Pathophysiology of erectile dysfunction

International Journal of Andrology

Volumn 26, Issue 3, 2003, Pages 129-136

  Salonia, Andrea ^a   Briganti, Alberto ^a   Dehò, Federico ^a   Naspro, Richard ^a   Scapaticci, Emanuele ^a   Scattoni, Vincenzo ^a   Rigatti, Patrizio ^a   Montorsi, Francesco ^a  

^a VITA SALUTE SAN RAFFAELE UNIVERSITY   (Italy)

Author keywords

Erectile dysfunction; Pathophysiology

Indexed keywords

ANDROGEN; ANTIHYPERTENSIVE AGENT; CARDIAC AGENT; ORAL ANTIDIABETIC AGENT; VASODILATOR AGENT;

AGING; CARDIOVASCULAR DISEASE; CIGARETTE SMOKING; CONFERENCE PAPER; DISEASE CLASSIFICATION; ERECTILE DYSFUNCTION; HEMODYNAMICS; HUMAN; HYPERTENSION; HYPOGONADISM; MALE; NONHUMAN; PATHOGENESIS; PATHOPHYSIOLOGY; PENIS ERECTION; PRIORITY JOURNAL; RISK FACTOR; SEXUAL FUNCTION; VEIN OCCLUSION;

ANDROGENS; CARDIOVASCULAR DISEASES; HUMANS; IMPOTENCE; IMPOTENCE, VASCULOGENIC; MALE; RISK FACTORS; SMOKING;

EID: 0038509019     PISSN: 01056263     EISSN: None     Source Type: Journal    
DOI: 10.1046/j.1365-2605.2003.00342.x     Document Type: Conference Paper

References (100)

