Could erectile dysfunction be cured by gadget on iPhone or three other advanced treatments?

IT isn’t overly sexy - for most men, it’s downright embarrassing - but the future of erectile dysfunction treatment is looking pretty tantalising right now.

One in 10 men will experience it at some stage in their lifetime, but there’s more to be done than popping a ‘little blue pill’.

Professor David Ralph, Consultant Urologist at University College London and Medical Director of St Peter’s Andrology Centre tells Sun Health: "Erectile dysfunction is a health problem that a lot of men deal with, especially as they get older.

“There are plenty of treatment options, depending on how serious the problem is.

“For some, we still use injections or even surgery, like fitting a penile implant.

“These can work well but aren’t for everyone.”

But he is ‘optimistic’ about the future of men’s erectile health.

Just last month, scientists raised hopes that in the future, 3D-printed tissue could be implanted into the penis to help it function again.

They tested it in animals with penile deformities and it helped animals mate and reproduce within just a few weeks.

Reporting in the journal Nature, the team from America, Japan and China outlined how their model featured blood vessels like those found in real penises.

“Our findings support the further development of 3D-printed blood-vessel-rich functional organs for transplantation,” they said.

While that tech is a long way off being used in humans, it’s just one example of a more, ahem, perky-looking area of research. Here we look at what you can do NOW to help your ED, and what might become available in the future…

ED, also known as impotence, is particularly common in men over 40.

Prof Ralph says: “The older the patient, the more likely they are to get erectile dysfunction.

"By age 50 or 60, up to 50% of men may experience it [at some stage].”

Erections occur when blood fills spongy tissue in the penis.

But this is disrupted when the intricate system of vessels that allow blood to flow into the penis is damaged.

Prof Ralph says: “There can be vascular causes, so people with heart disease and blood vessel disease, blood pressure [issues], diabetes, and furring up of the arteries.”

Even psychological stress or the pressure to perform can disrupt this process, which Prof Ralph says is more common among young men.

It can also occur after surgery, such as removal of the prostate.

Prof Ralph adds: “Then there can be certain diseases of the penis, such as Peyronie's disease [when the penis curves when erect], which can cause erectile dysfunction.”

Whatever the cause, the outcome can extend beyond the bedroom.

Prof Ralph says: “It can affect the relationship, it can affect their self esteem, sometimes cause a bit of depression.”

SEE YOUR GP FIRST

IF you’re struggling with ED, Prof Ralph says don’t suffer in silence.

He advises seeing a GP rather than ordering devices that promise a ‘cure’ on the internet.

“Every patient with erectile dysfunction could be treated,” he says.

“This is a good opportunity to do a health check on men who don't actually go to their GP usually, to exclude diabetes, check their blood pressure and perhaps their cholesterol, and that can obviously be treated.”

CURRENT TREATMENT OPTIONS

HEALTH check done? Most men start with medication.

Prof Ralph says: “Pills like Viagra (known as PDE5 inhibitors) are still the first choice for many, and newer liquid versions make them easier to take for some patients.

“But the effect is temporary – they don’t fix the underlying problem.

“They also come with side effects like headaches, which some patients find hard to tolerate over time.”

Four tablets - sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra) - ara available to help increase blood flow to the penis, but only Viagra is accessible over the counter without a prescription.

Prof Ralph adds: “Non-invasive treatments like vacuum erection devices or penis pumps can also help by creating a vacuum around the penis to draw blood into it and assist with an erection.”

Vacuum pumps are plastic cylinders that are placed over the penis.

Using a hand pump connected via a tube, air is removed from the cylinder, creating a vacuum and drawing blood to the penis.

Penile implants, which require surgery, tend to be used for ED that treatment has failed.

An inflatable implant, the most common type, is placed inside the penis and can be activated using a pump in the scrotum.

MOVE over pumps and pills - treatment in ED is advancing to fix the root problem, not just put a plaster over it.

“Newer treatments are now aiming to help the body work naturally again,” says Prof Ralph.

THIS so-called ‘regenerative treatment’ is designed to boost blood flow and improve penile tissues.

“It uses sound waves to stimulate circulation,” says Prof Ralph, noting it has been available for around a decade.

It costs between £75 and £350 per session and you usually need a course.

“Patients go to a clinic, they have a 20 to 30 minute session of shockwaves all over the penis, and the shockwaves are thought to cause new blood vessel formation in the penis,” says Prof Ralph.

“Clearly, if you've got diabetes, that would be a benefit, because you have vascular disease in that particular group of patients.”

How effective is it?

Prof Ralph says that under medical guidelines, it is considered “effective, perhaps good for mild erectile dysfunction”.

THIS one involves injecting platelet-rich plasma (PRP) from the patient’s own blood into the penis to promote tissue repair.

A small amount of blood, around 10ml, is taken from the patient.

The blood sample is ‘spun’ to separate the plasma, which contains platelets - components of blood that contain growth factors.

“Then you inject that into the penis,” Prof Ralph says.

The idea is that these growth factors promote tissue repair or even grow new cells in the penis.

However, evidence for its effectiveness is limited, and it costs around £1,000 per shot, with results lasting around one year.

“It's relatively safe, but from an erectile dysfunction point of view, the evidence is pretty poor,” claims Prof Ralph.

“Nice, the NHS, haven't got good enough evidence that it works to be able to put it into the mainstream.”

ALL sounding a bit clinical? Then look to products like Vertica.

“Vertica stands out because it can be done at home and is the first to address the leading cause of ED, when blood leaks from the penis,” says Prof Ralph, who is a Vertica expert.

Vertica is a Medicines and Healthcare products Regulatory Agency (MHRA) approved device that looks a bit like a games console with a ring in the centre that the penis is placed into.

“It uses radiofrequency energy to improve the body’s natural ability to achieve and maintain erections,” says Prof Ralph.

Costing £1,275, it’s an investment.

But Prof Ralph says the benefits are that it’s easy to use, and at home.

“So unlike shockwave therapy, where they have to come and have up to 12 sessions in the clinic, the patients can do it in the peace and quiet of their home.

“For many men, that means they can enjoy spontaneous sex again without having to plan around a pill or clinic appointment."

In a small 12-week trial of 28 men, 89 per cent saw an improvement in their erectile function.

Some 91 per cent had an erection that was hard enough for penetration three months after their treatment ended, compared with 46 per cent at the baseline.

“Now we're waiting for a slightly larger study, and there's one in multiple centers in the United States,” Prof Ralph says, adding that he is involved in research.

IT’S the year 2025, but men are still manually pumping their penises.That could all change by 2030, however.

Prof Ralph says: “There's going to be an electronic penile prosthesis so you don't have to pump it up and down, it can be done remotely.

“It can be done electronically with your iPhone.

“We're waiting for that to come on board in about three or four years' time.”

It would involve a medical device being implanted into the penis to help it become rigid, along with an electronic control unit.

The benefit? The technology is easier to operate and can give men better control - and spontaneity - in the bedroom.

Prof Ralph adds “Many people in ED medical circles mention the potential for stem cells.

“Everyone thinks stem cells cure everything, but there are groups using it, and it really hasn't gathered momentum.”