Prostaglandins and the Aetiology and Treatment of Erectile Dysfunction

  • J. Y. Jeremy
  • D. P. Mikhailidis


Both animal and human penile tissue synthesize prostaglandins (PGs). Furthermore, intracavernous injection of certain PGs elicits erection in men with erectile dysfunction (ED; Godschalk et al. 1994). It is also well established that PGs are involved in the pathophysiology of atherosclerosis. Since atherosclerosis is a major cause of ED (Virag et al. 1985), it has been suggested that disruption of PG synthesis in penile tissues and related vasculature may play a role in the pathogenesis of ED (Jeremy and Mikhailidis 1990). The present chapter therefore focuses on the role of PGs in normal penile erection as well as on the pathophysiology and treatment of ED with PGs and related drugs. Several recent reviews on these areas are of interest (Juenemann and Alken 1989; Jeremy and Mikhailidis 1990; Linet 1993; Miller and Morgan 1994).


Erectile Dysfunction Cigarette Smoke Extract Penile Erection Intracavernous Injection Prostacyclin Synthesis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Aboseif S, Riemer RK, Stackl W, et al (1993) Quantification of PGE1 receptors in cavernous tissue of men, monkeys and dogs. Urol Int 50:48–152CrossRefGoogle Scholar
  2. Bosch RJLH, Benard F, Aboseif SR (1989) Changes in penile hemodynamics after intra cavernous injection of PGEI and prostaglandin 12 in pig-tailed monkeys. Int J Impotence Res 1:211–221Google Scholar
  3. Broderick GA, Gordon D, Hypolite L, Levin RM (1994) Anoxia and corporal smooth muscle dysfunction: a model for ischaemic priapism. J Urol 151:259–262PubMedGoogle Scholar
  4. Cameron NE, Cotter MA, Dines KC et al (1993) The effects of evening primrose oil on nerve function and capillarization in streptozotocin diabetic models modulation by the cyclooxygenase inhibitor, flurbiprofen. Br J Pharmacol 109:972–979PubMedGoogle Scholar
  5. Chen KK, Chan KY, Chang LS, et al (1992) Intracavernous pressure as an experimental index in a rat model for the evaluation of penile erection. J Urol 147:1124–1128PubMedGoogle Scholar
  6. Godschalk MF, Chen Z, Katz PG, Mulligan T (1994) Treatment of erectile failure with prostaglandin El: a double blind placebo-controlled, dose response study. J Urol 151:1530–1536PubMedGoogle Scholar
  7. Hadhazy P, Malomvolgyi B, Magyar K (1988) Endogenous prostanoids and arterial contractility. Prostaglandins Leukot Essent Fatty Acids 32:175–187PubMedCrossRefGoogle Scholar
  8. Hedlund H, Andersson K (1985) Contraction and relaxation induced by some prostanoids in isolated human penile erectile tissue and cavernous artery. J Urol 134:1245–1250PubMedGoogle Scholar
  9. Hendra T, Betteridge DJ (1988) Platelet function, platelet prostanoids and vascular prostacyclin synthesis in diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids 35:197–212CrossRefGoogle Scholar
  10. Hirschkowitz M, Karacan I, Howell W, et al (1992) Nocturnal penile tumescence in cigarette smokers with erectile dysfunction. Urol 39:101–107CrossRefGoogle Scholar
  11. Horrobin DF (1988) The roles of fatty acids in the development of diabetic neuropathy and other complications of diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids 31:181–197PubMedGoogle Scholar
  12. Horrobin DF, Manku MS (1990) Clinical biochemistry of essential fatty acids. In: Horrobin DF (ed) Omega-6 fatty acids: pathophysiology and roles in clinical medicine. Liss, New York, pp 21–54Google Scholar
  13. Ishii N, Watanabe H, Irisawa C, et al (1989) Intracavernous injection of PGEI for the treatment of erectile impotence. J Urol 141:323–325PubMedGoogle Scholar
  14. Jeremy JY (1994) Smoking and vascular defence mechanisms. J Smoking Related Disorders 5[Suppl 1]: 49–54Google Scholar
  15. Jeremy JY, Mikhailidis DP (1990) Prostaglandins and the penis: possible role in impotence. Sex Marital Ther 5:155–165CrossRefGoogle Scholar
  16. Jeremy JY, Mikhailidis DP, Thompson CS, Dandona P (1985) Experimental diabetes mellitus inhibits prostacyclin synthesis by the rat penis: pathological implications. Diabetologia 28:365–368PubMedGoogle Scholar
  17. Jeremy JY, Morgan RJ, Mikhailidis DP, Dandona P (1986a) Prostacyclin synthesis by the corpora cavernosa of the human penis: evidence for muscarinic control and pathological implications. Prostaglandins Leukot Essent Fatty Acids 23:211–216Google Scholar
  18. Jeremy JY, Morgan RJ, Mikhailidis DP, Dandona P (1986b) Muscarinic stimulation of prostacyclin synthesis by the rat penis. Eur J Pharmacol 123:67–71PubMedCrossRefGoogle Scholar
  19. Jeremy JY, Thompson CS, Barradas MA, Mikhailidis DP, Dandona P (1986c) Duration but not severity determines effects on prostacyclin synthesis in the rat aorta, penis and bladder. Prog Lipid Res 25:505–507CrossRefGoogle Scholar
