Manfredi Celeste, Castiglione Fabio, Fode Mikkel, Lew-Starowicz Michal, Romero-Otero Javier, Bettocchi Carlo, Corona Giovanni
Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Urology, University College London Hospitals NHS Trust, London, UK.
Int J Impot Res. 2023 Dec;35(8):699-705. doi: 10.1038/s41443-022-00602-3. Epub 2022 Jul 27.
The significant discontinuation rate of available therapies and the paucity of curative options promoted the research on potential novel treatments suitable for erectile dysfunction patients. The aim of this study was to provide a summary of available evidence regarding the news and future perspectives related to the non-surgical treatment of erectile dysfunction. A narrative review of the literature was performed. A comprehensive search in the MEDLINE, Embase, and Scopus databases was done. Papers in English-language, published until April 2022, were included. No chronological restriction was applied. Retrospective and prospective clinical studies, as well as meta-analyses, were considered. Oro-dispersible formulations of phosphodiesterase type 5 inhibitors are particularly indicated in patients who have difficulty in swallowing solid dosage form; in addition, they constitute a discrete route of administration not requiring water. Low-intensity extracorporeal shock wave therapy is indicated in mild vasculogenic erectile dysfunction and in patients with vasculogenic erectile dysfunction poorly responsive to phosphodiesterase type 5 inhibitors. Stem cell therapy, platelet-rich plasma injections, and gene therapy seem promising regenerative treatments for selected patients with erectile dysfunction. Novel oral formulations of drugs commonly used in erectile dysfunction patients have recently become part of standard clinical practice. Regenerative treatments have been emerging in recent years and could become routine curative options in the near future. Further well-designed randomized controlled trials are needed to provide conclusive evidence on this topic and guide appropriate recommendations.
现有疗法的显著停药率以及治愈选择的匮乏推动了对适合勃起功能障碍患者的潜在新疗法的研究。本研究的目的是总结关于勃起功能障碍非手术治疗的最新情况和未来前景的现有证据。对文献进行了叙述性综述。在MEDLINE、Embase和Scopus数据库中进行了全面检索。纳入了截至2022年4月发表的英文论文。未应用时间顺序限制。纳入回顾性和前瞻性临床研究以及荟萃分析。5型磷酸二酯酶抑制剂的口腔崩解制剂特别适用于吞咽固体剂型有困难的患者；此外，它们构成了一种无需用水的独立给药途径。低强度体外冲击波疗法适用于轻度血管性勃起功能障碍以及对5型磷酸二酯酶抑制剂反应不佳的血管性勃起功能障碍患者。干细胞疗法、富血小板血浆注射和基因疗法似乎是针对特定勃起功能障碍患者的有前景的再生治疗方法。勃起功能障碍患者常用药物的新型口服制剂最近已成为标准临床实践的一部分。再生治疗近年来不断涌现，可能在不久的将来成为常规的治愈选择。需要进一步设计良好的随机对照试验来提供关于该主题的确凿证据并指导适当的建议。
