Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-20T00:19:02.508Z Has data issue: false hasContentIssue false

Chapter 36 - Molecular Biology and Physiology of Erectile Function and Dysfunction

from Section 5 - Medical and Surgical Management of Issues of Male Health

Published online by Cambridge University Press:  06 December 2023

By
James L. Liu ,
Arthur L. Burnett  and
Amin S. Herati
Edited by
Douglas T. Carrell ,
Alexander W. Pastuszak  and
James M. Hotaling
Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
Get access

Summary

Male erectile dysfunction is a common condition that can significantly impact quality of life and interpersonal relationships. It is strongly associated with aging, comorbid conditions, poor lifestyle, and adverse cardiovascular health. Deficits in psychologic, neurologic, vascular, and endocrine function can all lead to erectile dysfunction. The aim of this chapter is to review the molecular biology required for erectile function as well as delve into the clinical pathophysiology that leads to erectile dysfunction.

Keywords

erectile functionnitric oxidemolecular mediatorsvascular dysfunctionneurologic deficitspsychogenic
Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
 , pp. 289 - 294
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Johannes, CB, Araju, AB, Feldman, HA, Derby, CA, Kleinman, KP, McKinlay, JB. Incidence of erectile dysfunction in men 40–69 years old: longitudinal results from the Massachusetts Male Aging Study. J Urol. 2000;163(2):460–463.CrossRefGoogle Scholar
Aytac, IA, McKinlay, JB, Krane, RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999;84(1):50–56.CrossRefGoogle Scholar
Yafi, FA, Jenkins, L, Albertsen, M, et al. Erectile dysfunction. Nat Rev Dis Primers. 2016;2:16003.Google Scholar
Hawksworth, DJ, Burnett, AL. Pharmacotherapeutic management of erectile dysfunction. Clin Pharmacol Ther. 2015;98(6):602–610.Google Scholar
Tanagho, EA, Lue, TF. Anatomy of the genitourinary tract. In: McAnich, JW, Lue, TF, eds. Smith and Tanagho’s General Urology. 18th ed. The McGraw Hill Companies; 2013:Chapter 1.Google Scholar
Gratzke, C, Angulo, J, Chitaley, K, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med. 2010;7(1 Pt 2):445–475.Google Scholar
Dean, RC, Lue, TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32(4):379–395.CrossRefGoogle ScholarPubMed
Andersson, KE, Hedlund, P, Alm, P. Sympathetic pathways and adrenergic innervation of the penis. Int J Impotent Res. 2000;12(Suppl. 1):S5–S12.Google Scholar
Saenz de Tejada, I, Kim, N, Lagana, I, et al. Regulation of adrenergic activity in penile corpus cavernosum. J Urol. 1989;142(4):1117–1121.CrossRefGoogle ScholarPubMed
Saenz d Tejada, I, Carson, MP, de las Morenas, A, et al. Endothelin: localization, synthesis, activity, and receptor types in human penile corpus cavernosum. Am J Physiol. 1991;261:H1078–H1085.Google Scholar
Sachs, B, Meisel, R. The physiology of male sexual behavior. In: Knobil, E, Neill, J, eds. Physiology of Reproduction. Raven Press; 1998:1393–1423.Google Scholar
Stoleru, S, Redoute, J, Costes, N, et al. Brain processing of visual sexual stimuli in men with hypoactive sexual desire disorder. Psychiatry Res. 2003;124(2):67–86.Google Scholar
Ferrettti, A, Caulo, M, Del Gratta, C, et al. Dynamics of male sexual arousal: distinct components of brain activation reveal by fMRI. Neuroimage. 2005;26(4):1086–1096.CrossRefGoogle Scholar
Root, W, Bard, P. The mediation of feline erection through sympathetic pathway with some reference on sexual behavior after deafferentation of the genitalia. Am J Physiol. 1947;151:80–90.Google Scholar
Montorsi, F, Oettel, M. Testosterone and sleep-relate erections: an overview. J Sex Med. 2005;2(6):771–784.Google Scholar
Wang, H, Eto, M, Steers, WD, et al. RhoA-mediated Ca2+ sensitization in erectile function. J Biol Chem. 2002;277:30614–30621.CrossRefGoogle ScholarPubMed
Cellk, S, Rees, RW, Kalsi, J. A Rho-kinase inhibitor, soluble guanylate cyclase activator and nitric oxide-releasing PDE5 inhibitors: novel approaches to erectile dysfunction. Expert Opin Investig Drugs. 2002;11:1563–1573.Google Scholar
Hurt, KJ, Musicki, B, Palese, MA, et al. Akt-dependent phosphorylation of endothelial nitric-oxide synthase meditate penile erection. Proc Natl Acad Sci USA. 2002;99(6):4061–4066.CrossRefGoogle Scholar
Lizza, EF, Rosen, RC. Definition and classification of erectile dysfunction: report of the nomenclature committee of the International Society of Impotence Research. Int J Impot Res. 1999;11(3):141–143.CrossRefGoogle ScholarPubMed
Levine, FJ, Greenfield, AJ, Goldstein, I. Arteriographically determined occlusive disease within the hypogastric-cavernous bed in impotent patients following blunt perineal and pelvic trauma. J Urol. 1990;144(5):1147–1153.CrossRefGoogle ScholarPubMed
Goldstein, I, Feldman, MI, Deckers, PJ, et al. Radiation-associated impotence. a clinical study of its mechanism. JAMA. 1984;251(7):903–910.CrossRefGoogle ScholarPubMed
