The majority of men who undergo radical prostatectomy for the treatment of prostate cancer will suffer from erectile dysfunction due to disruption of the cavernous nerve. This nerve has been identified as responsible for penile erection. The oral erectogenic PDE5 (phosphodiesterase-5) inhibitors like Viagra rely on the functioning of this nerve to provide the initial burst of nitric oxide (NO) necessary to initiate an erection. Several other patient groups, such as diabetics, where endothelial nitric oxide production is impaired are also refractory to orally administered PDE5 inhibitors.
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