Treatments for ED:

Fifty years ago, psychotherapy was the mainstay treatment and undoubtedly was limited in its success. During the 1970s, penile prostheses combined with psychotherapy remained popular but relatively inaccessible. In the 1980s, intracavernosal injection (ICI) emerged, followed by intraurethral therapy in the mid-1990s. The true revolution in the non-surgical management of ED was with the introduction of oral phosphodiesterase type 5 inhibitors (PDE5Is) in the late 1990s and subsequently. PDE5Is rapidly became the patient-friendly method of ED treatment and are currently considered as first-line monotherapy; Other compounds are under development. However, PDE5I therapy does have limitations, especially for patients who may need organic nitrates for the treatment of Heart Conditions.

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Low-intensity extracorporeal shockwave therapy (LI-ESWT) has recently been used for treating ED. Clinical studies have shown that LI-ESWT has the potential to affect PDE5I non-responders, with few adverse effects. The mechanism of action of LI-ESWT for ED is related to increased expression of vascular endothelial growth factor (VEGF) smooth muscle and endothelial content through the recruitment of endogenous mesenchymal stem cells (MSCs).

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Stem-Cells for ED:

Recently, stem cell (SC) therapy has become a focus of experimental and clinical research for the treatment of ED. Numerous studies have investigated the capacity of SCs for both self-renewal and directed differentiation and hence have confirmed that SCs represent a great promise for regenerative medicine.

Mesenchymal Stem Cells (MSCs) have been shown to be able to functionally regenerate damaged tissues, depending on the stimuli or signals that they receive. Several types including bone-marrow MSCs, adipose tissue-derived SCs, and muscle-derived SCs, have been investigated for neural, vascular, endothelial, or smooth muscle regeneration in models of ED. Several studies have investigated the potential curative effect of MSCs with varying populations and strategies. Currently, SC therapy appears to be one of the most promising treatments of ED.