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Erschienen in: Current Urology Reports 2/2021

01.02.2021 | Men's Health (R Carrion, Section Editor)

Alternative Treatment for Erectile Dysfunction: a Growing Arsenal in Men’s Health

verfasst von: Wade Muncey, Nicholas Sellke, Tyler Kim, Kirtishri Mishra, Nannan Thirumavalavan, Aram Loeb

Erschienen in: Current Urology Reports | Ausgabe 2/2021

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Abstract

Purpose of Review

To highlight and review encouraging preliminary studies behind several alternative products and interventions for erectile dysfunction (ED).

Recent Findings

Alternative treatments for ED are becoming more prevalent with increased consumer interest. “Natural” products are sold online, and numerous clinics offer various off-label and investigational interventions. These alternative treatments have demonstrated varying degrees of efficacy in randomized trials and meta-analyses, but none of these interventions has robust enough evidence to be considered first-line therapy. These treatments may find a role in combination with guideline treatments or may be used in novel penile rehabilitation research protocols.

Summary

With growing interest in alternative treatment for men’s health, an awareness of the literature is imperative for patient counsel. Alternative treatments, like l-arginine, have a growing body of evidence for efficacy in combination with PDE5i, and low-intensity shock wave therapy and stem cell therapy continue to demonstrate encouraging outcomes in ED trials.
Literatur
1.
Zurück zum Zitat Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120:151–7.PubMed Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120:151–7.PubMed
2.
Zurück zum Zitat Montorsi F, Adaikan G, Becher E, Giuliano F, Khoury S, Lue TF, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2010;7:3572–88.PubMed Montorsi F, Adaikan G, Becher E, Giuliano F, Khoury S, Lue TF, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2010;7:3572–88.PubMed
3.
Zurück zum Zitat Dunn KM, Croft PR, Hackett GI. Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. J Epidemiol Community Health. 1999;53:144–8.PubMedPubMedCentral Dunn KM, Croft PR, Hackett GI. Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. J Epidemiol Community Health. 1999;53:144–8.PubMedPubMedCentral
4.
Zurück zum Zitat Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200:633–41.PubMed Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200:633–41.PubMed
5.
Zurück zum Zitat Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol. 2010;58:243–8.PubMed Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol. 2010;58:243–8.PubMed
6.
Zurück zum Zitat Li H, Matheu MP, Sun F, Wang L, Sanford MT, Ning H, et al. Low-energy shock wave therapy ameliorates erectile dysfunction in a pelvic neurovascular injuries rat model. J Sex Med. 2016;13:22–32.PubMed Li H, Matheu MP, Sun F, Wang L, Sanford MT, Ning H, et al. Low-energy shock wave therapy ameliorates erectile dysfunction in a pelvic neurovascular injuries rat model. J Sex Med. 2016;13:22–32.PubMed
7.
Zurück zum Zitat Gotte G, Amelio E, Russo S, Marlinghaus E, Musci G, Suzuki H. Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment. FEBS Lett. 2002;520:153–5.PubMed Gotte G, Amelio E, Russo S, Marlinghaus E, Musci G, Suzuki H. Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment. FEBS Lett. 2002;520:153–5.PubMed
8.
Zurück zum Zitat Lu Z, Lin G, Reed-Maldonado A, Wang C, Lee YC, Lue TF. Low-intensity extracorporeal shock wave treatment improves erectile function: a systematic review and meta-analysis. Eur Urol. 2017;71:223–33.PubMed Lu Z, Lin G, Reed-Maldonado A, Wang C, Lee YC, Lue TF. Low-intensity extracorporeal shock wave treatment improves erectile function: a systematic review and meta-analysis. Eur Urol. 2017;71:223–33.PubMed
9.
Zurück zum Zitat Angulo JC, Arance I, de Las Heras MM, Meilán E, Esquinas C, Andrés EM. Efficacy of low-intensity shock wave therapy for erectile dysfunction: a systematic review and meta-analysis. Actas Urol Esp. 2017;41:479–90.PubMed Angulo JC, Arance I, de Las Heras MM, Meilán E, Esquinas C, Andrés EM. Efficacy of low-intensity shock wave therapy for erectile dysfunction: a systematic review and meta-analysis. Actas Urol Esp. 2017;41:479–90.PubMed
10.
Zurück zum Zitat Clavijo RI, Kohn TP, Kohn JR, Ramasamy R. Effects of low-intensity extracorporeal shockwave therapy on erectile dysfunction: a systematic review and meta-analysis. J Sex Med. 2017;14:27–35.PubMed Clavijo RI, Kohn TP, Kohn JR, Ramasamy R. Effects of low-intensity extracorporeal shockwave therapy on erectile dysfunction: a systematic review and meta-analysis. J Sex Med. 2017;14:27–35.PubMed
11.
Zurück zum Zitat Zou Z-J, Tang L-Y, Liu Z-H, Liang J-Y, Zhang R-C, Wang Y-J, et al. Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis. Int Braz J Urol. 2017;43:805–21.PubMedPubMedCentral Zou Z-J, Tang L-Y, Liu Z-H, Liang J-Y, Zhang R-C, Wang Y-J, et al. Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis. Int Braz J Urol. 2017;43:805–21.PubMedPubMedCentral
12.
Zurück zum Zitat Man L, Li G. Low-intensity extracorporeal shock wave therapy for erectile dysfunction: a systematic review and meta-analysis. Urology. 2018;119:97–103.PubMed Man L, Li G. Low-intensity extracorporeal shock wave therapy for erectile dysfunction: a systematic review and meta-analysis. Urology. 2018;119:97–103.PubMed
13.
