Abstract
Erectile dysfunction adversely affects up to 20% of all men and is the most commonly treated sexual disorder. The public health implications of this condition are significant and represent a challenge for our healthcare system. The physiological pathways responsible for erections have been extensively studied, and much advancement has been made since the introduction of phosphodiesterase 5 inhibitors. Newer agents, such as dopaminergic and melanocortin receptor agonists, which target central erectogenic pathways, are under investigation. Newer formulations and delivery methods of existing medications such as alprostadil will also be introduced in the near future. Furthermore, low-intensity shockwave lithotripsy and stem cell regenerative techniques are innovative approaches to the treatment of erectile dysfunction.
Highlights
Erectile dysfunction (ED) is a prevalent condition among men that has significant public health implications, and is defined as the inability to initiate or maintain an erection that is satisfactory for sexual intercourse[1]
Stem cell transplant Stem cell therapy is a new treatment option that offers the potential to reverse the underlying causes of ED and reduce patient reliance on the transitory effects of phosphodiesterase 5 inhibitors (PDE5-Is) medications. It has been studied in several animal models in subjects who poorly respond to PDE5-Is
PDE5-Is have been the cornerstone of ED therapy and because of their effectiveness, the incentive to develop newer drugs has been lacking
Summary
Erectile dysfunction (ED) is a prevalent condition among men that has significant public health implications, and is defined as the inability to initiate or maintain an erection that is satisfactory for sexual intercourse[1]. SAR407899 is a more recently developed Rho-kinase inhibitor and has shown promising results in one study when compared to placebo and sildenafil In this phase II clinical trial, a single dose of SAR407899 was used to assess the increased duration of rigidity of erection. Stem cell transplant Stem cell therapy is a new treatment option that offers the potential to reverse the underlying causes of ED and reduce patient reliance on the transitory effects of PDE5-I medications It has been studied in several animal models in subjects who poorly respond to PDE5-Is (cavernous nerve injury and DM). Patients given the two highest doses of hMaxi-K had apparent sustained improvements in erectile function as indicated by improved IIEF domain scores over the length of the study This was a small study, but the encouraging safety profiles and effectiveness provide evidence that gene therapy is a viable option for the future. The role of stem cell regenerative therapy, in conjunction with gene therapy, will be heavily researched for the treatment of ED in the coming years
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