1. Ahn, A. S., Park, C. M. & Lee, S. W. (2000) The clinical relevance of sex hormone levels and sexual activity in the ageing male. BJU International 89, 526-530.
2. Andersson, K. E. (2001a) Neurophysiology/pharmacology of erection. International Journal of Impotence Research 13 (Suppl. 3), S8-S17.
3. Andersson, K. E. (2001b) Pharmacology of erectile function and dysfunction. Urologic Clinics of North America 28, 233-247.
4. Andersson, K. E. & Wagner, G. (1995) Physiology of penile erection. Physiological Reviews 75, 191-236.
5. Aversa, A., Isidori, A. M., De Martino, M. U., Caprio, M., Fabbrini, E., Rocchietti-March, M., Frajese, G. & Fabbri, A. (2000) Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clinical Endocrinology (Oxf) 53, 517-522.
6. Azadzoi, K. M. & Saenz de Tejada, I. (1991) Hypercholesterolemia impairs endothelium-dependent relaxation of rabbit corpus cavernosum smooth muscle. Journal of Urology 146, 238-240.
7. Azadzoi, K. M. & Goldstein, I. (1992) Erectile dysfunction due to atherosclerotic vascular disease: the development of an animal model. Journal of Urology 147, 1675-1681.
8. Azadzoi, K. M., Siroky, M. B. & Goldstein, I. (1996) Study of etiologic relationship of arterial atherosclerosis to corporal venoocclusive dysfunction in the rabbit. Journal of Urology 155, 1795-1800.
9. Azadzoi, K. M., Goldstein, I. & Siroky, M. B. (1997) Relationship between cavernosal ischemia and corporal veno-occlusive dysfunction in an animal model. Journal of Urology 157, 1011-1017.
10. Baskin, L. S., Sutherland, R. S., Di Sandro, M.J., Hayward, S. W., Lipshultz, J. & Cunha, G. R. (1997) The effect of testosterone on androgen receptors and human penile growth. Journal of Urology 158, 1113-1118.
11. Benet, A. E. & Melman, A. (1995) The epidemiology of erectile dysfunction. Urologic Clinics of North America 22, 699-709.
12. Bernardo, A. (2001) Sexuality in patients with coronary disease and heart failure. Herz 26, 353-359.
13. Bierman, B. L. (1991) Atherosclerosis and other forms of arteriosclerosis. In: Harrison's Principles of Internal Medicine, Vol. I. 12th edn, Chapter 195, (eds J. D. Wilson, E. Braunwald & K. J. Isselbacher), pp. 992-1001. McGraw-Hill, New York.
14. Border, W. A. & Noble, N. A. (1994) Transforming growth factor beta in tissue fibrosis. New England Journal of Medicine 331, 1286-1292.
15. Brown, S. L., Seftel, A. D., Strohl, K. P. & Herbener, T. E. (2000) Vasculogenic impotence and cavernosal oxygen tension. International Journal of Impotence Research 12, 19-22.
16. Burchardt, M., Burchardt, T., Anastasiadis, A. G., Kiss, A. J., Shabsigh, A., de La Taille, A., Pawar, R. V., Baer, L. & Shabsigh, R. (2001) Erectile dysfunction is a marker for cardiovascular complications and psychological functioning in men with hypertension. International Journal of Impotence Research 13, 276-281.
17. Burris, A. S., Banks, S. M., Carter, C. S., Davidson, J. M. & Sherins, R. J. (1992) A long-term prospective study of the physiologic and behavioural effects of hormone replacement in untreated hypogonadal men. Journal of Andrology 13, 297-304.
18. Bush, H. S. (2001) Safe use of sildenafil in patients with coronary artery disease. Cleveland Clinic Journal of Medicine 68, 349-352.
19. Cappelleri, J. C., Rosen, R. C., Smith, M. D., Mishra, A. & Osterloh, I. H. (1999) Diagnostic evaluation of the erectile function domain of the international index of erectile function. Urology 54, 346-351.
20. Chung, W. S., Sohn, J. H. & Park, Y. Y. (1999) Is obesity an underlying factor in erectile dysfunction? European Urology 36, 68-70.
21. Crook, D. (1999) Androgen therapy in the aging male: assessing the effect on heart disease. Aging Male 2, 151-156.
22. Davies, M. J. (1991) Hypertension and atherosclerotic (ischemic) heart disease. Journal of Human Hypertension 5 (Suppl. 1), 23-29.
