Abstract
PDE5 inhibitor is the only approved oral medication to treat erectile dysfunction (ED) in the US. However, there is a need for an alternative medication when PDE5 inhibitor treatment fails or there is a contraindication. The β3-adrenoceptor has been shown in human corpus cavernosum (CC). CC relaxation is induced by β3-adrenoceptor activation via cAMP-PKA dependent and/or cAMP-PKA independent pathway. Preclinical studies suggested mechanisms such as activation of K+ channels and closure of voltage-gated Ca2+ channels, cGMP accumulation by NO release and H2S pathway. However, the role of β3-adrenoceptor on penile erection in men is still unclear. Mirabegron is the first β3-adrenoceptor agonist that has been approved for the treatment of overactive bladder (OAB). The disorders of lower genitourinary tract such as OAB and ED share a common pathophysiologic mechanism. Mirabegron may act simultaneously in bladder and CC via β3-adrenoceptor activation and can offer a pharmacologic target for ED.
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