Zurück zum Zitat • Campbell JD, Trock BJ, Oppenheim AR, Anusionwu I, Gor RA, Burnett AL. Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction. Ther Adv Urol. 2019;11:175628721983836 This recent meta-analysis rigorously investigated using LI-ESWT as a therapy for vasculogenic ED specifically. The meta-analysis showed statistically significant improvement in IIEF, along with an EHS ≥ 3. • Campbell JD, Trock BJ, Oppenheim AR, Anusionwu I, Gor RA, Burnett AL. Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction. Ther Adv Urol. 2019;11:175628721983836 This recent meta-analysis rigorously investigated using LI-ESWT as a therapy for vasculogenic ED specifically. The meta-analysis showed statistically significant improvement in IIEF, along with an EHS ≥ 3.
14.
Zurück zum Zitat Sokolakis I, Hatzichristodoulou G. Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials. Int J Impot Res. 2019;31:177–94.PubMed Sokolakis I, Hatzichristodoulou G. Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials. Int J Impot Res. 2019;31:177–94.PubMed
15.
Zurück zum Zitat Kalyvianakis D, Memmos E, Mykoniatis I, Kapoteli P, Memmos D, Hatzichristou D. Low-intensity shockwave therapy for erectile dysfunction: a randomized clinical trial comparing 2 treatment protocols and the impact of repeating treatment. J Sex Med. 2018;15:334–45.PubMed Kalyvianakis D, Memmos E, Mykoniatis I, Kapoteli P, Memmos D, Hatzichristou D. Low-intensity shockwave therapy for erectile dysfunction: a randomized clinical trial comparing 2 treatment protocols and the impact of repeating treatment. J Sex Med. 2018;15:334–45.PubMed
16.
Zurück zum Zitat Patel P, Katz J, Lokeshwar SD, Molina M, Reis IM, Clavijo R, et al. Phase II randomized, clinical trial evaluating 2 schedules of low-intensity shockwave therapy for the treatment of erectile dysfunction. Sex Med. 2020:1–9. Patel P, Katz J, Lokeshwar SD, Molina M, Reis IM, Clavijo R, et al. Phase II randomized, clinical trial evaluating 2 schedules of low-intensity shockwave therapy for the treatment of erectile dysfunction. Sex Med. 2020:1–9.
17.
Zurück zum Zitat Khattab AA, Brodersen B, Schuermann-Kuchenbrandt D, Beurich H, Tölg R, Geist V, et al. Extracorporeal cardiac shock wave therapy: first experience in the everyday practice for treatment of chronic refractory angina pectoris. Int J Cardiol. 2007;121:84–5.PubMed Khattab AA, Brodersen B, Schuermann-Kuchenbrandt D, Beurich H, Tölg R, Geist V, et al. Extracorporeal cardiac shock wave therapy: first experience in the everyday practice for treatment of chronic refractory angina pectoris. Int J Cardiol. 2007;121:84–5.PubMed
18.
Zurück zum Zitat Ter Haar G. Therapeutic ultrasound. Eur J Ultrasound. 1999;9:3–9.PubMed Ter Haar G. Therapeutic ultrasound. Eur J Ultrasound. 1999;9:3–9.PubMed
19.
Zurück zum Zitat Hanawa K, Ito K, Aizawa K, Shindo T, Nishimiya K, Hasebe Y, et al. Low-intensity pulsed ultrasound induces angiogenesis and ameliorates left ventricular dysfunction in a porcine model of chronic myocardial ischemia. PLoS One. 2014;9:e104863.PubMedPubMedCentral Hanawa K, Ito K, Aizawa K, Shindo T, Nishimiya K, Hasebe Y, et al. Low-intensity pulsed ultrasound induces angiogenesis and ameliorates left ventricular dysfunction in a porcine model of chronic myocardial ischemia. PLoS One. 2014;9:e104863.PubMedPubMedCentral
20.
Zurück zum Zitat Lei H, Xin H, Guan R, et al. Low-intensity pulsed ultrasound improves erectile function in Streptozotocin-induced type i diabetic rats. Urology. 2015;86:1241.e11–8. Lei H, Xin H, Guan R, et al. Low-intensity pulsed ultrasound improves erectile function in Streptozotocin-induced type i diabetic rats. Urology. 2015;86:1241.e11–8.
21.
Zurück zum Zitat • Cui W, Li H, Guan R, et al. Efficacy and safety of novel low-intensity pulsed ultrasound (LIPUS) in treating mild to moderate erectile dysfunction: a multicenter, randomized, double-blind, sham-controlled clinical study. Transl Androl Urol. 2019;8:307–19 This recent clinical study was the first to evaluate the efficacy of LIPUS as a therapeutic device for mild to moderate ED. The study had promising results with significantly higher IIEF-EF scores with the intervention compared to control.PubMedPubMedCentral • Cui W, Li H, Guan R, et al. Efficacy and safety of novel low-intensity pulsed ultrasound (LIPUS) in treating mild to moderate erectile dysfunction: a multicenter, randomized, double-blind, sham-controlled clinical study. Transl Androl Urol. 2019;8:307–19 This recent clinical study was the first to evaluate the efficacy of LIPUS as a therapeutic device for mild to moderate ED. The study had promising results with significantly higher IIEF-EF scores with the intervention compared to control.PubMedPubMedCentral
22.
