In-office Therapies for Men with Erectile Dysfunction

madman

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Summary:

Jesse N. Mills, MD, discusses the effectiveness of a selection of experimental in-office therapies for erectile dysfunction treatment. Throughout his presentation, Dr. Mills explores the outlook, benefits, and challenges of experimental therapy options currently pushed by external market forces, including:

  • Low-intensity Shockwave Therapy (LiSWT)
  • Platelet-Rich Plasma (PRP)
  • Stem Cell Therapy
  • Intracavernosal Injection (ICI)
  • Hyperbaric Oxygen


Dr. Mills concludes by stressing that although these therapy options are still considered experimental, urologists should strive to observe these therapies and hold balanced conversations with patients regarding their efficacy. He encourages urologists to stay optimistic about erectile dysfunction treatment as stewards of male health, suggesting they watch for new data in the world of experimental treatments.
 
* Until these studies are done, restorative therapies should be reserved for clinical trials and not offered in routine clinical practice


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Radial Shockwave Therapy (RST)

* Still available, energy generated appears to be insufficient to stimulate much endothelial activity, enough said!




Low-intensity Shockwave Therapy (LiSWT)

* Gold standard

* Approved as first-line therapy in Europe

* Not FDA approved but FDA cleared, therefore no insurance code yet.


* CPT has been presented to AMA, we'll see.

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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