Conclusion
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.