  20. Jeremy JY, Thompson CS, Mikhailidis DP, Dandona P (1986d) The effect of cigarette smoke and diabetes mellitus on muscarinic stimulation of prostacyclin synthesis by the rat penis. Diabetes Res 3:467–469PubMedGoogle Scholar
  21. Jeremy JY, Mikhailidis DP, Dandona P (1988) Excitatory receptor-linked prostanoid synthesis in mammalian smooth muscle: the role of calcium, protein kinase C and G proteins. Prostaglandins Leukot Essential Fatty Acids 34:215–228Google Scholar
  22. Jeremy JY, Gill J, Mikhailidis DP (1993) Effect of murinone on human platelet cAMP phosphodiesterase, iloprost cAMP, thromboxane A2 synthesis and calcium uptake. Eur J Pharmacol 245:67–73PubMedCrossRefGoogle Scholar
  23. Juenemann K, Alken P (1989) Pharmacology of erectile dysfunction: a review. Int J Impotence Res 1:71–93Google Scholar
  24. Khan N, Miller M, Thompson CS, Mikhailidis DP, Morgan RJ, Jeremy JY (1995) 5′ nucleotidase activity in the aorta and penis of the diabetic rat. J Mol Cardiol (in press)Google Scholar
  25. Kim N, Vardi Y, Padma-Nathan H, et al (1993) Oxygen tension regulates the nitric oxide pathway. J Clin Invest 91:437–442PubMedCrossRefGoogle Scholar
  26. Kim J, Klyachkin ML, Svendsen E, et al (1994) Experimental hypercholesterolaemia in rabbits induces cavernosal atherosclerosis with endothelial and smooth muscle cell dysfunction. J Urol 151:198–205PubMedGoogle Scholar
  27. Klinge E, Sjostrand NO (1977) Comparative study of some isolated smooth muscle effectors of penile erection. Acta Physiol Scand 100:354–367PubMedCrossRefGoogle Scholar
  28. Ledda A, Tenaglia R, Belcaro G (1991) Laser-Doppler flowmetry in impotent smokers. Arteres et Veines 10:179–180Google Scholar
  29. Leung W, Lau C, Wong C (1993) Beneficial effect of cholesterol-lowering therapy on coronary endothelium-dependent relaxation in hypercholesterolaemic patients. Lancet 341:1496–1500PubMedCrossRefGoogle Scholar
  30. Linet OI (1993) Prostaglandins in erectile dysfunction. In: Vane JR and O’Grady J (eds) Therapeutic applications of prostaglandins. Arnold, Boston, pp 105–121Google Scholar
  31. McCulloch DK, Campbell IW, Wu FC (1980) The prevalence of diabetic impotence. Diabetologia 18:279–283PubMedCrossRefGoogle Scholar
  32. Mikhailidis DP, Jeremy JY (1994) Smoking and Impotence. Int Angiol 12:297–298Google Scholar
  33. Mikhailidis DP, Jeremy JY, Dandona P (1988) The role of prostaglandins, leukotrienes and essential fatty acids in the pathogenesis of the complications associated with diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids 33:205–206PubMedCrossRefGoogle Scholar
  34. Miller MAW, Morgan RJ (1994) Eicosanoids, erections and erectile dysfunction. Prostaglandins Leukot Essent Fatty Acids 51:1–9PubMedCrossRefGoogle Scholar
  35. Miller MAW, Morgan RJ, Thompson CS, Mikhailidis DP, Jeremy JY (1994) Adeny-late and guanylate cyclase activity in the penis and aorta of the diabetic rat: an in vitro study. Br J Urol 74:106–111PubMedCrossRefGoogle Scholar
  36. Miller M, Morgan RJ, Thompson CS, Mikhailidis DP, Jeremy JY (1995) Alterations of phosphodiesterase activity in the penis and aortae of diabetic rats (abstract). Int J Impotence Res (in press)Google Scholar
  37. Miller MAW, Thompson CS, Jeremy JY (1993) Managing impotence in diabetes-no need for a service. Br Med J 307:738CrossRefGoogle Scholar
  38. Molderings GJ, Gothert M, Van Ahlen H, Porst H (1989) Noradrenaline release in human corpus cavernosum and in modulation via presynaptic alpha adrenoceptors. Fundam Clin Pharmacol 102:261–267Google Scholar
  39. Porst H (1993) PGE1 and nitric oxide donor linsidomine for erectile failure: a diagnostic comparative study of 40 patients. J Urol 149:1280–1283PubMedGoogle Scholar
  40. Roy AC, Tan SM, Kottegoda SR, Ratnam SS (1984) Ability of the human corpora cavernosa muscle to generate prostaglandins and thromboxanes in vitro. IRCS J Med Sci 12:608–609Google Scholar
  41. Saenz de Tajeda I, Goldstein I, Krane RJ (1988) Local control of penile erection. Nerves, smooth muscle and endothelium. Urol Clin North Am 15:9–15Google Scholar
  42. Stackl W, Hasun R, Marberger M (1988) Intracavernous injection of PGEl in impotent men. J Urol 140:66–68PubMedGoogle Scholar
  43. Virag R, Bouilly P, Frydman D (1985) Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet I:181–184CrossRefGoogle Scholar
  44. Willersen JT, Sheng-Kun Y, McNatt J, et al (1994) Liposome-bound prostaglandin El often prevents cyclic flow variations in stenosed and endothelium-injured canine coronary arteries. Circulation 89:1786–1791Google Scholar

Copyright information

© Springer -Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • J. Y. Jeremy
  • D. P. Mikhailidis

There are no affiliations available

Personalised recommendations