Comprehensive management of erectile dysfunction in diabetes mellitus: pathogenesis, treatment modalities, and future perspectives
DOI:
https://doi.org/10.12775/QS.2024.17.53372Keywords
Erectile dysfunction (ED), Diabetes mellitus (DM), PDE5 inhibitorsAbstract
Diabetes mellitus (DM) significantly increases the risk of erectile dysfunction (ED), affecting up to 52% of diabetic males. This review examines the epidemiology, pathophysiology, and treatment modalities of ED in diabetic patients. Key factors influencing ED in this population include poor glycemic control, obesity, hypertension, and the duration of diabetes.
Both the latest reports on treatment and well-known articles containing fundamental knowledge about this condition were analyzed, mainly using online databases like PubMed.
Effective management of ED in diabetic patients requires optimal glycemic control and lifestyle modifications such as diet, exercise, and weight management. Pharmacological treatments involve phosphodiesterase type 5 (PDE5) inhibitors like sildenafil, tadalafil, and vardenafil, which enhance erectile function by increasing cGMP levels. Alternatives for those unresponsive to oral medications include intracavernous injections, intraurethral alprostadil, vacuum constriction devices, low-intensity extracorporeal shock wave therapy (Li-ESWT), and penile prosthesis implantation. Emerging therapies like mesenchymal stem cell therapy and novel drug combinations offer promising avenues, focusing on cellular regeneration and improved vascular function.
Despite the availability of these treatments, ED remains underreported due to patient embarrassment and healthcare provider hesitation, underscoring the need for increased awareness and proactive management. As projections indicate a rising global prevalence of ED, integrating ED management into comprehensive diabetes care is essential to enhance patient quality of life and address this significant public health issue.
References
IDF Diabetes Atlas 2021 | IDF Diabetes Atlas [Internet]. [cited 2024 Jun 21]. Available from: https://diabetesatlas.org/atlas/tenth-edition/
Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, et al. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes Metab Res Rev. 2022 Feb;38(2):e3494. https://doi.org/10.1002/dmrr.3494
Kouidrat Y, Pizzol D, Cosco T, Thompson T, Carnaghi M, Bertoldo A, et al. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabet Med J Br Diabet Assoc. 2017 Sep;34(9):1185–92. https://doi.org/10.1111/dme.13403
NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993 Jul 7;270(1):83–90.
Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Microvascular Complications of Type 2 Diabetes Mellitus. Curr Vasc Pharmacol. 2020;18(2):117–24. https://doi.org/10.2174/1570161117666190502103733
Cayetano-Alcaraz AA, Tharakan T, Chen R, Sofikitis N, Minhas S. The management of erectile dysfunction in men with diabetes mellitus unresponsive to phosphodiesterase type 5 inhibitors. Andrology. 2023 Feb;11(2):257–69. https://doi.org/10.1111/andr.13257
Dęmbe K, Jasik M, S, Karnafel W. Pathogenesis and frequency of erectile dysfunction in patients with diabetes. J Sex Ment Health. 2004;2(2):51–4.