23. Dhabuwala, C. B., Kumar, A. & Pierce, J. M. (1986) Myocardial infarction and its influence on male sexual function. Archives of Sexual Behavior 15, 499-504.
24. Diokno, A. C., Brown, M. B., Goldstein, N. G. & Herzog, A. R. (1994) Urinary flow rates and voiding pressures in elderly men living in a community. Journal of Urology 151, 1550-1553.
25. Diokno, A. C., Brown, M. B. & Herzog, R. (1990) Sexual function in the elderly. Archives of Internal Medicine 150, 197-200.
26. Egashira, K., Inou, T. & Hirooka, Y. (1993a) Effects of age on endothelium dependent vasodilation of resistance coronary artery by acetylcholine in humans. Circulation 88, 77-81.
27. Egashira, K., Inou, T. & Hirroka, Y. (1993b) Impaired coronary blood flow response to acetylcholine in patients with coronary risk factors and proximal atherosclerotic lesions. Journal of Clinical Investigation 91, 29-37.
28. Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. T. & McKinlay, J. B. (1994) Impotence and its medical and psychosocial correlates: results of the Massachussets male aging study. Journal of Urology 151, 54-61.
29. Feldman, H. A., Longcope, C., Derby, C. A., Johannes, C. B., Araujo, A. B., Coviello, A. D., Bremner, W. J. & McKinlay, J. B. (2002) Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging study. Journal of Clinical Endocrinology and Metabolism 87, 589-598.
30. Ferrini, R. L. & Barrett-Connor, E. (1998) Sex hormones and age: a cross-sectional study of testosterone and estradiol and their bioavailable fractions in community dwelling men. American Journal of Epidemiology 147, 750-754.
31. Fogari, R. & Zoppi, A. (2002) Effects of antihypertensive therapy on sexual activity in hypertensive men. Current Hypertension Reports 4, 202-210.
32. Frank, E., Anderson, C. & Rubinstein, D. (1978) Frequency of sexual dysfunction in 'normal' couples. New England Journal of Medicine 299, 111-115.
33. Friedman, S. (2000) Cardiac disease, anxiety, and sexual functioning. American Journal of Cardiology 86, 46F-50F.
34. Geokas, M. C., Conteas, C. N. & Majumdar, A. P. (1985) The aging gastrointestinal tract, liver and pancreas. Clinics in Geriatric Medicine 1, 177-205.
35. Greenstein, A., Chen, J., Miller, H., Matzkin, H., Villa, Y. & Braf, Z. (1997) Does severity of ischemic coronary disease correlate with erectile function? International Journal of Impotence Research 9, 123-126.
36. Heaton, J. P. (2000) Central neuropharmacological agents and mechanisms in erectile dysfunction: the role of dopamine. Neuroscience and Biobehavioral Reviews 24, 507-516.
37. Hooi, J. D., Stoffers, H. E., Knottnerus, J. A., Rinkens, P. E. & van Ree, J. W. (2001) Asymptomatic peripheral arterial occlusive disease and erection problems. British Journal of General Practice 51, 404.
38. Hsieh, J. T., Muller, S. C. & Lue, T. F. (1989) The influence of blood flow and blood pressure on penile erection. International Journal of Impotence Research 1, 35-42.
39. Johnstone, M. T., Creager, S.J., Scales, K. M., Cusco, J. A., Lee, B. K. & Creager, M. A. (1993) Impaired endothelium-dependent vasodilation in patients with insulin dependent diabetes mellitus. Circulation 88, 2510-2516.
40. Karacan, I., Williams, R., Thornby, J. & Salis, P.J. (1975) Sleep-related penile tumescence as a function of age. American Journal of Psychiatry 132, 932-937.
41. Kawanishi, Y., Lee, K. S., Kimura, K., Koizumi, T., Nakatsuji, H., Kojima, K., Yamamoto, A., Numata, A. & Sogou, T. (2001) Screening of ischemic heart disease with cavernous artery blood flow in erectile dysfunctional patients. International Journal of Impotence Research 13, 100-103.
42. Keil, J. E., Sutherland, S. E., Knapp, R. G., Waid, L. R. & Gazes, P. C. (1992) Self reported sexual functioning in elderly blacks and whites: the Charleston heart study experience. Journal of Aging and Health 4, 112-116.
