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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
The good, bad, and the ugly of regenerative therapies for erectile dysfunction
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<blockquote data-quote="madman" data-source="post: 175810" data-attributes="member: 13851"><p><strong>Abstract:</strong> 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.</p><p></p><p></p><p></p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">*</span><span style="color: rgb(0, 0, 0)">Platelet-rich plasma </span><span style="color: rgb(184, 49, 47)">(PRP) </span></strong></p><p></p><p><span style="color: rgb(184, 49, 47)"><strong>*</strong></span><span style="color: rgb(0, 0, 0)"><strong>Amniotic fluid matrices Despite</strong></span></p><p></p><p><span style="color: rgb(184, 49, 47)"><strong>*</strong></span><span style="color: rgb(0, 0, 0)"><strong>Low-intensity extracorporeal shock wave therapy </strong></span><span style="color: rgb(184, 49, 47)"><strong>(LiESWT)</strong></span></p><p><span style="color: rgb(184, 49, 47)"><strong></strong></span></p><p><span style="color: rgb(184, 49, 47)"><strong>*</strong></span><span style="color: rgb(0, 0, 0)"><strong>Stem cell therapy </strong></span><span style="color: rgb(184, 49, 47)"><strong>(SCT) </strong></span></p><p></p><p></p><p></p><p></p><p><strong>Conclusions </strong></p><p></p><p><span style="color: rgb(184, 49, 47)">A significant number of preliminary trials have been conducted in order to investigate the various regenerative therapies of ED.</span> <span style="color: rgb(184, 49, 47)"><strong>While on the surface these approaches seem promising, the data is not conclusive enough to recommend any regenerative medicine techniques in urology. </strong></span>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.</p></blockquote><p></p>
[QUOTE="madman, post: 175810, member: 13851"] [B]Abstract:[/B] 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. [B][COLOR=rgb(184, 49, 47)]*[/COLOR][COLOR=rgb(0, 0, 0)]Platelet-rich plasma [/COLOR][COLOR=rgb(184, 49, 47)](PRP) [/COLOR][/B] [COLOR=rgb(184, 49, 47)][B]*[/B][/COLOR][COLOR=rgb(0, 0, 0)][B]Amniotic fluid matrices Despite[/B][/COLOR] [COLOR=rgb(184, 49, 47)][B]*[/B][/COLOR][COLOR=rgb(0, 0, 0)][B]Low-intensity extracorporeal shock wave therapy [/B][/COLOR][COLOR=rgb(184, 49, 47)][B](LiESWT) *[/B][/COLOR][COLOR=rgb(0, 0, 0)][B]Stem cell therapy [/B][/COLOR][COLOR=rgb(184, 49, 47)][B](SCT) [/B][/COLOR] [B]Conclusions [/B] [COLOR=rgb(184, 49, 47)]A significant number of preliminary trials have been conducted in order to investigate the various regenerative therapies of ED.[/COLOR] [COLOR=rgb(184, 49, 47)][B]While on the surface these approaches seem promising, the data is not conclusive enough to recommend any regenerative medicine techniques in urology. [/B][/COLOR]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. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
The good, bad, and the ugly of regenerative therapies for erectile dysfunction
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