Erectile dysfunction and Peyronie’s disease: from biologics to nanomedicine-enabled therapies

Introduction: Erectile dysfunction and Peyronie's disease are prevalent and frequently coexisting disorders in which guideline-based therapies improve symptoms more reliably than they reverse underlying corporal remodeling or tunical fibrosis. Regenerative biologics and nano-enabled delivery systems aim to intervene upstream in inflammatory and fibrotic pathways by improving local exposure, tissue persistence, and target engagement within the emerging field of regenerative sexual medicine. Objectives: To synthesize current evidence on regenerative biologics and nano-enabled delivery platforms for erectile dysfunction and Peyronie's disease, with emphasis on disease-specific delivery barriers, payload characterization, and translational readiness. Methods: This article was designed as a narrative translational review informed by a scoping search of PubMed/MEDLINE, Embase, and Web of Science (January 2000 to March 2025), supplemented by hand-searching of reference lists. Evidence was synthesized qualitatively by disease context (erectile dysfunction vs Peyronie's disease), payload class, delivery constraints, and translational maturity. Results: (CCH) remains the current clinical benchmark for plaque-targeted minimally invasive therapy in selected stable disease, whereas platelet-rich plasma and cell/vesicle-based approaches remain investigational. Across Peyronie's disease platforms, dense plaque architecture, restricted diffusion, and calcification constrain intralesional exposure, supporting plaque-confined depots, matrix-interactive materials, and targeted antifibrotic nanomedicines. Conclusion: Regenerative sexual medicine is evolving from empiric biologic injections toward better-characterized, anatomy-aligned, exposure-controlled therapeutic platforms, where durable clinical benefit will depend on sustained target engagement within penile tissues. Near-term progress is most likely through phenotype-enriched early-phase trials with rigorous sham-aware design and objective hemodynamic or imaging endpoints, whereas longer-term translation will depend on standardized potency assays, reproducible manufacturing, and durable penile tissue targeting.