Andersen, KV, Bovim, G. Impotence and nerve entrapment in long distance amateur cyclists. Acta Neurol Scand. 1997;95(4):233–240.Google Scholar
Gan, ZS, Ehlers, ME, Lin, FC, Wright, ST, Figler, BD, Coward, RM. Systematic review and meta-analysis of cycling and erectile dysfunction. Sex Med Rev. 2020;9(2):304–311.Google Scholar
Balasubramanian, A, Yu, J, Breyer, BN, Minkow, R, Eisenberg, ML. The association between pelvic discomfort and erectile dysfunction in adult male bicyclists. J Sex Med. 2020;7(5):919–929.Google Scholar
Gupta, N, Herati, A, Gilbert, BR. Penile Doppler ultrasound predicting cardiovascular disease in men with erectile dysfunction. Curr Urol Rep. 2015;16(3):16.Google Scholar
Heidler, S, Temml, C, Broessner, C, et al. Is the metabolic syndrome an independent risk factor for erectile dysfunction? J Urol. 2007;177(2):651–654.Google Scholar
Moreland, RB, Traish, A, McMilin, MA, Smith, B, Goldstein, I, Saenz de Tejada, I. PGE1 suppressed the induction of collagen synthesis by transforming growth factor-beta 1 in human corpus cavernosum smooth muscle. J Urol. 1995;153(3):826–834.CrossRefGoogle ScholarPubMed
Nehra, A, Azadozi, KM, Moreland, RB, et al. Cavernosal expandability is an erectile tissue mechanical property which predicts trabecular histology in an animal model of vasculogenic erectile dysfunction. J Urol. 1998;159(6):2229–2236.CrossRefGoogle Scholar
Steers, WD. Neural control of penile erection. Semin Urol. 1990;8(2):66–79.Google Scholar
El-Sakka, AI. Reversion of penile fibrosis: current information and a new horizon. Arab J Urol. 2011;9(1):49–55.Google Scholar
Zeiss, AM, Davies, HD, Wood, M, Tinklenberg, JR. The incidence and correlates of erectile problems in patients with Alzheimer’s disease. Arch Sex Behav. 1990;19(4):325–331.CrossRefGoogle ScholarPubMed
Nehra, A, Moreland, RB. Neurologic erectile dysfunction. Urol Clin. 2001;28(20):289–308.Google Scholar
Brock, GB, Lue, TF. Drug-induced male sexual dysfunction. An update. Drug Saf. 1993;8(6):414–426.CrossRefGoogle ScholarPubMed
Eardley, I, Kirby, R. Neurogenic impotence. In: Kirby, R, Carson, C, Webster, G, eds. Impotence: Diagnosis and Management of Male Erectile Dysfunction. Butterworth-Heinemann; 1991:227–231.Google Scholar
Nandipati, KC, Raina, R, Agarwal, A, et al. Erectile dysfunction following radical retropubic prostatectomy: epidemiology, pathophysiology and pharmacological management. Drugs Aging. 2006;23(2):101–117.Google Scholar
Danzi, M, Ferulano, GP, Abate, S, et al. Male sexual function after abdominoperineal resection for rectal cancer. Dis Colon Rectum. 1983;26(10):665–668.Google Scholar
Quinlan, DM, Epstein, JI, Carter, BS, et al. Sexual function following radical prostatectomy: influence of preservation of neurovascular bundles. J Urol. 1991;145(5):998–1002.CrossRefGoogle ScholarPubMed
Dean, RC, Lue, TF. Neuroregenerative strategies after radical prostatectomy. Rev Urol. 2005;7(2):26–32.Google Scholar
Bratu, O, Oprea, I, Marcu, D, et al. Erectile dysfunction post-radical prostatectomy: a challenge for both patient and physician. J Med Life. 2017;10(1):13–18.Google Scholar
Metze, M, Tiemann, AH, Josten, C. Male sexual dysfunction after pelvic trauma. J Trauma. 2007;62(2):394–401.Google Scholar
Mulligan, T, Schmitt, B. Testosterone for erectile failure. J Gen Intern Med. 1993;8(9):517–521.Google Scholar
Booth, A, Johnson, DR, Granger, DA. Testosterone and men’s health. J Behav Med. 1999;22(1):1–19.Google Scholar
Corona, G, Rastrelli, G, Morgentaler, A, et al. Meta-analysis of results of testosterone therapy on sexual function based on international index of erectile function scores. Eur Urol. 2017;72(6):1000–1011.Google Scholar
Alhathal, N, Elshal, AM, Carrier, S. Synergetic effect of testosterone and phosphodiesterare-5 inhibitors in hypogonadal men with erectile dysfunction: a systematic review. Can Urol Assoc J. 2012;6(4):269–274.CrossRefGoogle ScholarPubMed
Buena, F, Swerdloff, RS, Steiner, BS, et al. Sexual function does not change when serum testosterone levels are pharmacologically varied within the normal male range. Fertil Steril. 1993;59(5):1118–1123.Google Scholar
Hotta, Y, Kataoka, T, Kimura, K. Testosterone deficiency and endothelial dysfunction: nitric oxide asymmetric dimethylarginine, and endothelial progenitor cells. Sex Med Rev. 2019;7(4):661–668.CrossRefGoogle ScholarPubMed
Ludwig, W, Phillips, M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014;92(1):1–6.Google Scholar
Kim, SC, Oh, MM. Norepinephrine involvement in response to intracorporeal injection of papaverine in psychogenic impotence. J Urol. 1992;147(6):1530–1532.Google Scholar
Rosen, RC. Psychogenic erectile dysfunction: classification and management. Urol Clin North Am. 2001;28(2):269–278.Google Scholar
Keene, LC, Davies, PH. Drug-related erectile dysfunction. Adverse Drug React Toxiol Rev. 1999;18(1):5–24.Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×