he problem of erectile dysfunction (ED) has had considerable attention during recent times. We are all familiar with the advent of Viagra, its widespread use and the subsequent marketing of other similar products. Technically, Viagra and its congeners are PDE5 - phosphodiesterase Type 5 - inhibitors, quite a mouthful. In general terms, PDE5 inhibitors improve erectile function by dispersion into the smooth muscle of the corpora cavernosa of the penis. This increased relaxation of the smooth muscle allows increased blood flow which in turn allows an erection to occur. Wikipedia provides a detailed explanation of the physiology involved in both males and females (1).
Recently, active medical minds have turned to the most common current form of increasing blood flow to other parts of the human body, namely the placement of stents in various arteries of the body - mostly, the coronary arteries of the heart, but also the carotid arteries that supply the brain, the abdominal aorta and its tributaries, the femoral arteries that supply the legs.
The vascular supply to the genital area goes via the pudendal arteries (see figure). Rogers and colleagues (2) have collected data by means of pelvic angiography and selective visualization of the male genital circulation (see illustration). Without going into too much medical jargon, the penis is supplied by the left and right internal pudendal arteries, which are branches of the left and right internal iliac arteries. Just as cholesterol can accumulate in the walls of coronary arteries, it can also accumulate in the walls of the internal pudendal arteries. Rogers' study showed a 100% correlation in patients with coronary artery disease i.e., 100% of patients with CAD (coronary artery disease) also had internal pudendal arteriosclerosis resulting in ED.
2. Pelvic angiography in non-responders to PDE5 inhibitors http://clinicaltrials.gov/ct2/show/NCT00574184