Erectile Dysfunction: Endothelial Function and Hormonal Interaction, Effects on Vascular Health - From Molecular Pathophysiology to Clinical Aspects -

This doctoral thesis explores the hormonal and vascular pathophysiological mechanisms underlying erectile dysfunction (ED) and their implications for advanced treatments. It identifies a significant correlation between a higher estradiol/testosterone ratio and the severity of ED in patients with Klinefelter syndrome. The study also finds an association between cardiovascular disease markers and erectile function tests, such as nocturnal erections and penile Doppler ultrasound, indicating a link with vascular risk profiles. Additionally, high satisfaction levels were observed in patients with psychogenic and organic ED after penile prosthesis implantation, suggesting that psychogenic etiology should not exclude this treatment option. Overall, the findings emphasize the need for a multidimensional approach to ED diagnosis and treatment, integrating pathophysiological evaluation into individualized clinical decision-making.