Zurück zum Zitat Kim WS, Park BS, Sung JH, Yang JM, Park SB, Kwak SJ, et al. Wound healing effect of adipose-derived stem cells: a critical role of secretory factors on human dermal fibroblasts. J Dermatol Sci. 2007;48:15–24.PubMed Kim WS, Park BS, Sung JH, Yang JM, Park SB, Kwak SJ, et al. Wound healing effect of adipose-derived stem cells: a critical role of secretory factors on human dermal fibroblasts. J Dermatol Sci. 2007;48:15–24.PubMed
23.
Zurück zum Zitat Park JS, Suryaprakash S, Lao YH, Leong KW. Engineering mesenchymal stem cells for regenerative medicine and drug delivery. Methods. 2015;84:3–16.PubMedPubMedCentral Park JS, Suryaprakash S, Lao YH, Leong KW. Engineering mesenchymal stem cells for regenerative medicine and drug delivery. Methods. 2015;84:3–16.PubMedPubMedCentral
25.
Zurück zum Zitat Bochinski D, Lin GT, Nunes L, Carrion R, Rahman N, Lin CS, et al. The effect of neural embryonic stem cell therapy in a rat model of cavernosal nerve injury. BJU Int. 2004;94:904–9.PubMed Bochinski D, Lin GT, Nunes L, Carrion R, Rahman N, Lin CS, et al. The effect of neural embryonic stem cell therapy in a rat model of cavernosal nerve injury. BJU Int. 2004;94:904–9.PubMed
26.
Zurück zum Zitat Kendirci M, Trost L, Bakondi B, Whitney MJ, Hellstrom WJG, Spees JL. Transplantation of nonhematopoietic adult bone marrow stem/progenitor cells isolated by p75 nerve growth factor receptor into the penis rescues erectile function in a rat model of cavernous nerve injury. J Urol. 2010;184:1560–6.PubMedPubMedCentral Kendirci M, Trost L, Bakondi B, Whitney MJ, Hellstrom WJG, Spees JL. Transplantation of nonhematopoietic adult bone marrow stem/progenitor cells isolated by p75 nerve growth factor receptor into the penis rescues erectile function in a rat model of cavernous nerve injury. J Urol. 2010;184:1560–6.PubMedPubMedCentral
27.
Zurück zum Zitat Bahk JY, Jung JH, Han H, Min SK, Lee YS. Treatment of diabetic impotence with umbilical cord blood stem cell intracavernosal transplant: preliminary report of 7 cases. Exp Clin Transplant. 2010;8. Bahk JY, Jung JH, Han H, Min SK, Lee YS. Treatment of diabetic impotence with umbilical cord blood stem cell intracavernosal transplant: preliminary report of 7 cases. Exp Clin Transplant. 2010;8.
28.
Zurück zum Zitat Yiou R, Hamidou L, Birebent B, Bitari D, Lecorvoisier P, Contremoulins I, et al. Safety of intracavernous bone marrow-mononuclear cells for postradical prostatectomy erectile dysfunction: an open dose-escalation pilot study. Eur Urol. 2016;69:988–91.PubMed Yiou R, Hamidou L, Birebent B, Bitari D, Lecorvoisier P, Contremoulins I, et al. Safety of intracavernous bone marrow-mononuclear cells for postradical prostatectomy erectile dysfunction: an open dose-escalation pilot study. Eur Urol. 2016;69:988–91.PubMed
29.
Zurück zum Zitat Yiou R, Hamidou L, Birebent B, Bitari D, le Corvoisier P, Contremoulins I, et al. Intracavernous injections of bone marrow mononucleated cells for postradical prostatectomy erectile dysfunction: final results of the INSTIN clinical trial. Eur Urol Focus. 2017;3:643–5.PubMed Yiou R, Hamidou L, Birebent B, Bitari D, le Corvoisier P, Contremoulins I, et al. Intracavernous injections of bone marrow mononucleated cells for postradical prostatectomy erectile dysfunction: final results of the INSTIN clinical trial. Eur Urol Focus. 2017;3:643–5.PubMed
30.
Zurück zum Zitat Al Demour S, Jafar H, Adwan S, AlSharif A, Alhawari H, Alrabadi A, et al. Safety and potential therapeutic effect of two intracavernous autologous bone marrow derived Mesenchymal stem cells injections in diabetic patients with erectile dysfunction: an open label phase I clinical trial. Urol Int. 2018;101:358–65.PubMed Al Demour S, Jafar H, Adwan S, AlSharif A, Alhawari H, Alrabadi A, et al. Safety and potential therapeutic effect of two intracavernous autologous bone marrow derived Mesenchymal stem cells injections in diabetic patients with erectile dysfunction: an open label phase I clinical trial. Urol Int. 2018;101:358–65.PubMed
31.
Zurück zum Zitat Haahr MK, Jensen CH, Toyserkani NM, Andersen DC, Damkier P, Sørensen JA, et al. Safety and potential effect of a single intracavernous injection of autologous adipose-derived regenerative cells in patients with erectile dysfunction following radical prostatectomy: an open-label phase I clinical trial. EBioMedicine. 2016;5:204–10.PubMedPubMedCentral Haahr MK, Jensen CH, Toyserkani NM, Andersen DC, Damkier P, Sørensen JA, et al. Safety and potential effect of a single intracavernous injection of autologous adipose-derived regenerative cells in patients with erectile dysfunction following radical prostatectomy: an open-label phase I clinical trial. EBioMedicine. 2016;5:204–10.PubMedPubMedCentral
32.
