Tag: shockwave therapy

  • Updated Algorithm for the Treatment of ED

    Updated Algorithm for the Treatment of ED

    Treatment algorithm for erectile dysfunction, page 1 of 4

    Treatment algorithm for erectile dysfunction, page 2 of 4

    Treatment algorithm for erectile dysfunction, page 3 of 4

    Treatment algorithm for erectile dysfunction, page 4 of 4

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    References Regarding the Above Algorithm

    Abdelrahman, Islam Fathy Soliman, Amr Abdel Raheem, Yaser Elkhiat, Abdelrahman A. Aburahma, Tarek Abdel-Raheem, and Hussein Ghanem. “Safety and Efficacy of Botulinum Neurotoxin in the Treatment of Erectile Dysfunction Refractory to Phosphodiesterase Inhibitors: Results of a Randomized Controlled Trial.” Andrology 10, no. 2 (2022): 254–61. https://doi.org/10.1111/andr.13104.
    Ausó, Eva, Violeta Gómez-Vicente, and Gema Esquiva. “Visual Side Effects Linked to Sildenafil Consumption: An Update.” Biomedicines 9, no. 3 (March 12, 2021): 291. https://doi.org/10.3390/biomedicines9030291.
    Chung, Eric. “Medical Sciences A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction,” 2019, 1–11.
    Costa, Pierre, Gilles Grandmottet, Hien Duc Mai, and Stéphane Droupy. “Impact of a First Treatment with Phosphodiesterase Inhibitors on Men and Partners’ Quality of Sexual Life: Results of a Prospective Study in Primary Care.” The Journal of Sexual Medicine 10, no. 7 (July 2013): 1850–60. https://doi.org/10.1111/jsm.12186.
    El-Shaer, Waleed, Hussein Ghanem, Tamer Diab, Ahmed Abo-Taleb, and Wael Kandeel. “Intra-Cavernous Injection of BOTOX® (50 and 100 Units) for Treatment of Vasculogenic Erectile Dysfunction: Randomized Controlled Trial.” Andrology 9, no. 4 (2021): 1166–75. https://doi.org/10.1111/andr.13010.
    El‐Shaer, Waleed, Hussein Ghanem, Tamer Diab, Ahmed Abo‐Taleb, and Wael kandeel. “Intra‐cavernous Injection of BOTOX ® (50 and 100 Units) for Treatment of Vasculogenic Erectile Dysfunction: Randomized Controlled Trial.” Andrology 9, no. 4 (July 2021): 1166–75. https://doi.org/10.1111/andr.13010.
    Medscape. “Erectile Dysfunction Drugs Linked With Risk for Eye Problems.” Accessed June 12, 2022. http://www.medscape.com/viewarticle/972431.
    Mulhall, John P. “Deciphering Erectile Dysfunction Drug Trials.” Journal of Urology 170, no. 2 (August 2003): 353–58. https://doi.org/10.1097/01.ju.0000063377.12281.57.
    “Placebo Responses Among Men With Erectile Dysfunction Enrolled in Phosphodiesterase 5 Inhibitor Trials: A Systematic Review and Meta-Analysis | Clinical Pharmacy and Pharmacology | JAMA Network Open | JAMA Network.” Accessed June 15, 2022. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2762993?widget=personalizedcontent&previousarticle=2792726.
    Siroky, Mike B., and Kazem M. Azadzoi. “Vasculogenic Erectile Dysfunction: Newer Therapeutic Strategies.” Journal of Urology 170, no. 2S (August 2003): S24–30. https://doi.org/10.1097/01.ju.0000075361.35942.17.
    Cayetano‐Alcaraz, Axel Alberto, Tharu Tharakan, Runzhi Chen, Nikolaos Sofikitis, and Suks Minhas. “The Management of Erectile Dysfunction in Men with Diabetes Mellitus Unresponsive to Phosphodiesterase Type 5 Inhibitors.” Andrology 11, no. 2 (February 2023): 257–69. https://doi.org/10.1111/andr.13257.
    Geelhoed, Jeannette P., Olivier Wegelin, Ellen Tromp, Bert‐Jan De Boer, Igle‐Jan De Jong, and Jack J. H. Beck. “Improvement in the Ability to Have Sex in Patients with Peyronie’s Disease Treated with Collagenase Clostridium histolyticum .” BJUI Compass 4, no. 1 (January 2023): 66–73. https://doi.org/10.1002/bco2.185.
    Lin, Haocheng, and Run Wang. “The Science of Vacuum Erectile Device in Penile Rehabilitation after Radical Prostatectomy.” Translational Andrology and Urology 2, no. 1 (2013).
    ———. “The Science of Vacuum Erectile Device in Penile Rehabilitation after Radical Prostatectomy.” Translational Andrology and Urology 2, no. 1 (2013).
