Mitochondrial transplantation-a novel therapeutic strategy for erectile dysfunction: a narrative review

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background and objective Phosphodiesterase-5 inhibitors (PDE5i) remain the first-line treatment for erectile dysfunction (ED). However, nearly 30% of ED patients exhibit inadequate responses or intolerable side effects. Emerging evidence indicates that mitochondrial dysfunction, characterized by bioenergetic failure, oxidative stress, and apoptosis, plays a pivotal role in the pathogenesis of ED. Methods This review employed a systematic literature search to comprehensively synthesize evidence on mitochondrial transplantation (MT) and mitochondrial dysfunction in the context of ED. Databases searched included PubMed, Embase, and Web of Science, covering publications from January 1, 2000 to July 1, 2025. Search strategies utilized keywords such as "mitochondrial transplantation", "erectile dysfunction", "mitochondrial dysfunction", "ROS", and "apoptosis", combined with Boolean operators (e.g., "mitochondrial transplantation AND erectile dysfunction" or "mitochondrial dysfunction OR apoptosis AND ED"). Key content and findings The search initially identified 1,247 abstracts, from which 289 full-text articles were retrieved and evaluated for eligibility, ultimately yielding 58 key references incorporated into this review. This review systematically examines the potential of MT as a novel therapeutic strategy in ED. In preclinical ED models, MT restored adenosine triphosphate (ATP)

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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