Erectile dysfunction occurs when a man is unable to obtain or maintain an erection sufficient for satisfactory sexual intercourse. The causes of an erection problem can be numerous and be linked to physical or psychological health, sometimes both.
Erectile dysfunction: what are the different possible treatments?
To fight against erectile dysfunction, men must implement a certain number of hygiene and diet rules in order to be in better overall health and reduce their cardiovascular risk: balancing diabetes, hypertension, stopping smoking, weight loss weight if necessary, practice regular physical activity, and possibly modify an iatrogenic treatment.
Furthermore, the management of these erectile disorders is based on several treatment axes. “The first consists of trying to quickly improve erectile function and therefore sexual intercourse with a standard treatment: IPDE5 tablets (phosphodiesterase type 5 inhibitors such as viagracialis, levitra or spedra), intra-urethral or intra-cavernosal injections of prostaglandins E1 or taking testosterone if a deficiency has been identified”, explains Dr Faix.
A new product against erectile dysfunction has also been available since February in France. This is a spray to be applied to the glans which would cause a local vasodilation reaction. Its mode of operation is quite similar to that of creams which must be placed in the urethra using an applicator. Very recent, this product is not reimbursed by Social Security and does not require a medical prescription.
What are the new treatments for erectile dysfunction?
“The third part opens with a new generation of treatments which aim to ‘rejuvenate’ erectile function through tissue regeneration of the corpora cavernosa”, explains the urologist. These new treatments are entirely the responsibility of the patient and are not reimbursed by Social Security. What are they ?
Corpora cavernosa shock wave therapy
This technique has existed since the 2010s and was developed by a team of Israeli urologists. “It is intended for patients whose erectile dysfunction is not too severe and in whom we will seek to improve basic erectile function 3 to 6 months after initial treatment.”, explains Dr. Faix. Shock wave therapy consists of carrying out 6 to 12 sessions of 10 to 15 minutes during which a probe which emits low intensity shock waves is in contact with the penis opposite the 2 corpora cavernosa. The process is painless and does not require anesthesia.
“The supposed principle of this technique is that it would stimulate stem cells to promote neoangiogenesis, that is to say the tissue repair of small blood vessels.”, specifies the urologist. The local vascular state of the penis could therefore be improved thanks to the restoration of the endothelial cells of the cavernous tissue. “According to the studies, the results are quite discordant. Some report an improvement of 60 to 70%, while others not at all”, nuance Dr Faix. In any case, you must wait 3 to 6 months to see if the treatment has worked.
Injections of PRP, platelet-rich plasma
The injection of PRP, platelet-enriched plasma, has already been used for around thirty years, particularly in sports medicine to promote healing or in the treatment of osteoarthritis. The indications are numerous, with variable results.
The patient’s blood is first centrifuged to separate the platelets, which contain tissue regeneration factors, from the rest of the blood elements (white and red blood cells). It is then reinjected into his penis after local anesthesia, during six injection cycles. “The patient is therefore his own medicine. It will thus receive massive and natural tissue regeneration factors in the cavernous tissues.”, explains the urologist. The latter specifies that the technique being recent, there is no clearly established protocol. “Recent studies are quite encouraging, although none of these options are magic, and PRP injection may improve some men partially in their basic erectile function”, he adds.
Botulinum toxin injections
Another very recent option and still under study: the injection of botulinum toxin (Botox) every six months into the corpora cavernosa. “Botulinum toxin is said to have a relaxing effect on the smooth muscle fibers of the corpora cavernosa. This method, which again is not magical, would improve two-thirds of men. observes Dr. Faix. The advantage of this technique is also that there would be no particular toxicity.
Thanks to Dr Antoine Faix, urological surgeon, andrologist and sexologist. Vice-President of the French Association of Urology (AFU).