Current & Future Therapies of Erectile Dysfunction in Neurological Disorders
Rocco S. Calabro, Giovanni Polimeni and Placido Bramanti
Affiliation: Neurorehabilitation Unit, IRCCS Centro Neurolesi “Bonino Pulejo”, via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy.
Erection is a neurovascular event characterized by the tumescence of the cavernous bodies that relies upon integration of neural and humoral mechanisms requiring the participation of autonomic and somatic nerves and the integration of numerous spinal and supraspinal sites. Erectile dysfunction (ED) is a highly prevalent problem increasing with age, as well as the major mens sexual concern. Significant advances in the pharmacological treatment of ED have occurred in recent years, most notably after the introduction of sildenafil, the first oral selective phosphodiesterase type 5 inhibitor. Nevertheless, many other oral, local and surgical treatments are available and their efficacy and safety depend on the specific cases. This review provides a comprehensive description of both currently available neurogenic ED treatments and most promising future therapies, including assigned patents.
Keywords: Dopaminergic agonists, guanylate-cyclase activators, melanocortins, neurogenic erectile dysfunction, patents, PDEi, potassium channel inhibitors, Neurophysiology, penis, neurotransmitter, noradranaline, trabecular smooth muscle, vasoconstrictor, Endothelin-1, corpus cavernosum, blood flow, endothelium, Endothelium-dependent, oxygen, guanylyl cyclase, cyclic guanosine, monophosphate, thoracolumbar sympathetic, somatic (pudendal) nerves, sacral spinal cord, pelvic plexus, pelvic nerve, Sympathetic preganglionic, thoracic, reflexogenic erections, dorsomedial, medullary raphe, DYSFUNCTION, Erectile dysfunction (ED), diabetes mellitus, dyslipidemia, smoking, obesity, engorgement, erections, ejaculation, climax, demyelinating, multifactorial, Multiple sclerosis (MS), inflammatory disorder, libido, orgasmic, urogenital symptoms, bulbocavernosus reflex, Phosphodiesterase 5 Inhibitors, phosphodiesterase 5, hypertension, cardiovascular diseases, depression, neurological disorders, Sildenafil citrate, dose, pharmacokinetic, bioavailability, hepatic cytochrome, serum, oral dosing, first-pass metabolism, erythromycin, ketoconazole, symptomatic hypotension, ischemic optic neuropathy, epidemiological evidence, cavernous nerve, penile rehabilitation, vascular disease, nasal congestion, headache, dizziness, tachycardia, Yohimbine, placebo, orthostatic hypotension, Apomorphine, dopamine agonist, efficacy, tolerability, hypersexuality, levodopa, hypogonadotropic hypogonadism, naltrexone, Trazodone, antidepressive drug, anxious, prostaglandin, opium alkaloid, phosphodiesterase, pathology, fibrosis, intraurethral pharmaceutical agents, psychogenic, neurogenic, minoxidil, aminophylline, co-dergocrine, anticoagulation therapy, intracorporeal fibrosis, micropenis, Peripherally Acting Compounds, potency, absorption, hypercholesterolemia, Lodenafil carbonate, rhinitis, respiratory distress syndrome
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