Erectile dysfunction (ED) is a common disease of the male reproductive system, which seriously affects the quality of life of patients and their partners. The pathogenesis of ED is still unclear, and it is mainly related to the nervous system, vascular system, drugs, spirit, and psychology. Despite the availability of several ED treatments, including PDE5-Is, ICI therapy with vasoactive substances, vacuum erection devices, and prosthetic implants, the proportion of patients who do not respond or are dissatisfied with clinically available treatments remains high. Studies have found that acupuncture has a significant effect on ED, which can significantly improve erectile ability and erectile quality, and improve the satisfaction of ED patients and their spouses with sexual life. At the same time, because of its good compliance, small economic burden, and high safety advantages, it is gradually recognized by the majority of patients in clinical practice. This article is a clinical original study. This study elaborates on the methods and procedures of acupuncture for ED, including patient selection, material preparation, surgical procedures, postoperative care, and precautions. The therapeutic efficacy of this approach was also evaluated.This study proposes and evaluates a standardized operation protocol for acupuncture treatment of ED and assesses its clinical efficacy in order to visualize this theory of ethnic medicine and promote its effective inheritance.

Erectile dysfunction (ED) is a common disease of the male reproductive system, which seriously affects the quality of life of patients and their partners. The pathogenesis of ED is still unclear, and it is mainly related to the nervous system, vascular system, drugs, spirit, and psychology. Despite the availability of several ED treatments, including PDE5-Is, ICI therapy with vasoactive substances, vacuum erection devices, and prosthetic implants, the proportion of patients who do not respond or are dissatisfied with clinically available treatments remains high. Studies have found that acupuncture has a significant effect on ED, which can significantly improve erectile ability and erectile quality, and improve the satisfaction of ED patients and their spouses with sexual life. At the same time, because of its good compliance, small economic burden, and high safety advantages, it is gradually recognized by the majority of patients in clinical practice. This article is a clinical original study. This study elaborates on the methods and procedures of acupuncture for ED, including patient selection, material preparation, surgical procedures, postoperative care, and precautions. The therapeutic efficacy of this approach was also evaluated.This study proposes and evaluates a standardized operation protocol for acupuncture treatment of ED and assesses its clinical efficacy in order to visualize this theory of ethnic medicine and promote its effective inheritance.

Diabetes mellitus-associated erectile dysfunction (DMED) is characterized by impaired nitric oxide signaling, microvascular injury, neuropathy, metabolic dysfunction, and cavernosal remodeling. These abnormalities may limit responses to phosphodiesterase type 5 inhibitors and compromise regenerative treatment. This focused narrative review examines the potential of nanotherapeutic delivery and microenvironment modulation to address these pathological barriers. We discuss catalytic nanozymes, hypoxia/reactive oxygen species-responsive neurotrophic constructs, mitochondria-targeted piezoelectric systems, fructose-1,6-bisphosphatase 1 (FBP1) mRNA-loaded lipid nanoparticles, and extracellular vesicle–hydrogel composites. By distinguishing cell experiments, interventions in diabetic animals, human observational studies, and early clinical experience with related non-nanoparticle interventions, we compare representative platforms in terms of mechanism, administration route, functional endpoints, biodistribution, duration of effect, and safety. Human functional studies provide strong evidence for impaired nitric oxide signaling, whereas therapeutic strategies targeting lactate metabolism, lactylation, ferroptosis, and mitochondrial turnover remain predominantly at the preclinical stage. We further discuss the potential value of candidate clinical phenotypes and exploratory biomarkers for future patient stratification and examine key translational challenges, including local dosing feasibility, off-target exposure, repeated-dose immunogenicity, reproductive safety, and manufacturing consistency. Overall, current findings provide a mechanistic rationale and research direction for further development of DMED nanotherapies. Further preclinical validation and clinical studies are needed to establish their efficacy, safety, and potential advantages over standard treatment.