    Welliver, R. Charles, Clay Mechlin, Brianne Goodwin, Joseph P. Alukal, and Andrew R. McCullough. “A Pilot Study to Determine Penile Oxygen Saturation Before and After Vacuum Therapy in Patients with Erectile Dysfunction After Radical Prostatectomy.” The Journal of Sexual Medicine 11, no. 4 (April 1, 2014): 1071–77. https://doi.org/10.1111/jsm.12445.
    Culha, Mehmet Gokhan, Erkan Erkan, Tugce Cay, and Uğur Yücetaş. “The Effect of Platelet-Rich Plasma on Peyronie’s Disease in Rat Model.” Urologia Internationalis 102, no. 2 (2019): 218–23. https://doi.org/10.1159/000492755.
    Geelhoed, Jeannette P., Olivier Wegelin, Ellen Tromp, Bert‐Jan De Boer, Igle‐Jan De Jong, and Jack J. H. Beck. “Improvement in the Ability to Have Sex in Patients with Peyronie’s Disease Treated with Collagenase Clostridium histolyticum .” BJUI Compass 4, no. 1 (January 2023): 66–73. https://doi.org/10.1002/bco2.185.
    Levine, Laurence A. “Peyronie’s Disease: Contemporary Review of Non-Surgical Treatment.” Translational Andrology and Urology 2, no. 1 (2013): 39–44. https://doi.org/10.3978/j.issn.2223-4683.2013.01.01.
    “Peyronie’s Disease in a Patient after COVID‐19 Infection_ A Case Report _ Enhanced Reader.” Accessed August 18, 2021. https://doi.org/10.1111/and.14219.
    Raheem, Amr Abdel, Giulio Garaffa, Tarek Abdel Raheem, Michelle Dixon, Amanda Kayes, Nim Christopher, and David Ralph. “The Role of Vacuum Pump Therapy to Mechanically Straighten the Penis in Peyronie’s Disease.” BJU International 106, no. 8 (2010): 1178–80. https://doi.org/10.1111/j.1464-410X.2010.09365.x.
    Safarinejad, M R. “Safety and Efficacy of Coenzyme Q10 Supplementation in Early Chronic Peyronie’s Disease: A Double-Blind, Placebo-Controlled Randomized Study.” International Journal of Impotence Research 22, no. 5 (2010): 298–309. https://doi.org/10.1038/ijir.2010.20.
    Virag, Ronald, Hélène Sussman, Sandrine Lambion, and Valérie de Fourmestraux. “Evaluation of the Benefit of Using a Combination of Autologous Platelet Rich-Plasma and Hyaluronic Acid for the Treatment of Peyronie’s Disease.” Sexual Health Issues 1, no. 1 (2017). https://doi.org/10.15761/SHI.1000102.
    Bosma-Den Boer, Margarethe M., Marie Louise Van Wetten, and Leo Pruimboom. “Chronic Inflammatory Diseases Are Stimulated by Current Lifestyle: How Diet, Stress Levels and Medication Prevent Our Body from Recovering.” Nutrition and Metabolism 9 (2012). https://doi.org/10.1186/1743-7075-9-32.
    Casabona, Francesco, Ilaria Gambelli, Federica Casabona, Pierluigi Santi, Gregorio Santori, and Ilaria Baldelli. “Autologous Platelet-Rich Plasma (PRP) in Chronic Penile Lichen Sclerosus: The Impact on Tissue Repair and Patient Quality of Life.” International Urology and Nephrology 49, no. 4 (April 2017): 573–80. https://doi.org/10.1007/s11255-017-1523-0.
    Chung. “A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction.” Medical Sciences 7, no. 9 (August 29, 2019): 91. https://doi.org/10.3390/medsci7090091.
    Chung, Eric. “Medical Sciences A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction,” 2019, 1–11.
    Everts, Peter, Kentaro Onishi, Prathap Jayaram, José Fábio Lana, and Kenneth Mautner. “Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020.” International Journal of Molecular Sciences 21, no. 20 (October 21, 2020): 7794. https://doi.org/10.3390/ijms21207794.
    Garcia, MM, TM Fandel, G Lin, AW Shindel, L Banie, CS Lin, and TF Lue. “Treatment of Erectile Dysfunction in the Obese Type 2 Diabetic ZDF Rat with Adipose Tissue-Derived Stem Cells,” 2010, 14.
    Israeli, Joseph M., Soum D. Lokeshwar, Iakov V. Efimenko, Thomas A. Masterson, and Ranjith Ramasamy. “The Potential of Platelet-Rich Plasma Injections and Stem Cell Therapy for Penile Rejuvenation.” International Journal of Impotence Research, November 6, 2021, 1–8. https://doi.org/10.1038/s41443-021-00482-z.
    Kumar, C.S. “265 Combined Treatment of Injecting Platelet Rich Plasma With Vacuum Pump for Penile Enlargement.” The Journal of Sexual Medicine 14, no. 1 (January 2017): S78. https://doi.org/10.1016/j.jsxm.2016.11.174.
    Lee, Ping-Jui, Yuan-Hong Jiang, and Hann-Chorng Kuo. “A Novel Management for Postprostatectomy Urinary Incontinence: Platelet-Rich Plasma Urethral Sphincter Injection.” Scientific Reports | 11 (123AD): 5371. https://doi.org/10.1038/s41598-021-84923-1.