Bahar A, Elyasi F, Moosazadeh M, Afradi G, Kashi Z. Sexual dysfunction in men with type II diabetes. Casp J Intern Med. 2020 May;11(3):295–303. https://doi.org/10.22088/cjim.11.3.295
Shiferaw WS, Akalu TY, Aynalem YA. Prevalence of Erectile Dysfunction in Patients with Diabetes Mellitus and Its Association with Body Mass Index and Glycated Hemoglobin in Africa: A Systematic Review and Meta-Analysis. Int J Endocrinol. 2020;2020:5148370. https://doi.org/10.1155/2020/5148370
Maalmi H, Herder C, Bönhof GJ, Strassburger K, Zaharia OP, Rathmann W, et al. Differences in the prevalence of erectile dysfunction between novel subgroups of recent-onset diabetes. Diabetologia. 2022 Mar;65(3):552–62. https://doi.org/10.1007/s00125-021-05607-z
Saito J, Kumano H, Ghazizadeh M, Shimokawa C, Tanemura H. Differences in Psychological Inflexibility Among Men With Erectile Dysfunction Younger and Older Than 40 Years: Web-Based Cross-Sectional Study. JMIR Form Res. 2024 Jan 3;8:e45998. https://doi.org/10.2196/45998
Shiferaw WS, Akalu TY, Petrucka PM, Areri HA, Aynalem YA. Risk factors of erectile dysfunction among diabetes patients in Africa: A systematic review and meta-analysis. J Clin Transl Endocrinol. 2020 Sep;21:100232. https://doi.org/10.1016/j.jcte.2020.100232
Malavige LS, Levy JC. Erectile Dysfunction in Diabetes Mellitus. J Sex Med. 2009 May 1;6(5):1232–47. https://doi.org/10.1111/j.1743-6109.2008.01168.x
Nanayakkara N, Curtis AJ, Heritier S, Gadowski AM, Pavkov ME, Kenealy T, et al. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia. 2021 Feb;64(2):275–87. https://doi.org/10.1007/s00125-020-05319-w
Al-Hunayan A, Al-Mutar M, Kehinde EO, Thalib L, Al-Ghorory M. The prevalence and predictors of erectile dysfunction in men with newly diagnosed with type 2 diabetes mellitus. BJU Int. 2007 Jan;99(1):130–4. https://doi.org/10.1111/j.1464-410X.2006.06550.x
Ighodaro OM. Molecular pathways associated with oxidative stress in diabetes mellitus. Biomed Pharmacother Biomedecine Pharmacother. 2018 Dec;108:656–62. https://doi.org/10.1016/j.biopha.2018.09.058
Shi Y, Vanhoutte PM. Macro- and microvascular endothelial dysfunction in diabetes. J Diabetes. 2017 May;9(5):434–49. https://doi.org/10.1111/1753-0407.12521
Mónica FZ, Bian K, Murad F. The Endothelium-Dependent Nitric Oxide-cGMP Pathway. Adv Pharmacol San Diego Calif. 2016;77:1–27. https://doi.org/10.1016/bs.apha.2016.05.001
Samidurai A, Xi L, Das A, Kukreja RC. Beyond Erectile Dysfunction: cGMP-Specific Phosphodiesterase 5 Inhibitors for Other Clinical Disorders. Annu Rev Pharmacol Toxicol. 2023 Jan 20;63:585–615. https://doi.org/10.1146/annurev-pharmtox-040122-034745
Altalhi R, Pechlivani N, Ajjan RA. PAI-1 in Diabetes: Pathophysiology and Role as a Therapeutic Target. Int J Mol Sci. 2021 Mar 20;22(6):3170. https://doi.org/10.3390/ijms22063170
Kim JE, Kim JS, Jo MJ, Cho E, Ahn SY, Kwon YJ, et al. The Roles and Associated Mechanisms of Adipokines in Development of Metabolic Syndrome. Mol Basel Switz. 2022 Jan 6;27(2):334. https://doi.org/10.3390/molecules27020334
Braffett BH, Wessells H, Sarma AV. Urogenital Autonomic Dysfunction in Diabetes. Curr Diab Rep. 2016 Dec;16(12):119. https://doi.org/10.1007/s11892-016-0824-5
Walton DM, Minton SD, Cook AD. The potential of transdermal nitric oxide treatment for diabetic peripheral neuropathy and diabetic foot ulcers. Diabetes Metab Syndr. 2019;13(5):3053–6. https://doi.org/10.1016/j.dsx.2018.07.003
Corona G, Rastrelli G, Isidori AM, Pivonello R, Bettocchi C, Reisman Y, et al. Erectile dysfunction and cardiovascular risk: a review of current findings. Expert Rev Cardiovasc Ther. 2020 Mar;18(3):155–64. https://doi.org/10.1080/14779072.2020.1745632
Rew KT, Heidelbaugh JJ. Erectile Dysfunction. Am Fam Physician. 2016 Nov 15;94(10):820–7.
