ED and presence of a flow limiting stenosis
Moreover, arterial lesions in the pudental arteries (penal erectile arteries) are much more common in men with ED than in the general population of a similar age. (24). Originally arterial disease was linked to ED by the French surgeon, Leriche in 1940. The cause for ED in such patients can be ascribed to the presence of a flow limiting stenosis (narrowing) caused by the artherosclerotic lesions, leading to a reduced blood flow to the corpus cavernosum (erectile tissue) during the erection process. This can lead to corporal veno-occlusive disorder (see below). Chronic ischaemia (oxygen deficiency) provoked by stenosis of the penile arteries is also associated with functional changes in the distal part of the penile vasculature such as decreased Nitric Oxide Synthase (NOS) activity and reduced endothelium dependent neurogenic NO-mediated relaxation in cavernosal tissue (25,26).
Vasculogenic and Drug Induced ED
Erectile dysfunction (ED) is more frequent in patients with other signs of artherosclerotic disease such as ischaemic heart disease and arterial leg disease (20-22) and erectile dysfunction and cardiovascular disease share the same risk factors such as hypertension, diabetes mellitus, hypercholesterolemia and smoking (23,21).