43. Kim, S. W., Paick, J., Park, D. W., Chae, I. & Oh, B. (2001) Potential predictors of asymptomatic ischemic heart disease in patients with vasculogenic erectile dysfunction. Urology 58, 441-445.
44. Kinsey, A. C., Pomeroy, W. B. & Martin, C. E. (1948) Age and sexual outlet. In: Sexual Behaviour in the Human Male (eds A. C. Kinsey, W. B. Pomeroy, & C. E. Martin), pp. 218-262. W.B. Saunders Co., Philadelphia.
45. Kloner, R. A. (2000) Sex and the patient with cardiovascular risk factors: focus on sildenafil. American Journal of Medicine 109 (Suppl. 9A), 13S-21S.
46. Krane, R. J., Goldstein, I. & Saenz de Tejada, I. (1989) Impotence. The New England Journal of Medicine 321, 1648-1659.
47. Lugg, J. A., Rajfer, J. & Gonzalez-Cadavid, N. F. (1995) Dihydrotestosterone is the active androgen in the maintenance of nitric oxide-mediated penile erection in the rat. Endocrinology 136, 1495-1501.
48. Lundberg, P. O. & Biriell, C. (1993) Sexual dysfunction as a suspected drug reaction reported to WHO Collaborating Centre for International Drug Monitoring. Therapie 48, 457-459.
49. Mahmud, A., Hennessy, M. & Feely, J. (2001) Effect of sildenafil on blood pressure and arterial wave reflection in treated hypertensive men. Journal of Human Hypertension 15, 707-713.
50. Mannino, D. M., Klevens, R. M. & Flandres, W. D. (1994) Cigarette smoking: an independent risk factor for impotence? American Journal of Epidemiology 140, 1003-1008.
51. Marwick, T. H. (2002) Safe sex for men with coronary artery disease: exercise, sildenafil, and risk of cardiac events. JAMA: the Journal of the American Medical Association 287, 766-767.
52. McVary, K. T., Carrier, S. & Wessells, H. (2001) Subcommittee on Smoking and Erectile Dysfunction Socioeconomic Committee, Sexual Medicine Society of North America. Smoking and erectile dysfunction: evidence based analysis. Journal of Urology 166, 1624-1632.
53. Meinhardt, W., Kripman, R. F., Vermeiji, P., Nijeholt, A. A. & Zwartendijk, J. (1997) The influence of medication on erectile dysfunction. International Journal of Impotence Research 9, 17-26.
54. Melman, A. & Gingell, J. C. (1999) The epidemiology and pathophysiology of erectile function. Journal of Urology 161, 5-11.
55. Mills, T. M., Reilly, C. M. & Lewis, R. W. (1996) Androgens and penile erection: a review. Journal of Andrology 17, 633-638.
56. Montorsi, F., Salonia, A., Montorsi, P., Margonato, A., Macchi, A., Buzzetti, F. et al. (2002) May erectile dysfunction predict ischemic heart disease? Journal of Urology 167 (Suppl.), A591.
57. Morales, A. & Heaton, J. P. W. (2001) Hormonal erectile dysfunction. Urologic Clinics of North America 28, 279-288.
58. Morales, A., Heaton, J. P. W., Johnston, B. & Adams, M. (1995) Oral and topical treatment of erectile dysfunction: present and future. Urologic Clinics of North America 22, 879-886.
59. Morales, A., Johnston, B., Heaton, J. P. W. & Lundie, M. (1997) Testosterone supplementation for hypogonadal impotence: assessment of biochemical measurements and therapeutic outcomes. Journal of Urology 157, 849-854.
60. Moreland, R. B. (1998) Is there a role of hypoxemia in penile fibrosis: a viewpoint presented to the Society for the Study of Impotence. International Journal of Impotence Research 10, 113-120.
61. Moreland, R. B., Traish, A. M., McMillin, M. A., Smith, B., Goldstein, I. & Saenz de Tejada, I. (1995) PGE1 suppresses the induction of collagen synthesis by TGF-beta 1 in human corpus cavernosum smooth muscle. Journal of Urology 153, 826-834.
62. Moreland, R. B., Huang, Y. H., Munarriz, R., Nehra, A., Goldstein, I. & Saenz de Tejada, I. (1995) Oxygen tension regulates the expression of transforming growth factor β1 in human corpus cavernosum smooth muscle. Journal of Urology 153, A1121.
