Restorative Therapies for Erectile Dysfunction: Position Statement From the Sexual Medicine Society of North America (SMSNA)

James L. Liu, MD; Kevin Y. Chu, MD; Andrew T. Gabrielson, MD; Run Wang, MD; Landon Trost, MD; Gregory Broderick, MD; Kelvin Davies, PhD; Gerald Brock, MD; John Mulhall, MD; Ranjith Ramasamy, MD; Trinity J. Bivalacqua, MD, PhD

Sexual Medicine (Jun 2021)

Restorative Therapies for Erectile Dysfunction: Position Statement From the Sexual Medicine Society of North America (SMSNA)

James L. Liu, MD,
Kevin Y. Chu, MD,
Andrew T. Gabrielson, MD,
Run Wang, MD,
Landon Trost, MD,
Gregory Broderick, MD,
Kelvin Davies, PhD,
Gerald Brock, MD,
John Mulhall, MD,
Ranjith Ramasamy, MD,
Trinity J. Bivalacqua, MD, PhD

Affiliations

James L. Liu, MD: The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Kevin Y. Chu, MD: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
Andrew T. Gabrielson, MD: The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Run Wang, MD: Division of Urology, The University of Texas McGovern Medical School and Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Landon Trost, MD: Department of Urology, Mayo Clinic, Rochester, MN, USA; Brigham Young University, Provo, UT, USA
Gregory Broderick, MD: Department of Urology, Mayo Clinic Florida, Jacksonville, FL, USA
Kelvin Davies, PhD: Department of Urology and Department of Physiology and Biophysics, Albert Einstein College of Medicine, New York, NY, USA
Gerald Brock, MD: Division of Urology, Department of Surgery, Western University, London, ON, Canada
John Mulhall, MD: Sexual and Reproductive Medicine Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Ranjith Ramasamy, MD: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
Trinity J. Bivalacqua, MD, PhD: The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding Author: Trinity J. Bivalacqua, MD, PhD, The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Marburg 409, Baltimore, MD 21287, USA. Tel: 410-614-0197; Fax: 410-614-3695

Journal volume & issue: Vol. 9, no. 3
p. 100343

Abstract

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ABSTRACT: Introduction: Current non-invasive treatments for erectile dysfunction (ED) include oral medications, intracavernosal injections, and vacuum-assisted devices. Though these therapies work well for many, a subset of patients have contraindications or are unsatisfied with these options. Restorative therapies for ED are a new frontier of treatments focused on regenerating diseased tissue and providing a potential “cure” for ED. Aim: The aim of this position statement is to examine existing clinical trial data for restorative therapies and identify elements that require further research before widespread adoption. Methods: A literature review was performed to identify all clinical trials performed with regenerative therapy for ED. This includes treatments such as stem cell therapy (SCT), platelet rich plasma (PRP), and restorative related technologies like low-intensity shockwave therapy (LiSWT). Main Outcome Measures: Most clinical trials in restorative therapies were assessed for safety, feasibility, or efficacy. This included recording adverse events, changes in sexual function and erectile function questionnaires, and diagnostics measures. Results: To date there is an absence of robust clinical data supporting the efficacy of restorative therapies regarding ED, though technologies such as LiSWT have established relative safety. Conclusions: Restorative therapies are a promising technology that represents a new frontier of treatment geared towards reversing disease pathology rather than just treating symptoms. However, current published clinical studies are limited. Future work needs to be adequately powered, multi-center, randomized, sham/placebo-controlled trials in well-characterized patient populations to ensure safety and demonstrate efficacy. Until these studies are done, restorative therapies should be reserved for clinical trials and not offered in routine clinical practice. Liu JL, Chu KY, Gabrielson AT, et al. Restorative Therapies for Erectile Dysfunction: Position Statement From the Sexual Medicine Society of North America (SMSNA). J Sex Med 2021;9:100343

Published in Sexual Medicine

ISSN: 2050-1161 (Online)
Publisher: Oxford University Press
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://academic.oup.com/smoa

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