Saturday, April 5, 2014

New Advances in Erectile Technology (part 13)


The current treatment algorithm for ED as outlined by the AUA includes PDE5-I initially followed by intracavernosal injection (ICI), VED, intraurethral suppositories and penile prosthesis implantation (in no particular order). Today's treatment options are limited. As technological advancements are applied to the treatment of ED, patients will ultimately have a plethora of new management options. For now, the external penile support devices with their unique innovative designs deserve future exploration. The handheld penile vibrator may serve as a good option for penile rehabilitation because it increases the neurotransmitters from the cavernous nerve terminals that are involved in penile erection. LI-ESW appears to improve erectile function through recruitment of endogenous stem cells and it may give hope that ED may one day be curable. Tissue engineering will make biological reconstruction of the phallus possible and nanotechnology will revolutionize local therapies for ED in the very near future. With further improvement of endovascular technology, we may cure ED caused by focal vascular lesions. VED will continue to be a popular penile rehabilitation strategy as a recent animal study has clearly shown that VED increases arterial flow and oxygen to the penis and improves early return of erectile function after radical prostatectomy. Current penile implants will continue to provide the most satisfactory option for patients with severe ED. However, new implants may provide easier patient usage and easier implantation by surgeons. The future of technological advancements in the field of sexual medicine is bright, what technologies gain entrance into the medical field will depend upon their safety, efficacy and patient satisfaction. Hopefully, even using a smart phone app to control the Inflatable penile prosthesis (IPP) may be available in the very near future.



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