Botulinum Neurotoxin and Its Potential Role in the Treatment of Erectile Dysfunction

Sex Med Rev. 2018 Jan;6(1):135-142. doi: 10.1016/j.sxmr.2017.07.008. Epub 2017 Aug 23.


Introduction: Botulinum toxin type A (BoNT-A) has been used to treat several striated and smooth muscle disorders. During the past year, human and animal studies conducted in Egypt and Canada by two different groups of investigators have suggested a possible role for the intracavernosal injection of BoNT-A in the treatment of erectile dysfunction (ED).

Aim: To discuss BoNT-A and its current medical uses, the rationale for its new potential use in the treatment of ED, and the available evidence and concerns.

Methods: A literature search was conducted. This review was based on the available studies presented at the European Society for Sexual Medicine, Sexual Medicine Society of North America, and International Society for Sexual Medicine meetings in 2016 by the two groups.

Main outcome measures: Sinusoidal diameter; penile color Doppler study; Erection Hardness Score; Sexual Health Inventory for Men questionnaire; and Sexual Encounter Profile questions 2 and 3.

Results: Two human studies conducted by the authors and two animal studies (one from the authors' group and one from Canada) were reviewed. These seemed to suggest generally favorable outcomes with the use of BoNT-A in the treatment of ED.

Conclusion: BoNT-A could be a potential therapy for ED. In addition to the findings of the three pilot studies, larger multicenter trials need to be conducted to further explore the true therapeutic efficacy and clinical safety of BoNT-A in the treatment of ED. Ghanem H, Raheem AA, AbdelRahman IFS, et al. Botulinum Neurotoxin and Its Potential Role in the Treatment of Erectile Dysfunction. Sex Med Rev 2018;6:135-142.

Keywords: Botox; Botulinum Neurotoxin Type A; Erectile Dysfunction; Intralesional Treatment.

Publication types

  • Review

MeSH terms

  • Botulinum Toxins, Type A / therapeutic use*
  • Erectile Dysfunction / drug therapy*
  • Erectile Dysfunction / physiopathology
  • Erectile Dysfunction / psychology
  • Evidence-Based Medicine
  • Humans
  • Male
  • Neuromuscular Agents / therapeutic use*
  • Penile Erection / drug effects*
  • Penile Erection / physiology
  • Quality of Life
  • Treatment Outcome


  • Neuromuscular Agents
  • Botulinum Toxins, Type A