Global Andrology Forum Position Statements on Regenerative Therapies for Erectile Dysfunction

Area of Science:

• Andrology
• Regenerative Medicine
• Urology

Background:

• Phosphodiesterase type 5 inhibitors (PDE5i) are standard ED treatments, but some patients lack response or desire natural erection restoration.
• Regenerative therapies (RT), including low-intensity shock wave therapy (LiSWT), platelet-rich plasma (PRP), and stem cell therapy (SCT), offer potential alternatives for ED management.

Purpose of the Study:

• To review evidence on RT for ED and provide Global Andrology Forum (GAF) graded statements and recommendations.
• To establish expert consensus on the current role and future directions of RT in ED treatment.

Main Methods:

• A comprehensive literature review of PubMed and Scopus databases up to February 2025.
• A modified Delphi consensus method and expert surveys were used to develop and grade recommendations using the GRADE system.
• 36 GAF experts from 18 countries participated in the consensus process.

Main Results:

• 17 statements and recommendations were developed and graded, with 11 classified as 'strong' and 6 as 'weak'.
• Evidence suggests modest short-term benefits of LiSWT for mild-to-moderate vasculogenic ED in younger men.
• The efficacy of PRP and SCT for ED is currently uncertain, lacking robust evidence.

Conclusions:

• Current RT protocols for ED lack standardization and long-term effectiveness data.
• Further clinical trials are essential to validate the efficacy and safety of PRP and SCT for ED.
• Clinicians should exercise caution, avoid overstating RT benefits, and provide realistic prognoses to patients with ED.