New Treatments for Erectile Dysfunction

Standard treatments for erectile dysfunction have been unchanged for 20 years. The first line treatment is an oral PDE-5 inhibitor: a pill, such as Viagra, Cialis, or their generic equivalents. Men who don't respond to PDE-5 inhibitors may use intracave ous penile injections of medications, a vacuum pump device, or an inflatable penile implant. Men with ED due to psychological causes may respond to counseling. None of these options is completely satisfactory, so there's a great deal of demand for new and more effective treatments. New treatments are currently under development, but they have not been approved by the US Food & Drug Administration (FDA). In some cases, there isn't much data available on their effectiveness and side effects. Gene Therapy Gene therapy involves inserting new genetic material into the patient's own cells. It has the potential to address several factors that contribute to ED, and early studies have been promising. However, it is in the early stages of clinical trials. Even if the potential pans out, it won't be available for years. Platelet-Rich Plasma (PRP) Injections PRP injections uses blood drawn from the patient. The blood is centrifuged to concentrate the platelets and growth factors, and then injected into the patient's penis. Proponents claim that this treatment can cure ED by healing nerves and blood vessels, and can even increase the size of the penis. PRP injections are widely available, often marketed by men's clinics under the brand name P-Shot® or Priapus-Shot®. There is very little clinical evidence that this treatment is effective. Dr. Sheldon Marks, writing on the WebMD website, states “there is no evidence to show it is scientifically proven to work as claimed and it has not been thoroughly tested for safety. Additionally, at a cost of several thousand dollars per shot, it’s an expensive gamble. Unless new research comes to light, I won’t be recommending this treatment to my patients.” Shockwave Therapy (LI-ESWT) Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) has been shown to promote healing and encourage the development of new blood vessels. The procedure is simple and painless; a portable device is applied directly to the penis. The treatment requires 2-3 treatment per week, for a period of 2-3 month; follow-up treatments may be required. A number of studies have shown positive results, especially for men with mild to moderate ED, so this is regarded as a promising treatment. The treatment is currently being offered by doctors and men's clinics, sometimes using the brand name GAINSWave®. The private medical clinics due not make their data available for peer-reviewed studies, so it's impossible to know if their claims are justified. Stem Cell Therapy Stem cell therapy uses stem cells derived from the patient's own body - typically fat cells. The cells are then injected into the patient's penis. Although this sounds similar to PRP injections, the two treatments rely on entirely different medical principles. And unlike PRP therapy, stem cells have shown very positive results in studies. Early human trials have been conducted, but this treatment will still not be available for several years. Topical Ointments Topical ointments or gels are massaged directly into the penis shortly prior to intercourse. They use the same active ingredients as intracave ous penile injections, a currently approved treatment for ED. The ointments have proven effective, but there are several problems, including losing effectiveness in storage, and rashes. These products are not currently available in the US, but may be approved once problems are worked out. Conclusions Shockwave therapy has shown promising results in clinical studies, and is currently available, though it's impossible to separate marketing claims from actual results. Topical ointments could be available very soon, depending on how long it takes to resolve current problems. Other promising treatments for ED are in the pipeline, but more study is needed before they are approved for use.