Abstract
Erectile dysfunction (ED) is one of the most common conditions affecting the sexual lives of middleaged and older men. The pathophysiology of penile erection is rather complex and concerns many specialists, such as andrologists, urologists, endocrinologists, and cardiologists. Recently, there has been a significant increase in our understanding of ED, detailed up to the gene and molecular level. Therefore, treatments for this disease are also more advanced and comprise numerous novel medications and therapies such as oral medications with phosphodiesterase type 5 inhibitor and modern penile prosthesis implantation. However, these therapeutic approaches have an impact in relieving the symptoms of ED and have not thoroughly resolved their reasons. Regenerative therapeutics including intracavernosal injection with platelet-rich plasma and stem cell therapy have gained considerable attention because of their ability to generate new penile tissue as well as reverse ED. The use of these novel ED treatments is emerging due to their safety and long-term efficacy based on substantial preclinical evidence. However, only a few clinical trials have been conducted and demonstrate promising outcomes. This article will briefly review the scientific evidence on these regenerative therapeutics for ED.
Highlights
The four sequential phases in the sexual response cycle consist of desire, arousal, orgasm, and resolution
The results showed an improvement in the International Index of Erectile Function (IIEF) score of an average of 4.14 points after PRF matrix (PRFM) injection
Ruffo et al reported that the patient group treated with a combination of low-intensity extracorporeal shock wave therapy (LiSWT) and autologous Platelet-rich plasma (PRP) for Erectile dysfunction (ED) had improved IIEF scores and peak systolic velocity (PSV) of the cavernosal artery compared with the group treated with only LiSWT after 12 weeks of follow-up 39
Summary
The four sequential phases in the sexual response cycle consist of desire, arousal, orgasm, and resolution. Erectile dysfunction (ED) is a disorder of the arousal phase and can be defined as the “inability to attain and/or maintain an erection sufficient for satisfactory sexual intercourse” 1. The prevalence of ED increases as men age, and about 20–30% of adult men have at least one episode of sexual dysfunction 4,5. Erection is a neurovascular event that simultaneously involves neural integrity, a functional vascular system as well as healthy cavernosal tissues. The corpora cavernosa, which consists of sinusoids covered by a layer of endothelial cells (ECs), a multilayer of cavernous smooth muscle cells (CSMCs), and the cavernous nerves (CNs), plays an integral role therein. The contractile systems (RhoA/Rho-kinase, α-adrenergic, endothelin, angiotensin, and thromboxane A2) oppose the vasodilatory second-messenger systems (adenylate cyclasecyclic AMP and guanylate cyclase-cyclic GMP) and participate in controlling cavernosal smooth muscle
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