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勃起功能障碍的再生疗法:当前全球实践趋势及全球男性健康联盟专家建议的调查

Regenerative Therapy in Erectile Dysfunction: A Survey on Current Global Practice Trends and GAF Expert Recommendations.

作者信息

Al Hashimi Manaf, Pinggera Germar-M, Mostafa Taymour, Rambhatla Amarnath, Hamoda Taha, Shah Rupin, Chung Eric, Harraz Ahmed, Arafa Mohamed, Toprak Tuncay, Raheem Omer, Giulioni Carlo, Birowo Ponco, Boeri Luca, Jassim Yassir, Kothari Priyank, Vishwakarma Ranjit, Sahin Bahadir, Atmoko Widi, Gamidov Safar, Rojas-Cruz Cesar, Katz Darren, Fregonesi Adriano, Gherabi Nazim, Zini Armand, Ho Christopher Chee Kong, Al-Marhoon Mohamed S, Martinez Marlon, Russo Giorgio Ivan, Rashed Ayman, Busetto Gian Maria, Ko Edmund, Park Hyun Jun, Cayan Selahittin, Saleh Ramadan, Rajmil Osvaldo, Kim Dong Suk, Colpi Giovanni, Smith Ryan, Ragab Maged, Kadioglu Ates, Nguyen Quang, Bocu Kadir, El-Sakka Ahmed, Thomas Charalampos, Alnajjar Hussain M, Alipour Hiva, Agarwal Ashok

机构信息

Department of Urology, Burjeel Hospital, Abu Dhabi, UAE.

Department of Clinical Urology, College of Medicine and Health Science, Khalifa University, Abu Dhabi, UAE.

出版信息

World J Mens Health. 2025 Apr;43(2):359-375. doi: 10.5534/wjmh.240086. Epub 2024 Jul 12.

Abstract

PURPOSE

This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.

MATERIALS AND METHODS

A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.

RESULTS

Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT's future use, despite pending guidelines support.

CONCLUSIONS

This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

摘要

目的

本研究旨在审视当前全球范围内用于治疗勃起功能障碍(ED)的再生疗法(RT)的实践情况,并针对其应用制定专家建议,以解决目前缺乏确凿证据和标准化指南的问题。

材料与方法

全球男科学论坛(GAF)的资深专家编制了一份包含39个问题的调查问卷,全面涵盖RT的临床方面。该问卷通过安全的在线谷歌表单,经由GAF网站、国际专业协会和社交媒体,在全球范围内分发给ED专家,对收集到的回复进行分析,并以百分比形式呈现频率。使用德尔菲法就RT应用的专家建议达成共识。

结果

来自62个国家的479名受访者中,三分之一报告使用过RT治疗ED。最常用的治疗方法是低强度冲击波疗法(54.6%),其次是富血小板血浆疗法(24.5%)及其联合疗法(14.7%),干细胞疗法使用最少(3.7%)。RT的主要适应证是磷酸二酯酶5抑制剂(PDE5i)难治或有不良反应的情况,中年及轻至中度ED患者的疗效最佳。受访者对其总体安全性有信心,尽管缺乏指南支持,但仍有相当一部分人对RT的未来应用表示感兴趣。

结论

这项首次开展的全球调查显示,RT在ED治疗中的应用日益增多,展示了其多样的临床应用及未来广泛应用的潜力。然而,缺乏全面的证据和明确的指南,需要进一步研究以规范RT在ED治疗中的实践应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b70/11937352/b085e6e25d6e/wjmh-43-359-g001.jpg

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