63. Morisaki, N., Kawano, M. & Koyama, N. (1991) Effects of TGF-beta1 on growth of aortic smooth muscle cells. Influences on interaction with growth factors, cell state, cell phenotype and cell cycle. Atherosclerosis 88, 227-234.
64. Morley, J. E. (1986) Impotence. American Journal of Medicine 80, 897-905.
65. Morley, J. E., Kaiser, F., Raum, W. J., Perry, H. M. III, Flood, J. F., Jensen, J., Silver, A. J. & Roberts, E. (1997) Potentially predictive and manipulable blood serum correlates of aging in the healthy human male: progressive decreases in bioavailable testosterone, dehydroepiandrosterone sulfate, and the ratio of insulin-like growth factor 1 to growth hormone. Proceedings of the National Academy of Sciences of the United States of America 94, 7537-7542.
66. Mulligan, T. & Katz, P. G. (1989) Why aged men become impotent. Archives of Internal Medicine 149, 1365-1366.
67. Mulligan, T., Retchin, S. M., Chinchilli, V. M. & Bettinger, C. B. (1988) The role of aging and chronic disease in sexual dysfunction. Journal of the American Geriatric Society 36, 520-524.
68. Nehra, A., Goldstein, I., Pabby, A., Nugent, M., Huang, Y., de las Morenas, A., Krane, R. J., Udelson, D., Saenz de Tejada, I. & Moreland, R. B. (1996) Mechanisms of venous leakage: a prospective clinicopathological correlation of corporeal function and structure. Journal of Urology 156, 1320-1329.
69. Nehra, A., Azadzoi, K. M., Hall, S. J., Moreland, R. B., Pabby, A., Siroky, M. B., Krane, R. J., Goldstein, I. & Udelson, D. (1998) Cavernosal expandability is an erectile tissue mechanical property which predicts trabecular histology in an animal model of vasculogenic erectile dysfunction. Journal of Urology 159, 2229-2236.
70. Nehra, A., Barret, D. M. & Moreland, R. B. (1999) Pharmacotherapeutic advances in the treatment of erectile dysfunction. Mayo Clinic Proceedings 74, 709-722.
71. Nieschlag, E. & Behere, H. M. (1998) Pharmacological and clinical uses of testosterone. In: Testosterone: Action, Deficiency, Substitution, (eds A. Nieschlar & H. M. Behere), pp. 294-321. Springer-Verlag, Berlin.
72. Pagani, M. (2000) Hypertension, stress and erectile dysfunction: potential insights from the analysis of heart rate variability. Current Medical Research and Opinion 16 (Suppl. 1), s3-s8.
73. Parazzini, F., Menchini, F. F., Bortolotti, A., Calabrò, A., Chatenoud, L., Colli, E. et al. (2000) Frequency and determinants of erectile dysfunction in Italy. European Urology 37, 43-49.
74. Pearlman, C. K. & Kobashi, L. I. (1990) Frequency of intercourse in men. Journal of Urology 107, 298-301.
75. Pfeiffer, E. & Davis, G. C. (1972) Determinants of sexual behaviour in middle and old age. Journal of the American Geriatric Society 20, 151-158.
76. Reilly, C. M., Zamorano, P., Stopper, V. S. & Mills, T. M. (1997) Androgenic regulation of NO availability in rat penile erection. Journal of Andrology 18, 110-115.
77. Rose, G. (1991) ABC of vascular diseases. Epidemiology of atherosclerosis. British Medical Journal 303, 1537-1539.
78. Rossi, A., Ganassini, A., Tantucci, C. & Grassi, V. (1996) Aging and the respiratory system. Aging 8, 143-161.
79. Saenz de Tejada, I., Goldstein, I., Azadzoi, K., Krane, R. J. & Cohen, R. A. (1989) Impaired neurogenic and endothelium-mediated relaxation of penile smooth muscle from diabetic men with impotence. New England Journal of Medidne 320, 1025-1030.
80. Saenz de Tejada, I., Moroukian, P., Tessier, J., Kim, J. J., Goldstein, I. & Frohrib, D. (1991) Trabecular smooth muscle modulates the capacitor function of the penis. Studies on a rabbit model. American Journal of Physiology 260, H1590-H1595.
81. Schiavi, R. C., Schreiner-Engel, P., Mandeli, J., Schanzer, H. & Cohen, E. (1990) Healthy aging and male sexual function. American Journal of Psychiatry 147, 766-771.
82. Schirar, A., Bonnefond, C., Meusnier, C. & Devinoy, E. (1997) Androgens modulate nitric oxide synthase messenger ribonucleic acid expression in neurons of the major pelvic ganglion in the rat. Endocrinology 138, 3093-3102.
