Erectile Dysfunction in Diabetes Mellitus

Abstract

Erectile dysfunction is extremely common and observed in 30 to 50% of diabetic men. Diabetes represents the major cause of erectile dysfunction worldwide. There have been considerable advances in the understanding of the pathophysiology of this condition. Neurovascular factors have been further implicated as key components in its development. In particular, however, there is greater insight into the biochemical mediators of smooth muscle relaxation and constriction within the corpus cavernosum and abnormalities of these processes in diabetic men with erectile dysfunction. Nitric oxide, for example, has been identified as an essential substance involved in penile smooth muscle relaxation and is implicated in the development of erectile dysfunction. This observation has been exploited in the production of new therapeutic approaches such as oral phosphodiesterase type 5 inhibitors. This class of agents has revolutionized the management of erectile dysfunction in diabetic men although for the nonresponder or in whom it is contraindicated, there are many other successful alternative treatment options that may be considered.