Dilixiati D, Waili A, Tuerxunmaimaiti A, Tao L, Zebibula A, Rexiati M. Risk factors for erectile dysfunction in diabetes mellitus: a systematic review and meta-analysis. Front Endocrinol. 2024;15:1368079. https://doi.org/10.3389/fendo.2024.1368079
Wittert G, Grossmann M. Obesity, type 2 diabetes, and testosterone in ageing men. Rev Endocr Metab Disord. 2022 Dec;23(6):1233–42. https://doi.org/10.1007/s11154-022-09746-5
Lee HK, Lee JK, Cho B. The role of androgen in the adipose tissue of males. World J Mens Health. 2013 Aug;31(2):136–40. https://doi.org/10.5534/wjmh.2013.31.2.136
Xiong Y, Zhang F, Zhang Y, Wang W, Ran Y, Wu C, et al. Insights into modifiable risk factors of erectile dysfunction, a wide-angled Mendelian Randomization study. J Adv Res. 2024 Apr;58:149–61. https://doi.org/10.1016/j.jare.2023.05.008
Manolis A, Doumas M, Ferri C, Mancia G. Erectile dysfunction and adherence to antihypertensive therapy: Focus on β-blockers. Eur J Intern Med. 2020 Nov;81:1–6. https://doi.org/10.1016/j.ejim.2020.07.009
Dobrek L. Lower Urinary Tract Disorders as Adverse Drug Reactions-A Literature Review. Pharm Basel Switz. 2023 Jul 20;16(7):1031. https://doi.org/10.1016/j.ejim.2020.07.009
Yuan P, Chen Y, Sun T, Cui L, Wei Y, Li T, et al. Exploring potential genes and mechanisms linking erectile dysfunction and depression. Front Endocrinol. 2023;14:1221043. https://doi.org/10.3389/fendo.2023.1221043
Park M, Reynolds CF. Depression among older adults with diabetes mellitus. Clin Geriatr Med. 2015 Feb;31(1):117–37, ix. https://doi.org/10.1016/j.cger.2014.08.022
Yau JWY, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012 Mar;35(3):556–64. https://doi.org/10.2337/dc11-1909
Fan J, Peng T, Hui J, Ding W, He B, Zhang H, et al. Erectile Dysfunction in Type-2 Diabetes Mellitus Patients: Predictors of Early Detection and Treatment. Urol Int. 2021;105(11–12):986–92. https://doi.org/10.1159/000514700
Hatzimouratidis K, Hatzichristou D. How to treat erectile dysfunction in men with diabetes: from pathophysiology to treatment. Curr Diab Rep. 2014;14(11):545. https://doi.org/10.1007/s11892-014-0545-6
Phé V, Rouprêt M. Erectile dysfunction and diabetes: a review of the current evidence-based medicine and a synthesis of the main available therapies. Diabetes Metab. 2012 Feb;38(1):1–13. https://doi.org/10.1016/j.diabet.2011.09.003
Melchiode Z, Nguyen T, Dawood O, Bobo GA, Hellstrom WJG. Phosphodiesterase 5 inhibitors: preclinical and early-phase breakthroughs for impotence treatments. Expert Opin Investig Drugs. 2023;32(7):635–42. https://doi.org/10.1080/13543784.2023.2242768
Moon DG, Yang DY, Lee CH, Ahn TY, Min KS, Park K, et al. A therapeutic confirmatory study to assess the safety and efficacy of Zydena (udenafil) for the treatment of erectile dysfunction in male patients with diabetes mellitus. J Sex Med. 2011 Jul;8(7):2048–61. https://doi.org/10.1111/j.1743-6109.2011.02268.x
Park HJ, Moon KH, Lee SW, Lee WK, Kam SC, Lee JH, et al. Mirodenafil for the treatment of erectile dysfunction: a systematic review of the literature. World J Mens Health. 2014 Apr;32(1):18–27. https://doi.org/10.1111/j.1743-6109.2011.02268.x
