Erectile dysfunction (ED) is a serious medical condition that affects 52% of men between the ages of 40 and 70. The incidence of ED increases with age, coronary artery disease, peripheral vascular disease, smoking, dyslipidemia, higher BMI, diabetes mellitus, and postradical prostatectomy. Forty to seventy percent of prostate cancer patients treated by radiotherapy and 30%-87% of patients treated by radical prostatectomy experience ED. Although potency improves with time postprostatectomy, sexual dysfunction was common 5 years following radical prostatectomy.
Current treatment options for ED, including self-injection or intra-urethral administration of alprostadil, vacuum erection devices, and phosphodiesterase 5a (PDE5A) therapy, have proven to be only partially effective; PDE5A inhibitors are ineffective in 29%-86% of prostatectomy patients who experience ED, depending on their nerve injury status. The reduced efficacy of all treatments makes prostatectomy patients a population for whom novel therapeutic approaches to treat ED are needed. Smooth muscle cell atrophy is abundant in PDE5A nonresponders.