The good, bad, and the ugly of regenerative therapies for erectile dysfunction

[madman]

Abstract: Erectile dysfunction (ED) is a common condition which reduces quality of life of both patients and their partners, and is a significant health care expense every year. Although phosphodiesterase type 5 inhibitors are the current first-line treatment for men with ED, they are limited by their on-demand dosing, intolerance, and variable efficacy in complex patient populations such as men with multiple medical comorbidities or ED after pelvic surgery. Regenerative medicine has been introduced and investigated in andrology as an encouraging strategy to restore diseased erectile tissue structure and function. Novel regenerative therapies for ED are controversial but are perceived to offer a durable and safe tissue restorative approach to act as a long-term solution to this cumbersome disease process. Here, we review platelet-rich plasma, amniotic fluid membranes, low-intensity extracorporeal shockwave therapy, and stem cell therapy as regenerative strategies to treat ED. Most of these approaches have preclinical and occasionally clinical data to support their ongoing investigation; however, none of these treatments are currently supported for use in ED patients outside of clinical trials.





*Platelet-rich plasma (PRP)

*Amniotic fluid matrices Despite

*Low-intensity extracorporeal shock wave therapy (LiESWT)

*Stem cell therapy (SCT)




Conclusions

A significant number of preliminary trials have been conducted in order to investigate the various regenerative therapies of ED. While on the surface these approaches seem promising, the data is not conclusive enough to recommend any regenerative medicine techniques in urology. At the present time, patients should not be offered these therapies unless as part of a well-designed clinical trial (14). Additional RCTs with adequate controls, long follow-up periods, standardized protocols, and translatable patient populations are essential before any of these therapies can be part of our daily armamentarium.

 

[Golfboy307]

Thanks for posting Madman.. you find some terrific research articles. I had planned on writing a long review regarding shock wave therapy, but things are so crazy right now with shutdown.

At age 53, I have had mild ED issues for the last 6-7 years (mainly leakage). Going on TRT helped a bunch 4 years ago. Love the benefits. But I feel like I am always chasing that last 10% of EQ that gets me back to age 30 or so. Viagra works great for me, only 50mg is all I need for any duration. Cialis is kinda "meh". Hit or miss. I am in good shape, a runner, eat well etc. Mild hypertension controlled with lisinopril

By Body Logic doctor started offering Gainswave therapy last year. I would be one of his first patients on this machine, so he said I could do it "half price". Well now I was more interested! I did 10 treatments for $1,000. Seems like a lot, but I have seen some crazy prices ($300 to $500 per session). I will skip the details, but it really was a pretty minor deal. No side effects, other than numb for a couple of hours afterward due to the lidocaine.

Results: Amazing during the six weeks I was under treatment. Especially 24-48 hours right after treatment. Harder than I have been in awhile. I am about a month removed from the last session, and I think the results have faded somewhat. Now, I am under extreme stress right now as an essential worker working 16 hour days, so maybe that isn't fair. I will be interested to see what things are like in a month or two. I can tell you sure: something DEFINITELY happened with this treatment. I think the question is how long will it last... will keep you posted.

 

[DorianGray]

@Golfboy307 Great to see you have had positive results with this type of treatment. I've been following the research on this for a while now. It seems the latest evolution of this approach is what had been called "sparkwave" technology, now called "softwave" (probably scared people with the other name). This was developed in Germany and is now in the US. Irwin Goldstein, MD is using it and has been conducting a clinical trial. I contacted them but the distance was too far for me to participate. I would post a link to the device but not sure if it is allowed here. Personally I've become more optimistic about this therapy. I think venous leakage becomes an increasing factor in ED in older guys. It appears that this type of device may contribute to the development of collateral circulation and maybe other tissues through stem cell generation. For this reason, more longer term benefits would occur with repeated treatment. That would be my approach would be to do this every 3-6 months for a one or two year period. I think $1,000 for 10 treatments is reasonable.

 

[Golfboy307]

Thanks DG... my doctor is pretty conservative and doesn't jump into a lot of these newer treatments. He seems to think this will have decent long term results. I kind of view this as a physical therapy type treatment. Similar to if you are having joint problems. Something you could do repeatedly that might help over the long term.

I agree with you, I think "erection fade" becomes increasingly common as you age for a number of factors, even if you get pretty hard at the beginning. That is at least my main issue. As I mentioned, it sure helped during those 6 weeks I was doing the sessions.

I will wait to see if there are some more benefits over the next couple of months. I would mind doing at again since the sessions were harmless. As long as you don't mind having a medical professional handle your package!

 

[Dr.V.P.C.]

Does someboby have real self results with one of that home shockwave therapy ( like that " the rocket" ) or anothe one :?

 

[madman]

@Golfboy307 Great to see you have had positive results with this type of treatment. I've been following the research on this for a while now. It seems the latest evolution of this approach is what had been called "sparkwave" technology, now called "softwave" (probably scared people with the other name). This was developed in Germany and is now in the US. Irwin Goldstein, MD is using it and has been conducting a clinical trial. I contacted them but the distance was too far for me to participate. I would post a link to the device but not sure if it is allowed here. Personally I've become more optimistic about this therapy. I think venous leakage becomes an increasing factor in ED in older guys. It appears that this type of device may contribute to the development of collateral circulation and maybe other tissues through stem cell generation. For this reason, more longer term benefits would occur with repeated treatment. That would be my approach would be to do this every 3-6 months for a one or two year period. I think $1,000 for 10 treatments is reasonable.

erectile dysfunction due to cavernovenous leakage

Ultrasonography after pharmacological stimulation of erection for the diagnosis and therapeutic follow-up of erectile dysfunction due to cavernovenous leakage Summary The goal of this work was to demonstrate that Doppler ultrasound (DUS) after pharmacological stimulation of erection (PSE)...

www.excelmale.com

Erectile dysfunction (ED) is defined as the permanent or recurrent inability to achieve or maintain an erection of sufficient rigidity to permit satisfactory sexual activity. It is a frequent symptom more and more widely recognized and treated in numerous populations. Its prevalence increases with age in insofar as it presently affects more than 30% of men under 40 and more than 50% of men from 40 to 70 years of age [1]. It is a multifactorial pathology involving a mixture of functional (psychogenic) and organic (metabolic, neurovascular et endocrinal) aspects.

 

[bygeorge]

Does someboby have real self results with one of that home shockwave therapy ( like that " the rocket" ) or anothe one :?

I did the doctor directed Gainswave with no noticeable benefit.