Chen Y, Dai Y, Wang R. Treatment strategies for diabetic patients suffering from erectile dysfunction. Expert Opin Pharmacother. 2008 Feb;9(2):257–66. https://doi.org/10.1517/14656566.9.2.257
Moncada I, Martinez-Salamanca J, Ruiz-Castañe E, Romero J. Combination therapy for erectile dysfunction involving a PDE5 inhibitor and alprostadil. Int J Impot Res. 2018 Oct;30(5):203–8. https://doi.org/10.1038/s41443-018-0046-2
Redrow GP, Thompson CM, Wang R. Treatment strategies for diabetic patients suffering from erectile dysfunction: an update. Expert Opin Pharmacother. 2014 Sep;15(13):1827–36. https://doi.org/10.1517/14656566.2014.934809
Wibowo DNSA, Soebadi DM, Soebadi MA. Yohimbine as a treatment for erectile dysfunction: A systematic review and meta-analysis. Turk J Urol. 2021 Nov;47(6):482–8. https://doi.org/10.5152/tud.2021.21206
Yuan J, Hoang AN, Romero CA, Lin H, Dai Y, Wang R. Vacuum therapy in erectile dysfunction--science and clinical evidence. Int J Impot Res. 2010;22(4):211–9. https://doi.org/10.1038/ijir.2010.4
Ma M, Qin F, Wu C, Xiong W, Yu B, Wei S, et al. Optimal vacuum erectile device therapy regimen for penile rehabilitation in a bilateral cavernous nerve crush rat model. Andrology. 2021 May;9(3):894–905. https://doi.org/10.1111/andr.12968
Khayyamfar F, Forootan SK, Ghasemi H, Miri SR, Farhadi E. Evaluating the efficacy of vacuum constrictive device and causes of its failure in impotent patients. Urol J. 2014 Jan 4;10(4):1072–8.
Brison D, Seftel A, Sadeghi-Nejad H. The resurgence of the vacuum erection device (VED) for treatment of erectile dysfunction. J Sex Med. 2013 Apr;10(4):1124–35. https://doi.org/10.1111/jsm.12046
Beaudreau SA, Van Moorleghem K, Dodd SM, Liou-Johnson V, Suresh M, Gould CE. Satisfaction with a Vacuum Constriction Device for Erectile Dysfunction among Middle-Aged and Older Veterans. Clin Gerontol. 2021;44(3):307–15. https://doi.org/10.1080/07317115.2020.1823922
Sultana A, Grice P, Vukina J, Pearce I, Modgil V. Indications and characteristics of penile traction and vacuum erection devices. Nat Rev Urol. 2022 Feb;19(2):84–100. https://doi.org/10.1038/s41585-021-00532-7
Wang JC, Zhou Y. Suppressing bubble shielding effect in shock wave lithotripsy by low intensity pulsed ultrasound. Ultrasonics. 2015 Jan;55:65–74. https://doi.org/10.1016/j.ultras.2014.08.004
Yue L, Chen H, Feng TH, Wang R, Sun HL. Low-intensity extracorporeal shock wave therapy for midshaft clavicular delayed union: A case report and review of literature. World J Clin Cases. 2021 Sep 26;9(27):8242–8. https://doi.org/10.12998/wjcc.v9.i27.8242
Gadomski BC, McGilvray KC, Easley JT, Palmer RH, Jiao J, Li X, et al. An investigation of shock wave therapy and low‐intensity pulsed ultrasound on fracture healing under reduced loading conditions in an ovine model. J Orthop Res. 2018 Mar;36(3):921–9. https://doi.org/10.1002/jor.23666
