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Nat Rev Dis Primers. 2016 Feb 4;2:16003. doi: 10.1038/nrdp.2016.3.

Erectile dysfunction.

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Tulane University School of Medicine, Department of Urology, Box SL 42, 1430 Tulane Avenue, New Orleans, Louisiana 70112-2699, USA.
Sexual and Reproductive Medicine Program, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA.
Laboratory for Experimental Urology, Gene and Stem Cells Applications, Department of Development and Regeneration, University of Leuven, Leuven, Belgium.
Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy.
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Department of Psychiatry &Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.
Department of Medicine, Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy.
Department of Urology, Tan Tock Seng Hospital, Singapore.


Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including organic, relational and psychological. Roles for nonendocrine (neurogenic, vasculogenic and iatrogenic) and endocrine pathways have been proposed. Owing to its strong association with metabolic syndrome and cardiovascular disease, cardiac assessment may be warranted in men with symptoms of erectile dysfunction. Minimally invasive interventions to relieve the symptoms of erectile dysfunction include lifestyle modifications, oral drugs, injected vasodilator agents and vacuum erection devices. Surgical therapies are reserved for the subset of patients who have contraindications to these nonsurgical interventions, those who experience adverse effects from (or are refractory to) medical therapy and those who also have penile fibrosis or penile vascular insufficiency. Erectile dysfunction can have deleterious effects on a man's quality of life; most patients have symptoms of depression and anxiety related to sexual performance. These symptoms, in turn, affect his partner's sexual experience and the couple's quality of life. This Primer highlights numerous aspects of erectile dysfunction, summarizes new treatment targets and ongoing preclinical studies that evaluate new pharmacotherapies, and covers the topic of regenerative medicine, which represents the future of sexual medicine.

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