A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction

Chung, Eric

doi:10.3390/medsci7090091

Cited by 9 publications

(7 citation statements)

References 69 publications

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“…Platelets-rich plasma is another cellular therapy that has proved to be safe and effective in patients with ED [86,87]. This technique is still lacking standardization of procedure and dose [86].…”

Section: What Are the Other Lines And Combination Therapy?mentioning

confidence: 99%

Considerations for prescribing pharmacotherapy for the treatment of erectile dysfunction

Bakr

El-Sakka

El‐Sakka

2020

Expert Opinion on Pharmacotherapy

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Introduction:The effectiveness of phosphodiesterase type 5 inhibitors (PDE5i) in treating erectile dysfunction (ED) creates a new field of both medical practice and pharmaceutical manufacturing. Both paved the way for emerging minimally invasive therapies to restore male sexual function. However, what is the best drug to achieve the optimum outcome is still a challenging question to be answered. Areas covered:The general viewpoint of matching the pharmacotherapeutic characteristics with the patient's medical, social, and psychological variables, in order to balance between efficacy and safety. Several studies had investigated considerations for preference and long-term adherence for PDE5i. However, a thorough investigation of considerations for prescribing ED pharmacotherapy is still lacking in the literature. This is the aim of this manuscript. Expert opinion: Several issues should be considered in the planning of ED management such as the patient's and partner's expectations, etiologic considerations, performance status, safety, adverse effects, ease of administration, compliance, bad experiences with previous treatment, availability, cost, social factors, satisfaction, and finally, regimen considerations. Addressing the patient's and partner's individual needs help to tailoring treatment in order to minimize compromises and optimize gains.

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Section: What Are the Other Lines And Combination Therapy?mentioning

confidence: 99%

Considerations for prescribing pharmacotherapy for the treatment of erectile dysfunction

Bakr

El-Sakka

El‐Sakka

2020

Expert Opinion on Pharmacotherapy

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“…[38]- [40] Methods required for standardization of PRP processing and associated concentrations of growth factors, as well as more qualitative randomized control trials involving larger patient cohorts and subsequent long-term follow-up investigations are necessary to properly assess efficacy and safety of treatment in patient populations diagnosed with ED and other urologic conditions. [8], [41], [42]…”

Section: Safety Of Platelet-rich Plasma For Erectile Dysfunction Treatmentmentioning

confidence: 99%

Availability of platelet-rich plasma for treatment of erectile dysfunction and associated costs and efficacy: A review of current publications and Canadian data

Britt

Blankstein

Lenardis

et al. 2020

CUAJ

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Introduction: Platelet-rich plasma (PRP) is an increasingly used unconventional treatment option for erectile dysfunction (ED). The validity of PRP as a potential treatment for ED has been proposed in limited human trials. Furthermore, the costs associated with PRP for ED treatment are not readily promoted to patients. The goal of this review was to determine the efficacy and costs of PRP based on currently available literature and Canadian data. Methods: A comprehensive literature review of available PRP studies and current published data pertaining to cost, availability, and provider clinics globally was conducted using the PubMed database. Physicians offering genital PRP in Canada were identified using internet searches and PRP provider directories. Physician qualifications, clinic locations, and cost information were obtained from provider websites and telephone calls to identified clinics. Results: Availability of PRP injections offered for treating ED is increasing globally. There are currently no peer-reviewed publications to substantiate anecdotal evidence pertaining to the efficacy of PRP as a viable treatment option for ED patients. Our results indicate 19 providers for PRP injections in Canada, costing on average $1777 CAD per injection. No providers were affiliated with academic institutions and providers varied in their area of clinical speciality and training. Conclusions: To our knowledge, there is currently no research underway investigating the clinical efficacy of PRP for ED treatment despite its broad availability and significant cost. Patients should be informed of the lack of substantiated efficacy and safety data, as the reliability of PRP treatments requires further evaluation.

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“…Intracavernosal injection therapy (ICI) is an effective form of medication used to treat erectile dysfunction (ED), commonly serving as an alternative to oral ED medications, such as PDE5i therapy. 1 , 2 , 3 Current American Urological Association guidelines indicate that men with ED be informed regarding the option of ICI therapy for management and treatment. 4 Composition of these injections can vary, ranging from monotherapies, such as papaverine (non-selective PDE5i) and alprostadil (PGE1 stimulating cAMP release), to combination medications, such as Trimix (alprostadil, phentolamine (a non-selective alpha adrenergic antagonist), and papaverine) and Bimix (phentolamine, papaverine).…”

Section: Introductionmentioning

confidence: 99%

Complication Rates in Patients Using Intracavernosal Injection Therapy for Erectile Dysfunction With or Without Concurrent Anticoagulant Use—A Single-Center, Retrospective Pilot Study

et al. 2022

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Background Intracavernosal injection therapy (ICI) is an effective intervention used to treat erectile dysfunction (ED). It has been proposed that caution should be exercised when prescribing ICI to patients currently taking anticoagulants (AC) due to the theoretical increased risk of bleeding, however, there is limited literature describing complication rates of actively anticoagulated patients utilizing ICI. Aim We sought to determine whether there was a difference in bleeding and other complications in a cohort of patients using ICI therapy with or without concurrent AC use. Methods We reviewed our institutional electronic health record and identified 168 patients who were seen in our clinic from January to August 2020 who had either currently or previously utilized ICI therapy for ED treatment. These patients were surveyed regarding their ICI therapy as well as given the erectile dysfunction inventory for treatment satisfaction questionnaire. Data from 85 patients was obtained; 43 concurrently using AC during ICI therapy and 42 with no AC use. Fisher's exact test for categorical variables and a 2-tailed t-test were used with P < .05 considered to be significant. Outcome Documented bleeding events (eg, bruising, hematoma), complications, and mean erectile dysfunction inventory for treatment satisfaction scores were compared between the 2 groups. Results There were more absolute bleeding complications in the AC group vs the no AC group, with 3 of 43 AC patients (7%, 95% confidence interval: 2.4–18.6) and 0/42 no AC patients (0%, 95% confidence interval: 0–8.4) experiencing some type of bleeding complication on ICI. However, there was no statistically significant difference found in overall or stratified documented bleeding events and complications between the 2 groups. Clinical Implications Patients with concurrent AC usage on ICI therapy reported a higher rate of absolute bleeding complications than our non-AC group. Strengths and Limitations The strength of this study is addressing question of safety of ICI therapy in patients with concurrent AC usage. Limitations include single-center retrospective study design and underpowered sample size limiting confidence with which conclusions from data should guide future patient counseling regarding ICI risks. Conclusion Findings from a single-center cohort of patients suggest that ICI therapy may be a safe and effective treatment modality for ED in patients with concurrent anticoagulant usage, however, given the higher rate of absolute bleeding events in our AC cohort, future assessment in a higher-powered study is warranted in determining a more accurate estimation of risk or propensity for bleeding complications in patients on AC using ICI therapy.

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A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction

Cited by 9 publications

References 69 publications

Considerations for prescribing pharmacotherapy for the treatment of erectile dysfunction

Considerations for prescribing pharmacotherapy for the treatment of erectile dysfunction

Availability of platelet-rich plasma for treatment of erectile dysfunction and associated costs and efficacy: A review of current publications and Canadian data

Complication Rates in Patients Using Intracavernosal Injection Therapy for Erectile Dysfunction With or Without Concurrent Anticoagulant Use—A Single-Center, Retrospective Pilot Study

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