Advances in erectile dysfunction treatment research: a narrative review

Area of Science:

• Urology
• Andrology
• Regenerative Medicine

Background:

• Erectile dysfunction (ED) is a prevalent condition in aging men, with multifactorial causes including vascular, neurological, metabolic, and psychological elements.
• The incidence of ED is increasing and affecting younger populations, linked to psychological disorders, hypertension, cardiovascular diseases, and lifestyle factors.

Purpose of the Study:

• To review the physiological mechanisms of penile erection.
• To provide an in-depth analysis of current and emerging ED treatments.
• To critically evaluate the advantages and limitations of various therapeutic approaches.

Main Methods:

• Literature search conducted on PubMed, Google Scholar, and Web of Science.
• Keywords included "erectile dysfunction", "stem cells", "low-intensity extracorporeal shock wave", "low-intensity pulsed ultrasound", "PDE5 inhibitors", "gene therapy", "penile prosthesis implantation", and "psychosexual therapy".
• Collected literature published from January 1990 to October 2024.

Main Results:

• Reviewed major ED treatments: phosphodiesterase type 5 (PDE5) inhibitors, gene therapy, low-intensity extracorporeal shock wave therapy (Li-ESWT), low-intensity pulsed ultrasound therapy (LIPUS), and psychological treatments.
• Analyzed the benefits and drawbacks of each treatment modality.
• Identified key risk factors contributing to ED, including psychological issues, hypertension, CVDs, and lifestyle choices.

Conclusions:

• ED treatment technologies are improving patient outcomes.
• Combined treatment strategies are emerging as the mainstream approach for ED management.
• Future ED treatments will increasingly focus on personalization and precision medicine for optimal patient care.