Tepeköylü C, Wang FS, Kozaryn R, Albrecht-Schgoer K, Theurl M, Schaden W, et al. Shock wave treatment induces angiogenesis and mobilizes endogenous CD31/CD34-positive endothelial cells in a hindlimb ischemia model: implications for angiogenesis and vasculogenesis. J Thorac Cardiovasc Surg. 2013 Oct;146(4):971–8. https://doi.org/10.1016/j.jtcvs.2013.01.017
Yao H, Wang X, Liu H, Sun F, Tang G, Bao X, et al. Systematic Review and Meta-Analysis of 16 Randomized Controlled Trials of Clinical Outcomes of Low-Intensity Extracorporeal Shock Wave Therapy in Treating Erectile Dysfunction. Am J Mens Health. 2022 Mar;16(2):155798832210875. https://doi.org/10.1177/15579883221087532
Sokolakis I, Dimitriadis F, Psalla D, Karakiulakis G, Kalyvianakis D, Hatzichristou D. Effects of low-intensity shock wave therapy (LiST) on the erectile tissue of naturally aged rats. Int J Impot Res. 2019 May;31(3):162–9. https://doi.org/10.1038/s41443-018-0064-0
Tzou KY, Hu SW, Bamodu OA, Wang YH, Wu WL, Wu CC. Efficacy of Penile Low-Intensity Shockwave Therapy and Determinants of Treatment Response in Taiwanese Patients with Erectile Dysfunction. Biomedicines. 2021 Nov 12;9(11):1670. https://doi.org/10.3390/biomedicines9111670
Shendy WS, Elsoghier OM, El Semary MM, Ahmed AA, Ali AF, Saber-Khalaf M. Effect of low-intensity extracorporeal shock wave therapy on diabetic erectile dysfunction: Randomised control trial. Andrologia. 2021 May;53(4):e13997. https://doi.org/10.1111/and.13997
Kitrey ND, Vardi Y, Appel B, Shechter A, Massarwi O, Abu-Ghanem Y, et al. Low Intensity Shock Wave Treatment for Erectile Dysfunction-How Long Does the Effect Last? J Urol. 2018 Jul;200(1):167–70. https://doi.org/10.1016/j.juro.2018.02.070
Spivak L, Shultz T, Appel B, Verze P, Yagudaev D, Vinarov A. Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction in Diabetic Patients. Sex Med Rev. 2021 Oct;9(4):619–27. https://doi.org/10.1016/j.sxmr.2019.06.007
Assaly-Kaddoum R, Giuliano F, Laurin M, Gorny D, Kergoat M, Bernabé J, et al. Low Intensity Extracorporeal Shock Wave Therapy Improves Erectile Function in a Model of Type II Diabetes Independently of NO/cGMP Pathway. J Urol. 2016 Sep;196(3):950–6. https://doi.org/10.1016/j.juro.2016.03.147
Jeon SH, Bae WJ, Zhu GQ, Tian W, Kwon EB, Kim GE, et al. Combined treatment with extracorporeal shockwaves therapy and an herbal formulation for activation of penile progenitor cells and antioxidant activity in diabetic erectile dysfunction. Transl Androl Urol. 2020 Apr;9(2):416–27. https://doi.org/10.21037/tau.2020.01.23
Shin D, Jeon SH, Tian WJ, Kwon EB, Kim GE, Bae WJ, et al. Extracorporeal shock wave therapy combined with engineered mesenchymal stem cells expressing stromal cell-derived factor-1 can improve erectile dysfunction in streptozotocin-induced diabetic rats. Transl Androl Urol. 2021 Jun;10(6):2362–72. https://doi.org/10.21037/tau-21-79
Liu S, Jiang C, Hu J, Chen H, Han B, Xia S. Low-Intensity Pulsed Ultrasound Enhanced Adipose-Derived Stem Cell-Mediated Angiogenesis in the Treatment of Diabetic Erectile Dysfunction through the Piezo-ERK-VEGF Axis. Stem Cells Int. 2022;2022:6202842. https://doi.org/10.1155/2022/6202842