Zurück zum Zitat Haahr MK, Harken Jensen C, Toyserkani NM, Andersen DC, Damkier P, Sørensen JA, et al. A 12-month follow-up after a single intracavernous injection of autologous adipose-derived regenerative cells in patients with erectile dysfunction following radical prostatectomy: an open-label phase I clinical trial. Urology. 2018;121:203.e6–203.e13. Haahr MK, Harken Jensen C, Toyserkani NM, Andersen DC, Damkier P, Sørensen JA, et al. A 12-month follow-up after a single intracavernous injection of autologous adipose-derived regenerative cells in patients with erectile dysfunction following radical prostatectomy: an open-label phase I clinical trial. Urology. 2018;121:203.e6–203.e13.
34.
Zurück zum Zitat Scott S, Roberts M, Chung E. Platelet-rich plasma and treatment of erectile dysfunction: critical review of literature and global trends in platelet-rich plasma clinics. Sex Med Rev. 2019;7:306–12.PubMed Scott S, Roberts M, Chung E. Platelet-rich plasma and treatment of erectile dysfunction: critical review of literature and global trends in platelet-rich plasma clinics. Sex Med Rev. 2019;7:306–12.PubMed
36.
Zurück zum Zitat Hall MP, Band PA, Meislin RT, Jazrawi LM, Cardone DA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009;17:602–8.PubMed Hall MP, Band PA, Meislin RT, Jazrawi LM, Cardone DA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009;17:602–8.PubMed
37.
Zurück zum Zitat Lee JW, Hyun Kwon O, Kim TK, Cho YK, Choi KY, Chung HY, et al. Platelet-rich plasma: quantitative assessment of growth factor levels and comparative analysis of activated and inactivated groups. Arch Plast Surg. 2013;40:530–5.PubMedPubMedCentral Lee JW, Hyun Kwon O, Kim TK, Cho YK, Choi KY, Chung HY, et al. Platelet-rich plasma: quantitative assessment of growth factor levels and comparative analysis of activated and inactivated groups. Arch Plast Surg. 2013;40:530–5.PubMedPubMedCentral
38.
Zurück zum Zitat Ding XG, Li SW, Zheng XM, Hu LQ, Hu WL, Luo Y. The effect of platelet-rich plasma on cavernous nerve regeneration in a rat model. Asian J Androl. 2009;11:215–21.PubMedPubMedCentral Ding XG, Li SW, Zheng XM, Hu LQ, Hu WL, Luo Y. The effect of platelet-rich plasma on cavernous nerve regeneration in a rat model. Asian J Androl. 2009;11:215–21.PubMedPubMedCentral
39.
Zurück zum Zitat Wu CC, Wu YN, Ho HO, Chen KC, Sheu MT, Chiang HS. The neuroprotective effect of platelet-rich plasma on erectile function in bilateral cavernous nerve injury rat model. J Sex Med. 2012;9:2838–48.PubMed Wu CC, Wu YN, Ho HO, Chen KC, Sheu MT, Chiang HS. The neuroprotective effect of platelet-rich plasma on erectile function in bilateral cavernous nerve injury rat model. J Sex Med. 2012;9:2838–48.PubMed
40.
Zurück zum Zitat Wu Y-N, Wu C-C, Sheu M-T, Chen K-C, Ho H-O, Chiang H-S. Optimization of platelet-rich plasma and its effects on the recovery of erectile function after bilateral cavernous nerve injury in a rat model. J Tissue Eng Regen Med. 2016;10:E294–304.PubMed Wu Y-N, Wu C-C, Sheu M-T, Chen K-C, Ho H-O, Chiang H-S. Optimization of platelet-rich plasma and its effects on the recovery of erectile function after bilateral cavernous nerve injury in a rat model. J Tissue Eng Regen Med. 2016;10:E294–304.PubMed
41.
Zurück zum Zitat Matz EL, Pearlman AM, Terlecki RP. Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions. Investig Clin Urol. 2018;59:61–5.PubMed Matz EL, Pearlman AM, Terlecki RP. Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions. Investig Clin Urol. 2018;59:61–5.PubMed
42.
Zurück zum Zitat Epifanova MV, Chalyi ME, Krasnov AO. Investigation of mechanisms of action of growth factors of autologous platelet-rich plasma used to treat erectile dysfunction. Urologiia. 2017:46–8. Epifanova MV, Chalyi ME, Krasnov AO. Investigation of mechanisms of action of growth factors of autologous platelet-rich plasma used to treat erectile dysfunction. Urologiia. 2017:46–8.
43.
Zurück zum Zitat Zorgniotti AW, Lizza EF. Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction. Int J Impot Res. 1994;6:33–5 discussion 36.PubMed Zorgniotti AW, Lizza EF. Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction. Int J Impot Res. 1994;6:33–5 discussion 36.PubMed
44.
Zurück zum Zitat Chen J, Wollman Y, Chernichovsky T, Iaina A, Sofer M, Matzkin H. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int. 1999;83:269–73.PubMed Chen J, Wollman Y, Chernichovsky T, Iaina A, Sofer M, Matzkin H. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int. 1999;83:269–73.PubMed
45.
Zurück zum Zitat Balasubramanian A, Thirumavalavan N, Srivatsav A, Yu J, Hotaling JM, Lipshultz LI, et al. An analysis of popular online erectile dysfunction supplements. J Sex Med. 2019;16:843–52.PubMed Balasubramanian A, Thirumavalavan N, Srivatsav A, Yu J, Hotaling JM, Lipshultz LI, et al. An analysis of popular online erectile dysfunction supplements. J Sex Med. 2019;16:843–52.PubMed
47.
