Extract

In 1992, nitric oxide (NO) was proclaimed the “molecule of the year” by Science magazine. Despite the apparent plainness of this chemical that simply combines the chemical elements nitrogen and oxygen, this tribute was hardly excessive. A spate of scientific work had led up to that event showing its remarkable, impactful role across diverse biological systems. Unprecedented as a gaseous molecular effector, NO was shown to operate in assorted scientific fields from immunology to vascular biology to neuroscience, among others. Now, nearly 30 years since its recognition as a major biologic regulator, NO remains relevant and even more distinctive in its scientific importance.

In sexual medicine, NO came onto the scene in the early 1990s, bringing excitement once it was realized that this molecule is the elusive chemical factor locally mediating penile erection.1–4 Prior to that time, the agency of this biological function was fundamentally related to the synergism of the vascular system (ie, blood flow effects in the penis) and the neurologic system (ie, impulse transmission of erectogenesis). But while the tissular components of penile erection were identified, no clear understanding existed as to what agent controlled penile erection—that is, how it was derived and released in the body and created the erection response.

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