozymes. J Urol 159:2164–2171CrossRefPubMed Ballard SA, Gingell CJ, Tang K, Turner LA, Price ME, Naylor AM (1998) Effects of sildenafil on the relaxation of human corpus cavernosum tissue in vitro and on the activities of cyclic nucleotide phosphodiesterase isozymes. J Urol 159:2164–2171CrossRefPubMed
15.
go back to reference Hellstrom WJ, Gittelman M, Karlin G, Segerson T, Thibonnier M, Taylor T, Padma-Nathan H, Vardenafil Study Group (2003) Sustained efficacy and tolerability of vardenafil, a highly potent selective phosphodiesterase type 5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial. Urology 61(4 Suppl. 1):8–14CrossRefPubMed Hellstrom WJ, Gittelman M, Karlin G, Segerson T, Thibonnier M, Taylor T, Padma-Nathan H, Vardenafil Study Group (2003) Sustained efficacy and tolerability of vardenafil, a highly potent selective phosphodiesterase type 5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial. Urology 61(4 Suppl. 1):8–14CrossRefPubMed
16.
go back to reference Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker WA, et al (1998) Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med 338:1397–1404CrossRefPubMed Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker WA, et al (1998) Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med 338:1397–1404CrossRefPubMed
17.
go back to reference Brock GB, McMahon CG, Chen KK, Costigan T, Shen W, Watkins V, Anglin G, Whitaker S (2002) Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol 168(4 Pt 1):1332–1336CrossRefPubMed Brock GB, McMahon CG, Chen KK, Costigan T, Shen W, Watkins V, Anglin G, Whitaker S (2002) Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol 168(4 Pt 1):1332–1336CrossRefPubMed
18.
go back to reference Desouza C, Parulkar A, Lumpkin D, Akers D, Fonseca VA (2002) Acute and prolonged effects of sildenafil on brachial artery flow-mediated dilatation in type 2 diabetes. Diabetes Care 25(8):1336–1339PubMedCrossRef Desouza C, Parulkar A, Lumpkin D, Akers D, Fonseca VA (2002) Acute and prolonged effects of sildenafil on brachial artery flow-mediated dilatation in type 2 diabetes. Diabetes Care 25(8):1336–1339PubMedCrossRef
19.
go back to reference Montorsi F, Maga T, Strambi LF, et al (2000) Sildenafil taken at bedtime significantly increases nocturnal erections: results of a placebo-controlled study. Urology 56(6):906–911CrossRefPubMed Montorsi F, Maga T, Strambi LF, et al (2000) Sildenafil taken at bedtime significantly increases nocturnal erections: results of a placebo-controlled study. Urology 56(6):906–911CrossRefPubMed
20.
go back to reference Rochira V, Granata AR, Balestrieri A, Madeo B, Carani C (2002) Effects of sildenafil on nocturnal penile tumescence and rigidity in normal men: randomized, placebo-controlled, crossover study. J Androl 23(4):566–571PubMed Rochira V, Granata AR, Balestrieri A, Madeo B, Carani C (2002) Effects of sildenafil on nocturnal penile tumescence and rigidity in normal men: randomized, placebo-controlled, crossover study. J Androl 23(4):566–571PubMed
21.
go back to reference El Galley R, Rutland H, Talic R, Keane T, Clark H (2001) Long-term efficacy of sildenafil and tachyphylaxis effect. J Urol 166:927–931CrossRefPubMed El Galley R, Rutland H, Talic R, Keane T, Clark H (2001) Long-term efficacy of sildenafil and tachyphylaxis effect. J Urol 166:927–931CrossRefPubMed
22.
go back to reference Behr-Roussel D, Gorny D, Mevel K, Caisey S, Bernabé J, Burgess G, Wayman C, Alexandre L, Giuliano F (2005) Chronic sildenafil improves erectile function and endothelium-dependent cavernosal relaxations in rats: lack of tachyphylaxis. Eur Urol 47:87–91CrossRefPubMed Behr-Roussel D, Gorny D, Mevel K, Caisey S, Bernabé J, Burgess G, Wayman C, Alexandre L, Giuliano F (2005) Chronic sildenafil improves erectile function and endothelium-dependent cavernosal relaxations in rats: lack of tachyphylaxis. Eur Urol 47:87–91CrossRefPubMed
23.