Zurück zum Zitat Cui T, Kovell RC, Brooks DC, Terlecki RP. A urologist’s guide to ingredients found in top-selling nutraceuticals for men’s sexual health. J Sex Med. 2015;12:2105–17.PubMed Cui T, Kovell RC, Brooks DC, Terlecki RP. A urologist’s guide to ingredients found in top-selling nutraceuticals for men’s sexual health. J Sex Med. 2015;12:2105–17.PubMed
48.
Zurück zum Zitat Klotz T, Mathers MJ, Braun M, Bloch W, Engelmann U. Effectiveness of oral L-arginine in first-line treatment of erectile dysfunction in a controlled crossover study. Urol Int. 1999;63:220–3.PubMed Klotz T, Mathers MJ, Braun M, Bloch W, Engelmann U. Effectiveness of oral L-arginine in first-line treatment of erectile dysfunction in a controlled crossover study. Urol Int. 1999;63:220–3.PubMed
49.
Zurück zum Zitat Chang Rhim H, Kim MS, Park YJ, Choi WS, Park HK, Kim HG, et al. The potential role of arginine supplements on erectile dysfunction: a systemic review and meta-analysis. J Sex Med. 2019;16:223–34. Chang Rhim H, Kim MS, Park YJ, Choi WS, Park HK, Kim HG, et al. The potential role of arginine supplements on erectile dysfunction: a systemic review and meta-analysis. J Sex Med. 2019;16:223–34.
50.
Zurück zum Zitat • El Taieb M, Hegazy E, Ibrahim A. Daily oral L-arginine plus tadalafil in diabetic patients with erectile dysfunction: a double-blinded, randomized, controlled clinical trial. J Sex Med. 2019;16:1390–7 This recent study is among the first RCTs to evaluate a combination therapy of tadalafil and L-arginine for ED. The study found that the combination therapy increased IIEF-5 scores more than either tadalafil or L-arginine alone.PubMed • El Taieb M, Hegazy E, Ibrahim A. Daily oral L-arginine plus tadalafil in diabetic patients with erectile dysfunction: a double-blinded, randomized, controlled clinical trial. J Sex Med. 2019;16:1390–7 This recent study is among the first RCTs to evaluate a combination therapy of tadalafil and L-arginine for ED. The study found that the combination therapy increased IIEF-5 scores more than either tadalafil or L-arginine alone.PubMed
51.
Zurück zum Zitat Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: a prospective, Randomized Multicentre Study. Sex Med. 2020. https://doi.org/10.1016/j.esxm.2020.02.003. Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: a prospective, Randomized Multicentre Study. Sex Med. 2020. https://​doi.​org/​10.​1016/​j.​esxm.​2020.​02.​003.
52.
Zurück zum Zitat Mantovani F, Patelli E, Colombo F, Pozzoni F, Confalonieri S, Pisani E. Erectile dysfunction after non-nerve sparing radical pelvic surgery. Therapeutical experience with sildenafil and L-arginine evaluated by buckling test. Minerva Med. 2001;92:285–7.PubMed Mantovani F, Patelli E, Colombo F, Pozzoni F, Confalonieri S, Pisani E. Erectile dysfunction after non-nerve sparing radical pelvic surgery. Therapeutical experience with sildenafil and L-arginine evaluated by buckling test. Minerva Med. 2001;92:285–7.PubMed
53.
Zurück zum Zitat El-Wakeel LM, Fouad FA, Saleem MD, Saber-Khalaf M. Efficacy and tolerability of sildenafil/l-arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrology. 2020;8:143–7.PubMed El-Wakeel LM, Fouad FA, Saleem MD, Saber-Khalaf M. Efficacy and tolerability of sildenafil/l-arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrology. 2020;8:143–7.PubMed
54.
Zurück zum Zitat Morris SM. Enzymes of arginine metabolism. J Nutr. 2004;134:2743S–7S.PubMed Morris SM. Enzymes of arginine metabolism. J Nutr. 2004;134:2743S–7S.PubMed
55.
Zurück zum Zitat Curis E, Nicolis I, Moinard C, Osowska S, Zerrouk N, Bénazeth S, et al. Almost all about citrulline in mammals. Amino Acids. 2005;29:177–205.PubMed Curis E, Nicolis I, Moinard C, Osowska S, Zerrouk N, Bénazeth S, et al. Almost all about citrulline in mammals. Amino Acids. 2005;29:177–205.PubMed
56.
Zurück zum Zitat Rimando AM, Perkins-Veazie PM. Determination of citrulline in watermelon rind. J Chromatogr A. 2005;1078:196–200.PubMed Rimando AM, Perkins-Veazie PM. Determination of citrulline in watermelon rind. J Chromatogr A. 2005;1078:196–200.PubMed
57.
Zurück zum Zitat Schwedhelm E, Maas R, Freese R, Jung D, Lukacs Z, Jambrecina A, et al. Pharmacokinetic and pharmacodynamic properties of oral L-citrulline and L-arginine: impact on nitric oxide metabolism. Br J Clin Pharmacol. 2008;65:51–9.PubMed Schwedhelm E, Maas R, Freese R, Jung D, Lukacs Z, Jambrecina A, et al. Pharmacokinetic and pharmacodynamic properties of oral L-citrulline and L-arginine: impact on nitric oxide metabolism. Br J Clin Pharmacol. 2008;65:51–9.PubMed
58.