83. Shabsigh, R. (1997) The effects of testosterone on the cavernous tissue and erection. World Journal of Urology 15, 21-26.
84. Sjogren, K. & Fugl-Meyer, A. R. (1983) Some factors influencing quality of sexual life after myocardial infarction. International Rehabilitation Medicine 5, 197-201.
85. Stief, C. G. (2002) Is there a common pathophysiology of erectile dysfunction and how does this relate to new pharmacotherapies? International Journal of Impotene Research 14 (Suppl. 1), S11-S16.
86. Sullivan, M. E., Miller, M. A., Bell, C. R., Jagroop, I. A., Thompson, C. S., Khan, M. A., Morgan, R. J. & Mikhailidis, D. P. (2001a) Fibrinogen, lipoprotein (a) and lipids in patients with erectile dysfunction. A preliminary study. International Angiology 20, 195-199.
87. Sullivan, M. E., Keoghane, S. R. & Miller, M. A. (2001b) Vascular risk factors and erectile dysfunction. BJU International 87, 838-845.
88. Tarcan, T., Azadzoi, K. M., Siroky, M. B., Goldstein, I. & Krane, R. J. (1998a) Age-related erectile and voiding dysfunction: the role of arterial insufficiency. British Journal of Urology 82 (Suppl. 1), 26-33.
89. Tarcan, T., Siroky, M. B., Krane, R. J., Edelstein, R. A. & Azadzoi, K. M. (1998b) Atherosclerosis-induced chronic ischemia causes bladder fibrosis and non compliance. The role of growth factors. Journal of Urology 159, 135A.
90. Toblli, J. E., Stella, I., Inserra, F., Ferder, L., Zeller, F. & Mazza, O. N. (2000) Morphological changes in cavernous tissue in spontaneously hypertensive rats. American Journal of Hypertension 13, 686-692.
91. Traish, A. T., Park, K., Dhir, V., Kim, N. N., Moreland, R. B. & Goldstein, I. (1999) Effects of castration and androgen replacement on erectile function in a rabbit model. Endocrinology 140, 1861-1868.
92. Udelson, D., Nehra, A., Hatzichristou, D. G., Azadzoi, K., Moreland, R. B., Krane, J., Saenz de Tejada, I. & Goldstein, I. (1998a) Engineering analysis of penile hemodynamic and structural-dynamic relationships. Part I - clinical implications of penile tissue mechanical properties. International Journal of Impotence Research 10, 15-24.
93. Udelson, D., Nehra, A., Hatzichristou, D. G., Azadzoi, K., Moreland, R. B., Krane, J., Saenz de Tejada, I. & Goldstein, I. (1998b) Engineering analysis of penile hemodynamic and structural-dynamic relationships. Part II - clinical implications of penile buckling. International Journal of Impotence Research 10, 25-35.
94. Udelson, D., Nehra, A., Hatzichristou, D. G., Azadzoi, K., Moreland, R. B., Krane, J., Saenz de Tejada, I. & Goldstein, I. (1998c) Engineering analysis of penile hemodynamic and structural-dynamic relationships: Part III - clinical considerations of penile hemodynamic and rigidity erectile responses. International Journal of Impotence Research 10, 89-99.
95. Vermeulen, A. (1991a) Androgens in the aging male. Journal of Clinical Endocrinology and Metabolism 73, 221-224.
96. Vermeulen, A. (1991b) Clinical review 24: androgens in the aging male. Journal of Clinical Endocrinology and Metabolism 73, 221-224.
97. Vermeulen, A. & Verdonck, L. (1972) Some studies on the biological significance of free testosterone. Journal of Steroid Biochemistry 3, 421-426.
98. Wabrek, A. J. & Burchell, R. C. (1980) Male sexual dysfunction associated with coronary artery disease. Archives of Sexual Behavior 9, 69-75.
99. Wespes, E. A. (1990) Is cavernous leakage related to a reduction of intracavernous smooth muscle fibers? International Journal of Impotence Research 2, 30.
100. Wespes, E. A., Goes, P. M., Schiffmann, S., Depierreux, M., Vanderhaeghen, J. J. & Schulman, C. C. (1991) Computerized analysis of smooth muscle fibers in potent and impotent patients. Journal of Urology 146, 1015-1017.