Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL 33136, United States.
Department of Urology, New York University Langone Health, New York, NY10016, United States.
Sex Med Rev. 2024 Jun 26;12(3):505-512. doi: 10.1093/sxmrev/qeae012.
Erectile dysfunction (ED) is a common condition that affects millions worldwide. Patients and urologists alike are seeking alternative therapies that can provide long-lasting results in the treatment of ED. This review provides a comprehensive overview of restorative treatments available for ED, such as platelet-rich plasma, stem cell therapy, and shockwave therapy.
The aim of this narrative review is to provide a primer for urologists and general practitioners on the basics of implementing ED restorative therapies in their practice.
The PubMed, MEDLINE, and Google Scholar databases were searched for articles in the English language through August 31, 2023, that included key terms such as "erectile dysfunction," "restorative therapy," "shockwave therapy," "platelet-rich plasma," "stem cell therapy," and "stromal vascular fraction." Reference lists of selected studies were manually reviewed to find articles not identified by the initial database search.
Shockwave therapy has demonstrated effectiveness in treating ED, with devices like the Medispec ED1000 and Storz Duolith showing statistically significant improvements in patient scores for International Index of Erectile Function (IIEF)-Erectile Function scores in clinical trials. In reported studies of platelet-rich plasma injections, a substantial percentage of patients reached a minimal clinically important difference in the IIEF-Erectile Function scale after treatment. Studies of ED treatment with stem cell therapy, while limited and with small sample sizes, have demonstrated encouraging improvements in patient scores for the abridged 5-item version of the IIEF after treatment.
Shockwave, platelet-rich plasma, and stem cell therapies are important, novel, noninvasive restorative treatments for ED that can provide relief for patients wishing to avoid a more invasive approach. While these therapies have shown promising results in clinical trials, more research is required to establish them as standardized and efficacious options in the management of ED.
勃起功能障碍（ED）是一种常见病症，影响着全球数百万人。患者和泌尿科医生都在寻求能够提供长期疗效的替代疗法。本综述全面介绍了可用于 ED 的修复治疗方法，如富含血小板的血浆、干细胞疗法和冲击波疗法。
本叙述性综述旨在为泌尿科医生和普通科医生提供关于在实践中实施 ED 修复疗法的基础知识。
通过 2023 年 8 月 31 日在 PubMed、MEDLINE 和 Google Scholar 数据库中搜索英文文献，使用的关键词包括“勃起功能障碍”、“修复疗法”、“冲击波疗法”、“富含血小板的血浆”、“干细胞疗法”和“基质血管成分”。手动查阅选定研究的参考文献，以找到未通过初始数据库搜索确定的文章。
冲击波疗法已被证明对 ED 有效，Medispec ED1000 和 Storz Duolith 等设备在临床试验中显示出患者国际勃起功能指数（IIEF）-勃起功能评分的统计学显著改善。在富含血小板的血浆注射治疗的报告研究中，相当比例的患者在 IIEF-勃起功能量表上达到了最小临床重要差异。虽然干细胞疗法治疗 ED 的研究有限且样本量较小，但在治疗后，患者的 IIEF 缩短 5 项版本评分有令人鼓舞的改善。
冲击波、富含血小板的血浆和干细胞疗法是 ED 的重要、新颖、非侵入性修复治疗方法，可以为希望避免更具侵入性方法的患者提供缓解。虽然这些疗法在临床试验中显示出了有希望的结果，但仍需要更多的研究来确立它们作为 ED 管理的标准化和有效的选择。
