New Treatments for Erectile Dysfunction

Over 30 million men in the US alone have erectile dysfunction. There are a number of treatments that are safe and effective for most men. These treatments include:

• Oral medications (PDE5 inhibitors) such as Viagra, Levitra, Cialis, Stendra, and their generic equivalents

• Intracavernous penile injections

• Vacuum pumps

• Penile implants

All of these treatments have been available for at least 20 years, and doctors are familiar with them.

More recently, there have been a number of new treatments developed. Some are promising, and some not-so-promising, but all should be considered experimental.

The Sexual Medicine Society of North America (SMSNA) has issued a position statement on the use of “regenerative” therapies for erectile dysfunction, including shock wave, platelet rich plasma, and stem cell treatments.

The new, experimental therapies include:

Functional Electrical Stimulation (FES)

In a small trial, periodic electrical stimulation of the penis showed statistically-significant improvement among patients.

FES should not be confused with Transcutaneous Electrical Nerve Stimulation (TENS) devices, which are intended for home use for pain relief, and are not effective in creating ED.

Verdict:  Promising, but more trials are needed.

Very early trials have shown statistically-significant improvement among patients.

Verdict:  Promising, but more trials are needed.  Probably years away from widespread use.

Platelet-Rich Plasma (PRP) Injection Therapy

PRP injection therapy uses the patient’s own blood to treat ED.  Blood is drawn from the patient and placed in a centrifuge to concentrate the platelets and growth factors, which are then injected into the patient's penis.

This therapy is being heavily promoted (often using the brand-names Priapus Shot® and P-Shot®) as a treatment for ED, and even to enlarge penis size, but the benefits are not supported by independent clinical trials.

Verdict:  Don't waste your money.

Shockwave Therapy (LI-ESWT)

Low-Intensity Extracorporeal Shockwave Therapy involves using a device that produces high-frequency sound waves to promote tissue regeneration in the penis.

There have been a number of trials that have shown good results, although the benefits of the therapy seem to decline after about 6 months.  

LI-ESWT therapy is marketed under various brand names, including GAINSWave®, REGENAWAVE®,  and SONICWAVE™, each with their own treatment protocol.

Verdict:  Benefits are well-established, but use caution when choosing a provider.

Stem Cell Therapy

Like gene therapy, very early studies have shown benefits, but more study is needed.

Verdict:  Promising, but more trials are needed.  Probably years away from widespread use.


Conclusion

There are a number of new therapies that may revolutionize the treatment of erectile dysfunction.  Unfortunately, some of these treatments are being rushed to market without full clinical trials.

Shockwave therapy seems to be effective and is likely to help many patients.

There is no evidence, however, that PRP injections work.   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.”





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