Zurück zum Zitat Wijnands KAP, Vink H, Briedé JJ, van Faassen EE, Lamers WH, Buurman WA, et al. Citrulline a more suitable substrate than arginine to restore no production and the microcirculation during endotoxemia. PLoS One. 2012;7:e37439.PubMedPubMedCentral Wijnands KAP, Vink H, Briedé JJ, van Faassen EE, Lamers WH, Buurman WA, et al. Citrulline a more suitable substrate than arginine to restore no production and the microcirculation during endotoxemia. PLoS One. 2012;7:e37439.PubMedPubMedCentral
59.
Zurück zum Zitat • Barassi A, Corsi Romanelli MM, Pezzilli R, Damele CAL, Vaccalluzzo L, Goi G, et al. Levels of L-arginine and L-citrulline in patients with erectile dysfunction of different etiology. Andrology. 2017;5:256–61 This study showed decreases in L-citrulline and L-arginine among patients with ED, specifically with an arteriogenic etiology. The study suggests that oral supplementation may reduce ED in these patients.PubMed • Barassi A, Corsi Romanelli MM, Pezzilli R, Damele CAL, Vaccalluzzo L, Goi G, et al. Levels of L-arginine and L-citrulline in patients with erectile dysfunction of different etiology. Andrology. 2017;5:256–61 This study showed decreases in L-citrulline and L-arginine among patients with ED, specifically with an arteriogenic etiology. The study suggests that oral supplementation may reduce ED in these patients.PubMed
60.
Zurück zum Zitat Cormio L, De Siati M, Lorusso F, Selvaggio O, Mirabella L, Sanguedolce F, et al. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology. 2011;77:119–22.PubMed Cormio L, De Siati M, Lorusso F, Selvaggio O, Mirabella L, Sanguedolce F, et al. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology. 2011;77:119–22.PubMed
61.
Zurück zum Zitat Hotta Y, Shiota A, Kataoka T, Motonari M, Maeda Y, Morita M, et al. Oral L-citrulline supplementation improves erectile function and penile structure in castrated rats. Int J Urol. 2014;21:608–12.PubMed Hotta Y, Shiota A, Kataoka T, Motonari M, Maeda Y, Morita M, et al. Oral L-citrulline supplementation improves erectile function and penile structure in castrated rats. Int J Urol. 2014;21:608–12.PubMed
62.
Zurück zum Zitat Shiota A, Hotta Y, Kataoka T, Morita M, Maeda Y, Kimura K. Oral l-citrulline supplementation improves erectile function in rats with acute arteriogenic erectile dysfunction. J Sex Med. 2013;10:2423–9.PubMed Shiota A, Hotta Y, Kataoka T, Morita M, Maeda Y, Kimura K. Oral l-citrulline supplementation improves erectile function in rats with acute arteriogenic erectile dysfunction. J Sex Med. 2013;10:2423–9.PubMed
63.
Zurück zum Zitat Shirai M, Hiramatsu I, Aoki Y, Shimoyama H, Mizuno T, Nozaki T, et al. Oral L-citrulline and transresveratrol supplementation improves erectile function in men with phosphodiesterase 5 inhibitors: a randomized, double-blind, placebo-controlled crossover pilot study. Sex Med. 2018;6:291–6.PubMedPubMedCentral Shirai M, Hiramatsu I, Aoki Y, Shimoyama H, Mizuno T, Nozaki T, et al. Oral L-citrulline and transresveratrol supplementation improves erectile function in men with phosphodiesterase 5 inhibitors: a randomized, double-blind, placebo-controlled crossover pilot study. Sex Med. 2018;6:291–6.PubMedPubMedCentral
65.
Zurück zum Zitat Chen X, Lee TJ. Ginsenosides-induced nitric oxide-mediated relaxation of the rabbit corpus cavernosum. Br J Pharmacol. 1995;115:15–8.PubMedPubMedCentral Chen X, Lee TJ. Ginsenosides-induced nitric oxide-mediated relaxation of the rabbit corpus cavernosum. Br J Pharmacol. 1995;115:15–8.PubMedPubMedCentral
66.
Zurück zum Zitat Kim HJ, Woo DS, Lee G, Kim JJ. The relaxation effects of ginseng saponin in rabbit corporal smooth muscle: is it a nitric oxide donor? Br J Urol. 1998;82:744–8.PubMed Kim HJ, Woo DS, Lee G, Kim JJ. The relaxation effects of ginseng saponin in rabbit corporal smooth muscle: is it a nitric oxide donor? Br J Urol. 1998;82:744–8.PubMed
67.
Zurück zum Zitat Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66:444–50.PubMedPubMedCentral Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66:444–50.PubMedPubMedCentral
68.
Zurück zum Zitat Kim TH, Jeon SH, Hahn EJ, Paek KY, Park JK, Youn NY, et al. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction. Asian J Androl. 2009;11:356–61.PubMedPubMedCentral Kim TH, Jeon SH, Hahn EJ, Paek KY, Park JK, Youn NY, et al. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction. Asian J Androl. 2009;11:356–61.PubMedPubMedCentral
69.
Zurück zum Zitat Choi YD, Park CW, Jang J, Kim SH, Jeon HY, Kim WG, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. Int J Impot Res. 2013;25:45–50.PubMed Choi YD, Park CW, Jang J, Kim SH, Jeon HY, Kim WG, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. Int J Impot Res. 2013;25:45–50.PubMed
70.
