Men with erectile dysfunction (ED) are not alone. This condition affects men of all ages, and it can have a negative impact on their relationships.
Shockwave Therapy
Shock wave therapy is a noninvasive treatment that has been used for years in orthopedics to help heal musculoskeletal injuries. Recently, urologists have begun offering this treatment to men suffering from ED. It works by sending high-energy shock waves into the penis to stimulate blood flow. The pulsations cause the penis to expand and then contract, stimulating the body’s natural healing process to build new blood vessels in the area. This increases the size of the penis, allowing for a larger and longer-lasting erection. Other ED medicine like:
In a recent trial, doctors used the MoreNova shock wave device made by Direx to treat men with mild to moderate vasculogenic erectile dysfunction. The results were promising, indicating that low-intensity shock wave therapy might help restore erectile function in this group of men. The trial did not include a sham control group, however, to assess for placebo effects. Furthermore, the researchers do not know how long the benefits of shock wave therapy last in this group of patients.
There is another type of shock wave therapy that has been marketed for erectile dysfunction called acoustic radial shock wave therapy or GAINSWave. This device does not use the same technology as the focused shock wave therapy devices. Instead, it uses very soft acoustic waves that do not have enough power to cause any damage to the penis. There is also no medical evidence that this type of acoustic shock wave therapy improves erectile function.
Penis Transplants
A penis implant provides an alternative to other surgical solutions that involve a lengthy healing period and carry the risk of infection. The implant consists of two tubes (cylinders) that stretch to create an erection when the person is sexually stimulated. Its primary advantages include improved self-image, ability to orgasm and ejaculate without having to squirt urine and increased sexual satisfaction. Its disadvantages include scrotal discomfort, auto-inflation, device malfunction and a possible narrowing of the opening to the foreskin.
A 2014 South African patient was reported to have urinated and had intercourse five weeks after surgery. He also impregnated his girlfriend the following year. Unlike the patient in this case, however, his testicles were not removed, which may have allowed his own sperm to enter the donor's reproductive system and possibly lead to offspring with genetic material from the donor1.
The first U.S. transplant was performed in a male who had undergone a partial penectomy due to cancer. Cetrulo and his team successfully attached a donated penis, scrotum, and part of the abdominal wallopens in new tab to the patient, who now has normal urinary and sexual function. A second transplant by the same team in 2018opens in a new tab involved a male who lost his genitals in a bomb blast during his tour of duty in Afghanistan. The patient, who chose to remain anonymous, had good urethra and sexual function by post-operative day 6.
Gene Therapy
Gene therapy is an experimental procedure where doctors deliver a healthy copy of a gene to cells inside the body. This allows the cell to replace a damaged gene or inactivate a mutated one, and it can also introduce a new gene into the cell. In order to do this, the doctor uses a carrier called a vector which can be either a modified virus that does not cause disease or a circular DNA molecule (plasmid DNA). Non-viral delivery systems are also being researched.
Several studies have used different vectors to target the penis and enhance the expression of genes that are involved in erectile dysfunction. These genes include nitric oxide/cyclic guanosine monophosphate, adenosine triphosphate, RhoA/Rho-kinase, growth factors, ion channels, peptides and control of oxidative stress.
These gene therapies have been shown to improve erectile function in animal models. For example, intracavernous injection of adenoviral encoding for the pore-forming alpha subunit of human large-conductance calcium-sensitive K+ channel (KATP) enhanced ICP responses to cavernosal nerve stimulation in aged rats. It was also associated with increased KATP channel mRNA and cGMP expression in the cavernosa 82.
Other studies have used adenoviral gene encoding for neurotrophic factor protein to improve erectile function in animals following injury of the sacral parasympathetic neurons innervating the penis. This was associated with a preservation of the cellular morphology and a restoration of nitric oxide production in these neurons.
Stem Cell Regenerative Techniques
Stem cells are able to differentiate into different types of cells and have the potential to restore damaged tissue. They also have the ability to generate new cell structures, such as blood vessels, smooth muscle, and nerves. This means that stem cells could be used to treat erectile dysfunction by rebuilding the vascular structure of the penis or by stimulating the growth of smooth muscle.
Stem cell therapies have been successfully used to treat various autoimmune, cardiovascular, and neurological disorders. They have been proven to have anti-inflammatory, immunomodulatory (substance that suppresses or stimulates the immune system), and restorative properties. Since the 1990s, there have been several studies that have indicated that stem cells can help treat erectile dysfunction.
These cellular therapy techniques use autologous stem cells from the patient’s fat or bone marrow and inject them directly into the area of the erectile tissues in order to boost blood flow and improve erectile function. It has been shown that a significant number of men who underwent this treatment were able to achieve a resumption of normal sexual function.
However, there is a need for additional research to determine the best type of stem cell to be used in this particular context. It is important that the correct cell type be selected to ensure that it will have an optimal impact on erectile function.