Medina-Polo J, García-Gómez B, Alonso-Isa M, Romero-Otero J. Clinical guidelines on erectile dysfunction surgery: EAU-AUA perspectives. Actas Urol Esp. 2020 Jun;44(5):289–93. https://doi.org/10.1016/j.acuro.2019.10.008
Cavayero CT, Leslie SW, McIntosh GV. Penile Prosthesis Implantation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Jul 2]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK563292/
Levine LA, Becher EF, Bella AJ, Brant WO, Kohler TS, Martinez-Salamanca JI, et al. Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine. J Sex Med. 2016 Apr;13(4):489–518. https://doi.org/10.1016/j.jsxm.2016.01.017
Lux M, Reyes-Vallejo L, Morgentaler A, Levine LA. Outcomes and satisfaction rates for the redesigned 2-piece penile prosthesis. J Urol. 2007 Jan;177(1):262–6. https://doi.org/10.1016/j.juro.2006.08.094
Van Huele A, Mennes J, Chung E, Van Renterghem K. Majority of erectile dysfunction patients would have preferred earlier implantation of their penile prosthesis: validation of the recently changed EAU guidelines. Int J Impot Res. 2023 Dec;35(8):731–5. https://doi.org/10.1038/s41443-022-00620-1
Pazir Y, Yanaral F, Caglar U, Ortac M, Sarilar O, Ozgor F. Evaluation of Satisfaction and Outcomes of Patients Who Underwent Two-Piece Inflatable Penile Prosthesis Implantation. Cureus. 2022 Jun;14(6):e26097. https://doi.org/10.7759/cureus.26097
Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999 Dec;11(6):319–26. https://doi.org/10.1038/sj.ijir.3900472
Billups KL, Bank AJ, Padma-Nathan H, Katz SD, Williams RA. Erectile dysfunction as a harbinger for increased cardiometabolic risk. Int J Impot Res. 2008;20(3):236–42. https://doi.org/10.1038/sj.ijir.3901634
Habous M, Tal R, Tealab A, Soliman T, Nassar M, Mekawi Z, et al. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int. 2018 Feb;121(2):293–300. https://doi.org/10.1111/bju.14076
Barham DW, Pyrgidis N, Gross MS, Hammad M, Swerdloff D, Miller J, et al. AUA-recommended Antibiotic Prophylaxis for Primary Penile Implantation Results in a Higher, Not Lower, Risk for Postoperative Infection: A Multicenter Analysis. J Urol. 2023 Feb;209(2):399–409. https://doi.org/10.1097/JU.0000000000003071
Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and “no touch” surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012 Jun;79(6):1310–5. https://doi.org/10.1016/j.urology.2011.11.076
Morey AF, Cefalu CA, Hudak SJ. High submuscular placement of urologic prosthetic balloons and reservoirs via transscrotal approach. J Sex Med. 2013 Feb;10(2):603–10. https://doi.org/10.1111/jsm.12000
Torremadé J, Presa M, Gorría Ó, de Burgos R, Oyagüez I, Lledó E. Systematic review of the implantation of penile prosthesis in major ambulatory surgery. Actas Urol Esp. 2023;47(6):341–50. https://doi.org/10.1016/j.acuroe.2022.08.019
Morey AF. Reconstructing penile supersonic transporter (SST) deformity using glanulopexy (glans fixation). J Urol. 2005 Sep;174(3):969.