go back to reference Rosano GMC, Aversa A, Vitale C, Fabbri A, Fini M, Spera G (2005) Chronic treatment with tadalafil improves endothelial function in men with increased cardiovascular risk. Eur Urol 47:214–222CrossRefPubMed Rosano GMC, Aversa A, Vitale C, Fabbri A, Fini M, Spera G (2005) Chronic treatment with tadalafil improves endothelial function in men with increased cardiovascular risk. Eur Urol 47:214–222CrossRefPubMed
24.
go back to reference Caretta N, Palego P, Ferlin A, Garolla A, Bettella A, Selice R, Foresta C (2005) Resumption of spontaneous erections in selected patients affected by erectile dysfunction and various degrees of carotid wall alteration: role of tadalafil. Eur Urol 48:326–332CrossRefPubMed Caretta N, Palego P, Ferlin A, Garolla A, Bettella A, Selice R, Foresta C (2005) Resumption of spontaneous erections in selected patients affected by erectile dysfunction and various degrees of carotid wall alteration: role of tadalafil. Eur Urol 48:326–332CrossRefPubMed
25.
go back to reference Porst H. Salvagetherapie mit täglicher Dosierung von Sildenafil bei Non-Respondern auf on demand Therapie mit 100 mg Sildenafil. Presented at the 55th Congress of the German Urological Association, Hamburg, Germany, 24–27 September 2003 Porst H. Salvagetherapie mit täglicher Dosierung von Sildenafil bei Non-Respondern auf on demand Therapie mit 100 mg Sildenafil. Presented at the 55th Congress of the German Urological Association, Hamburg, Germany, 24–27 September 2003
26.
go back to reference Porst H, van Ahlen H (1988) Stellenwert nächtlicher peniler Tumeszenz- und Rigiditätsmessungen (NPT) mit dem Rigiscan® bei erektiler Dysfunktion. Aktuel Urol 19:21–25CrossRef Porst H, van Ahlen H (1988) Stellenwert nächtlicher peniler Tumeszenz- und Rigiditätsmessungen (NPT) mit dem Rigiscan® bei erektiler Dysfunktion. Aktuel Urol 19:21–25CrossRef
27.
go back to reference Kim N, Vardi Y, Padma-Nathan H, Daley J, Goldstein I, Saenz de Tejada I (1993) Oxygen tension regulates the nitric oxide pathway. Physiological role in penile erection. J Clin Invest 91(2):437–442PubMed Kim N, Vardi Y, Padma-Nathan H, Daley J, Goldstein I, Saenz de Tejada I (1993) Oxygen tension regulates the nitric oxide pathway. Physiological role in penile erection. J Clin Invest 91(2):437–442PubMed
28.
go back to reference Foresta C, Caretta N, Lana A, Cabrelle A, Palu G, Ferlin A (2005) PDE-5 inhibitor, vardenafil, increases circulating progenitor cells in humans. Int J Impot Res 17(4):377–380CrossRefPubMed Foresta C, Caretta N, Lana A, Cabrelle A, Palu G, Ferlin A (2005) PDE-5 inhibitor, vardenafil, increases circulating progenitor cells in humans. Int J Impot Res 17(4):377–380CrossRefPubMed
29.
go back to reference Aicher A, Heeschen C, Dimmeler S (2004) The role of NOS3 in stem cell mobilization. Trends Mol Med 10:421–425CrossRefPubMed Aicher A, Heeschen C, Dimmeler S (2004) The role of NOS3 in stem cell mobilization. Trends Mol Med 10:421–425CrossRefPubMed
30.
go back to reference Foresta C, Caretta N, Lana A, Cabrelle A, Palu G, Ferlin A (2005) Circulating progenitor cells in subjects with erectile dysfunction. Int J Impot Res 17(3):288–290CrossRefPubMed Foresta C, Caretta N, Lana A, Cabrelle A, Palu G, Ferlin A (2005) Circulating progenitor cells in subjects with erectile dysfunction. Int J Impot Res 17(3):288–290CrossRefPubMed
31.
go back to reference Ornish D, Brown SE, Scherwitz LW, et al (1990) Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. Lancet 336(8708):129–133CrossRefPubMed Ornish D, Brown SE, Scherwitz LW, et al (1990) Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. Lancet 336(8708):129–133CrossRefPubMed
Metadata
Title
Treating erectile dysfunction by endothelial rehabilitation with phosphodiesterase 5 inhibitors
Authors
Frank Sommer
Wolfgang Schulze
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 6/2005
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-005-0021-7

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