    Littara, A., B. Palmieri, V. Rottigni, and T. Iannitti. “A Clinical Study to Assess the Effectiveness of a Hyaluronic Acid-Based Procedure for Treatment of Premature Ejaculation.” International Journal of Impotence Research 25, no. 3 (2013). https://doi.org/10.1038/ijir.2013.13.
    Liu, Ming-Che, Meng-Lin Chang, Ya-Chun Wang, Wei-Hung Chen, Chien-Chih Wu, and Shauh-Der Yeh. “Revisiting the Regenerative Therapeutic Advances Towards Erectile Dysfunction.” Cells 9, no. 5 (May 19, 2020): 1250. https://doi.org/10.3390/cells9051250.
    Masterson, Thomas A., Manuel Molina, Braian Ledesma, Isaac Zucker, Russell Saltzman, Emad Ibrahim, Sunwoo Han, Isildinha M. Reis, and Ranjith Ramasamy. “Platelet-Rich Plasma for the Treatment of Erectile Dysfunction: A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.” Journal of Urology, April 30, 2023, 10.1097/JU.0000000000003481. https://doi.org/10.1097/JU.0000000000003481.
    Matz, Ethan L, Amy M Pearlman, and Ryan P Terlecki. “Safety and Feasibility of Platelet Rich Fibrin Matrix Injections for Treatment of Common Urologic Conditions.” Investigative and Clinical Urology 59, no. 1 (January 2018): 61–65. https://doi.org/10.4111/icu.2018.59.1.61.
    ———. “Safety and Feasibility of Platelet Rich Fibrin Matrix Injections for Treatment of Common Urologic Conditions.” Investigative and Clinical Urology 59, no. 1 (January 2018): 61–65. https://doi.org/10.4111/icu.2018.59.1.61.
    Matz, Ethan L., Kyle Scarberry, and Ryan Terlecki. “Platelet-Rich Plasma and Cellular Therapies for Sexual Medicine and Beyond.” Sexual Medicine Reviews 10, no. 1 (January 2022): 174–79. https://doi.org/10.1016/j.sxmr.2020.07.001.
    Poulios, Evangelos, Ioannis Mykoniatis, Nikolaos Pyrgidis, Filimon Zilotis, Paraskevi Kapoteli, Dimitrios Kotsiris, Dimitrios Kalyvianakis, and Dimitrios Hatzichristou. “Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.” Journal of Sexual Medicine 18, no. 5 (May 1, 2021): 926–35. https://doi.org/10.1016/j.jsxm.2021.03.008.
    Raheem, Amr Abdel, Giulio Garaffa, Tarek Abdel Raheem, Michelle Dixon, Amanda Kayes, Nim Christopher, and David Ralph. “The Role of Vacuum Pump Therapy to Mechanically Straighten the Penis in Peyronie’s Disease.” BJU International 106, no. 8 (2010): 1178–80. https://doi.org/10.1111/j.1464-410X.2010.09365.x.
    Ruffo, A., M. Franco, E. Illiano, and N. Stanojevic. “Effectiveness and Safety of Platelet Rich Plasma (PrP) Cavernosal Injections plus External Shock Wave Treatment for Penile Erectile Dysfunction: First Results from a Prospective, Randomized, Controlled, Interventional Study.” European Urology Supplements 18, no. 1 (March 2019): e1622–23. https://doi.org/10.1016/S1569-9056(19)31175-3.
    Schirmann, A., E. Boutin, A. Faix, and R. Yiou. “Pilot Study of Intra-Cavernous Injections of Platelet-Rich Plasma (P-Shot®) in the Treatment of Vascular Erectile Dysfunction.” Progrès En Urologie, June 2022, S1166708722001300. https://doi.org/10.1016/j.purol.2022.05.002.
    Shaher, Hussein, Abdallah Fathi, Salah Elbashir, Shabieb A. Abdelbaki, and Tarek Soliman. “Is Platelet Rich Plasma Safe And Effective In Treatment Of Erectile Dysfunction? Randomized Controlled Study.” Urology, February 2023, S0090429523000742. https://doi.org/10.1016/j.urology.2023.01.028.
    Siroky, Mike B., and Kazem M. Azadzoi. “Vasculogenic Erectile Dysfunction: Newer Therapeutic Strategies.” Journal of Urology 170, no. 2S (August 2003). https://doi.org/10.1097/01.ju.0000075361.35942.17.
    ———. “Vasculogenic Erectile Dysfunction: Newer Therapeutic Strategies.” Journal of Urology 170, no. 2S (August 2003). https://doi.org/10.1097/01.ju.0000075361.35942.17.
    Towe, Maxwell, Akhil Peta, Russell G. Saltzman, Navin Balaji, Kevin Chu, and Ranjith Ramasamy. “The Use of Combination Regenerative Therapies for Erectile Dysfunction: Rationale and Current Status.” International Journal of Impotence Research, July 12, 2021, 1–4. https://doi.org/10.1038/s41443-021-00456-1.

