n engl j med 361;19 nejm.org november 5, 2009 1864 This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are prese...

Selective phosphodiesterase type-5 (PDE5) inhibitors such as sildenafil, vardenafil and tadalafil are commonly used first-line therapy for erectile dysfunction (ED). The safety and high tolerability of these drugs has garnered substantial interest among researchers to investigate further beneficial nonerectogenic uses for such drugs. PDE5 expression has shown to be increased in several human ma...