Bettocchi C, Ditonno P, Palumbo F, Lucarelli G, Garaffa G, Giammusso B, et al. Penile prosthesis: what should we do about complications? Adv Urol. 2008;2008:573560. https://doi.org/10.1155/2008/573560
Drevik JA, Dalimov Z, Lucas J, Simhan J, Cohn JA. Factors associated with postoperative urinary retention in patients undergoing penile prosthesis implantation. Int J Impot Res. 2024 May;36(3):201–5. https://doi.org/10.1038/s41443-022-00622-z
Garcia MM, Fandel TM, Lin G, Shindel AW, Banie L, Lin CS, et al. Treatment of erectile dysfunction in the obese type 2 diabetic ZDF rat with adipose tissue-derived stem cells. J Sex Med. 2010 Jan;7(1 Pt 1):89–98. https://doi.org/10.1111/j.1743-6109.2009.01541.x
Bonafede R, Scambi I, Peroni D, Potrich V, Boschi F, Benati D, et al. Exosome derived from murine adipose-derived stromal cells: Neuroprotective effect on in vitro model of amyotrophic lateral sclerosis. Exp Cell Res. 2016 Jan 1;340(1):150–8. https://doi.org/10.1016/j.yexcr.2015.12.009
Chen F, Zhang H, Wang Z, Ding W, Zeng Q, Liu W, et al. Adipose-Derived Stem Cell-Derived Exosomes Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes. J Sex Med. 2017 Sep;14(9):1084–94. https://doi.org/10.1016/j.jsxm.2017.07.005
Liu G, Sun X, Bian J, Wu R, Guan X, Ouyang B, et al. Correction of diabetic erectile dysfunction with adipose derived stem cells modified with the vascular endothelial growth factor gene in a rodent diabetic model. PloS One. 2013;8(8):e72790. https://doi.org/10.1371/journal.pone.0072790
Yang Q, Chen W, Zhang C, Xie Y, Gao Y, Deng C, et al. Combined Transplantation of Adipose Tissue-Derived Stem Cells and Endothelial Progenitor Cells Improve Diabetic Erectile Dysfunction in a Rat Model. Stem Cells Int. 2020;2020:2154053. https://doi.org/10.1155/2020/2154053
Luo C, Peng Y, Zhou X, Fan J, Chen W, Zhang H, et al. NLRP3 downregulation enhances engraftment and functionality of adipose-derived stem cells to alleviate erectile dysfunction in diabetic rats. Front Endocrinol. 2022;13:913296. https://doi.org/10.3389/fendo.2022.913296
Galhom RA, Korayem HE, Ibrahim MA, Abd-Eltawab Tammam A, Khalifa MM, Rashwan EK, et al. Urine-Derived Stem Cells Versus Their Lysate in Ameliorating Erectile Dysfunction in a Rat Model of Type 2 Diabetes. Front Physiol. 2022;13:854949. https://doi.org/10.3389/fphys.2022.854949
Xie Q, Liu R, Jiang J, Peng J, Yang C, Zhang W, et al. What is the impact of human umbilical cord mesenchymal stem cell transplantation on clinical treatment? Stem Cell Res Ther. 2020 Dec 1;11(1):519. https://doi.org/10.1186/s13287-020-02011-z
Cengiz T, Kaya E, Oral DY, Ozakca I, Bayatli N, Karabay AZ, et al. Intracavernous Injection of Human Umbilical Cord Blood Mononuclear Cells Improves Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats. J Sex Med. 2017 Jan;14(1):50–8. https://doi.org/10.1016/j.jsxm.2016.11.314
Mukti AI, Ilyas S, Warli SM, Putra A, Rasyid N, Munir D, et al. Umbilical Cord-Derived Mesenchymal Stem Cells Improve TGF-β, α-SMA and Collagen on Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats. Med Arch Sarajevo Bosnia Herzeg. 2022 Feb;76(1):4–11. https://doi.org/10.5455/medarh.2022.76.4-11
Feng H, Liu Q, Deng Z, Li H, Zhang H, Song J, et al. Human umbilical cord mesenchymal stem cells ameliorate erectile dysfunction in rats with diabetes mellitus through the attenuation of ferroptosis. Stem Cell Res Ther. 2022 Sep 5;13(1):450. https://doi.org/10.1186/s13287-022-03147-w
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