Zurück zum Zitat Borrelli F, Colalto C, Delfino DV, Iriti M, Izzo AA. Herbal dietary supplements for erectile dysfunction: a systematic review and meta-analysis. Drugs. 2018;78:643–73.PubMed Borrelli F, Colalto C, Delfino DV, Iriti M, Izzo AA. Herbal dietary supplements for erectile dysfunction: a systematic review and meta-analysis. Drugs. 2018;78:643–73.PubMed
71.
Zurück zum Zitat Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and meta- analysis of randomized clinical trials. J Urol. 1998;159:433–6.PubMed Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and meta- analysis of randomized clinical trials. J Urol. 1998;159:433–6.PubMed
72.
Zurück zum Zitat Tam SW, Worcel M, Wyllie M. Yohimbine: a clinical review. Pharmacol Ther. 2001;91:215–43.PubMed Tam SW, Worcel M, Wyllie M. Yohimbine: a clinical review. Pharmacol Ther. 2001;91:215–43.PubMed
73.
Zurück zum Zitat Guay AT, Spark RF, Jacobson J, Murray FT, Geisser ME. Yohimbine treatment of organic erectile dysfunction in a dose-escalation trial. Int J Impot Res. 2002;14:25–31.PubMed Guay AT, Spark RF, Jacobson J, Murray FT, Geisser ME. Yohimbine treatment of organic erectile dysfunction in a dose-escalation trial. Int J Impot Res. 2002;14:25–31.PubMed
74.
Zurück zum Zitat Lebret T, Hervé JM, Gorny P, Worcel M, Botto H. Efficacy and safety of a novel combination of L-arginine glutamate and yohimbine hydrochloride: a new oral therapy for erectile dysfunction. Eur Urol. 2002;41:608–13.PubMed Lebret T, Hervé JM, Gorny P, Worcel M, Botto H. Efficacy and safety of a novel combination of L-arginine glutamate and yohimbine hydrochloride: a new oral therapy for erectile dysfunction. Eur Urol. 2002;41:608–13.PubMed
75.
Zurück zum Zitat Akhondzadeh S, Amiri A, Bagheri AH. Efficacy and safety of Oral combination of Yohimbine and L-arginine (SX) for the treatment of erectile dysfunction: a multicenter, randomized, double blind, placebo-controlled clinical trial. Iran J Psychiatry. 2010;5:1–3.PubMedPubMedCentral Akhondzadeh S, Amiri A, Bagheri AH. Efficacy and safety of Oral combination of Yohimbine and L-arginine (SX) for the treatment of erectile dysfunction: a multicenter, randomized, double blind, placebo-controlled clinical trial. Iran J Psychiatry. 2010;5:1–3.PubMedPubMedCentral
76.
Zurück zum Zitat Belew D, Klaassen Z, Lewis RW. Intracavernosal injection for the diagnosis, evaluation, and treatment of erectile dysfunction: a review. Sex Med Rev. 2015;3:11–23.PubMed Belew D, Klaassen Z, Lewis RW. Intracavernosal injection for the diagnosis, evaluation, and treatment of erectile dysfunction: a review. Sex Med Rev. 2015;3:11–23.PubMed
77.
Zurück zum Zitat Hanchanale V, Eardley I. Alprostadil for the treatment of impotence. Expert Opin Pharmacother. 2014;15:421–8.PubMed Hanchanale V, Eardley I. Alprostadil for the treatment of impotence. Expert Opin Pharmacother. 2014;15:421–8.PubMed
78.
Zurück zum Zitat Padma-Nathan H, Yeager JL. An integrated analysis of alprostadil topical cream for the treatment of erectile dysfunction in 1732 patients. Urology. 2006;68:386–91.PubMed Padma-Nathan H, Yeager JL. An integrated analysis of alprostadil topical cream for the treatment of erectile dysfunction in 1732 patients. Urology. 2006;68:386–91.PubMed
80.
Zurück zum Zitat Rooney M, Pfister W, Mahoney M, Nelson M, Yeager J, Steidle C. Long-term, multicenter study of the safety and efficacy of topical alprostadil cream in male patients with erectile dysfunction. J Sex Med. 2009;6:520–34.PubMed Rooney M, Pfister W, Mahoney M, Nelson M, Yeager J, Steidle C. Long-term, multicenter study of the safety and efficacy of topical alprostadil cream in male patients with erectile dysfunction. J Sex Med. 2009;6:520–34.PubMed
82.
Zurück zum Zitat Lin K-C, Niu K-C, Tsai K-J, Kuo J-R, Wang L-C, Chio C-C, et al. Attenuating inflammation but stimulating both angiogenesis and neurogenesis using hyperbaric oxygen in rats with traumatic brain injury. J Trauma Acute Care Surg. 2012;72:650–9.PubMed Lin K-C, Niu K-C, Tsai K-J, Kuo J-R, Wang L-C, Chio C-C, et al. Attenuating inflammation but stimulating both angiogenesis and neurogenesis using hyperbaric oxygen in rats with traumatic brain injury. J Trauma Acute Care Surg. 2012;72:650–9.PubMed
83.
Zurück zum Zitat Tanaka T, Minami A, Uchida J, Nakatani T. Potential of hyperbaric oxygen in urological diseases. Int J Urol. 2019;26:860–7.PubMed Tanaka T, Minami A, Uchida J, Nakatani T. Potential of hyperbaric oxygen in urological diseases. Int J Urol. 2019;26:860–7.PubMed
84.