  • Men’s Health Talks about the Priapus Shot® [P-Shot®] Procedure…

    Men's Health graphic of a balloon and a syringe

     

     

     


    Men’s Health     Talks about the Priapus Shot® Procedure Combined with Gains Wave™<–

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  • Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients With Vasculogenic Erectile Dysfunction: A Triplex Ultrasonography-Based Sham-Controlled Trial

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    This is a really important study, the Journal of Sexual Medicine July of this year, 2017. What these investigators did is they had two groups of men, 30 in one group and 16 in the sham side, and then they did penile triplex ultrasonography. And then they repeated it at three months after treatment. And then they accessed them at six months, nine months to twelve months.

    So, studies have been done like this before. Here’s one where they did the same thing, and other studies. And multiple studies now showing results, like this study they showed results with improvement of erectile dysfunction scale after low intensity shock-wave therapy. But this one, they actually have a new objective measure. And they measured blood flow. Let’s think a little bit about how they did, how they applied it and then I’ll give the results.

    If you look at the picture here, what they did was 300 shock waves here, here, here, here and here. So five locations. If they did 300 waves at 160 shock waves per minute, then it takes about 20 minutes to treat one person. And you can see the energy there that they use. So it’s about 1500 shocks. It sounds horrible —shocks— but if you’ve experienced it, it’s like someone tapping you with their finger, and not even in a very hard way, just a tap. No pain control is needed at all.

    Here’s what’s exciting. If you look at this… here’s baseline, one month. Here’s erectile function scale. That’s a huge jumpfrom baseline to one month. From an average around 12 or 15 up to around 20. And then, if you look, that’s sustained at a year. That’s impressive, it’s very impressive.

    Here we go. That gives you a look at it, in a bar graph. But this is what’s really interesting to me. This is what makes the study unique. Lots of study showing benefit from shockwave therapy, but in this one they show that maximum peak systolic velocity increases.

    You don’t have to look hard to see which one of these groups you want to be in. Obviously, there’s some outliers. For example, in this active group, I don’t know what happened here. And here’s one where he’s treated with a sham, and he went and got a new girlfriend or something. I don’t know what happened.

    But as a general rule, you can just see you want to be in this group, not this group. And that’s in three months with sustaining benefits. So, I don’t want to belabor this… just wanted to make you aware of it and let you know how we’re doing this now.

    There’s a protocol, one of our Priapus Shot® providers invented a more aggressive protocol (GainsWave) with excellent results, but most people are using the protocol in this paper. Who knows what the right protocol’s going to turn out to be? We’re still in that phase where we’re proving that it works, and not yet developing the nuances of what works best.

    The same way with the Priapus Shot®, in one of the urologists in our group, published findings showing decrease venous leak and increase arterial pressure at one of his big urology meetings with our Priapus Shot® procedure.

    The thing that’s different about both of these, versus what we have available, for example, Viagra or injecting a vasodilator, neither of those two things correct the problem. What’s exciting about this is we’re getting to the place where we’re getting to the etiology.

    Notice that in this treatment group, this guy didn’t get better. And nothing is 100% … remember, 20% of the people in the hospital with pneumonia still die but that does not mean antibiotics don’t work, it just means that some people are more complicated. And so, for example, if someone has vascular disease in the iliac arteries, not getting good blood flow to the penis, or his testosterone level is in the dirt, then this is not going to work as well.

    In this study, they selected all their inclusion and exclusion criteria and selected out supposedly for a lot of those things that would’ve sabotage it. For example, radical prostatectomy can’t be in the study, penile anatomic abnormalities, or hormone abnormalities can’t be in the study. But we don’t want to simplify this, and obviously make our patients think that this happens to everything. Jumping this much, that’s a change in your life. So, check out the links below here. I’ll keep them updated for where you can find providers who have this method, providers who can combine this method with a Priapus Shot®. If you’re a urologist or gynecologist or family practitioner, then I’ll put link below the video about where you can find training and where you can buy the materials needed, or when you can find materials to both do this procedure and materials and training to do the Priapus Shot®, in combination —it’s the bomb!

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