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Phosphodiesterase type-5 inhibitor(PDE5-i) drugs were first marketed in 1998(sildenafil) for ’on-demand’ treatment of male erectile dysfunction(ED) of any origin.They selectively inhibit intrapenile PDE5 isoenz yme which in turn increases intracellular cyclic guanosine monophosphate levels,thus resulting in prolonged relaxation of cavernosum smooth muscle cells and facilitating the erectile proce ss.Since 2003,two new molecules(tadalafil and vard e na fil) have been introduced,resulting in greater interest in these compounds and leading patients to ask for more prescriptions from their doctors.The vast use of PDE5-i in diabetic and cardiovascular ED patients led resea rchers to investigate their possible extra sexual effects.Several studies investigating their effects on endothelium,coronary and pulmonary circulation,inf erior oesophageal sphincter and kidney functions have appeared and,finally,sildenafil was approved for the treatment of pulmonary arterial hyperten s ion.Recent animal studies highlighted a possible interaction between chronic PDE5 inhibition and glucose homeostasis which occurs through a marked improvem ent of high fat diet induced insulin resistance.If this data is extended to humans,a new scenario will be opened for the chronic use of PDE5-i for sexual rehabilit ation along with cardiovascular and metabolic benefits.
Phosphodiesterase type-5 inhibitor (PDE5-i) drugs were first marketed in 1998 (sildenafil) for ’on-demand’ treatment of male erectile dysfunction (ED) of any origin. resulting in prolonged relaxation of cavernosum smooth muscle cells and facilitating the erectile procedures ss.ince 2003, two new molecules (tadalafil and vard e na fil) have been introduced, resulting in greater interest in these compounds and leading patients to ask for more prescriptions from their doctors. vast use of PDE5-i in diabetic and cardiovascular ED patients led resea rchers to investigate their possible extra sexual effects. Several studies investigating their effects on endothelium, coronary and pulmonary circulation, inf erior oesophageal sphincter and kidney functions have appeared and, finally, sildenafil was approved for the treatment of pulmonary arterial hypertention. Recent animal studies highlighted a possible interaction between chronic PDE5 inhibition and glucose homeostasis which occurs through a marked improvement in ent of high fat diet induced insulin resistance. If this data is extended to humans, a new scenario will be opened for the chronic use of PDE5-i for sexual rehabilitate along with cardiovascular and metabolic benefits.