Zurück zum Zitat Müller A, Tal R, Donohue JF, Akin-Olugbade Y, Kobylarz K, Paduch D, et al. The effect of hyperbaric oxygen therapy on erectile function recovery in a rat cavernous nerve injury model. J Sex Med. 2008;5:562–70.PubMed Müller A, Tal R, Donohue JF, Akin-Olugbade Y, Kobylarz K, Paduch D, et al. The effect of hyperbaric oxygen therapy on erectile function recovery in a rat cavernous nerve injury model. J Sex Med. 2008;5:562–70.PubMed
85.
Zurück zum Zitat Yuan JB, Yang LY, Wang YH, Ding T, Chen TD, Lu Q. Hyperbaric oxygen therapy for recovery of erectile function after posterior urethral reconstruction. Int Urol Nephrol. 2011;43:755–61.PubMed Yuan JB, Yang LY, Wang YH, Ding T, Chen TD, Lu Q. Hyperbaric oxygen therapy for recovery of erectile function after posterior urethral reconstruction. Int Urol Nephrol. 2011;43:755–61.PubMed
86.
Zurück zum Zitat • Hadanny A, Lang E, Copel L, Meir O, Bechor Y, Fishlev G, et al. Hyperbaric oxygen can induce angiogenesis and recover erectile function. Int J Impot Res. 2018;30:292–9 This recent study was the first to investigate HBOT as a therapy for non-surgical ED. The study showed significant increases in IIEF scores, demonstrating improvement in erectile function. A subset of the experimental group also underwent dynamic contrast-enhanced MRI, demonstrating improvements in penile perfusion.PubMed • Hadanny A, Lang E, Copel L, Meir O, Bechor Y, Fishlev G, et al. Hyperbaric oxygen can induce angiogenesis and recover erectile function. Int J Impot Res. 2018;30:292–9 This recent study was the first to investigate HBOT as a therapy for non-surgical ED. The study showed significant increases in IIEF scores, demonstrating improvement in erectile function. A subset of the experimental group also underwent dynamic contrast-enhanced MRI, demonstrating improvements in penile perfusion.PubMed
87.
Zurück zum Zitat Sahin MO, Sen V, Eser E, Koc E, Gumus U, Karakuzu C, et al. The effect of hyperbaric oxygen therapy on erectile functions: a prospective clinical study. Urol Int. 2018;101:206–11.PubMed Sahin MO, Sen V, Eser E, Koc E, Gumus U, Karakuzu C, et al. The effect of hyperbaric oxygen therapy on erectile functions: a prospective clinical study. Urol Int. 2018;101:206–11.PubMed
88.
Zurück zum Zitat Sen V, Sahin MO, Irer B, Koc E, Yildiz G. The impact of hyperbaric oxygen therapy on erectile functions and serum testosterone levels in patients with erectile dysfunction. Aging Male. 2020;23:66–70.PubMed Sen V, Sahin MO, Irer B, Koc E, Yildiz G. The impact of hyperbaric oxygen therapy on erectile functions and serum testosterone levels in patients with erectile dysfunction. Aging Male. 2020;23:66–70.PubMed
89.
Zurück zum Zitat Chiles KA, Staff I, Johnson-Arbor K, Champagne A, McLaughlin T, Graydon RJ. A double-blind, randomized trial on the efficacy and safety of hyperbaric oxygenation therapy in the preservation of erectile function after radical prostatectomy. J Urol. 2018;199:805–11.PubMed Chiles KA, Staff I, Johnson-Arbor K, Champagne A, McLaughlin T, Graydon RJ. A double-blind, randomized trial on the efficacy and safety of hyperbaric oxygenation therapy in the preservation of erectile function after radical prostatectomy. J Urol. 2018;199:805–11.PubMed
91.
Zurück zum Zitat Segal RL, Tajkarimi K, Burnett AL, Rl S, Tajkarimi K, Viberect BAL (2013) Evaluation of its erectogenic efficacy. 5343–5346. Segal RL, Tajkarimi K, Burnett AL, Rl S, Tajkarimi K, Viberect BAL (2013) Evaluation of its erectogenic efficacy. 5343–5346.
92.
Zurück zum Zitat Fode M, Borre M, Ohl DA, Lichtbach J, Sønksen J. Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve-sparing radical prostatectomy: a randomized, controlled trial. BJU Int. 2014;114:111–7.PubMedPubMedCentral Fode M, Borre M, Ohl DA, Lichtbach J, Sønksen J. Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve-sparing radical prostatectomy: a randomized, controlled trial. BJU Int. 2014;114:111–7.PubMedPubMedCentral
93.
Zurück zum Zitat Clavell Hernandez J, Wu Q, Zhou X, Nguyen JN, Davis JW, Wang R. Penile vibratory stimulation in penile rehabilitation after radical prostatectomy: a randomized, controlled trial. J Sex Med. 2018;15:S253–4. Clavell Hernandez J, Wu Q, Zhou X, Nguyen JN, Davis JW, Wang R. Penile vibratory stimulation in penile rehabilitation after radical prostatectomy: a randomized, controlled trial. J Sex Med. 2018;15:S253–4.
Metadaten
Titel
Alternative Treatment for Erectile Dysfunction: a Growing Arsenal in Men’s Health
verfasst von
Wade Muncey
Nicholas Sellke
Tyler Kim
Kirtishri Mishra
Nannan Thirumavalavan
Aram Loeb
Publikationsdatum
01.02.2021
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 2/2021
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-020-01023-9

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