Retrospective comparative analysis of the efficacy of treatment modalities for erectile dysfunction; are the regenerative treatments effective?

BACKGROUND

Erectile dysfunction(ED) is a prevalent sexual that is commonly treated with phosphodiesterase type 5 inhibitors (PDE5Is). Regenerative modalities such as platelet-rich plasma(PRP) and low-intensity extracorporeal shockwave therapy(Li-ESWT) have gained attention for their potential to promote tissue repair and neurovascular regeneration. However, comparative data evaluating their effectiveness alone or in combination with standard therapies remain limited. This study assessed treatment outcomes across commonly used ED modalities, with a particular focus on regenerative approaches.

METHODS

121 men with ED were evaluated. Demographic and clinical characteristics, laboratory parameters and erectile function assessments (IIEF-15, SHIM, PEDT) were recorded at baseline and 3-month follow-up. Treatment modalities included PDE5Is, Li-ESWT, PRP injections and their combinations. Standardized protocols were applied: all PDE5I users received a 3-month regimen of tadalafil 5 mg; patients completing 6 ESWT sessions or 3 PRP sessions were analyzed.

RESULTS

Significant improvements were observed in all erectile function measures. IIEF-15 and SHIM scores increased markedly post-treatment, while PEDT scores decreased. Categorical analyses confirmed substantial shifts toward higher erectile function levels and reduced premature ejaculation severity. Treatment modality significantly influenced ΔIIEF-15, with combination therapies demonstrating greater improvement than monotherapy. Demographic, clinical, and laboratory variables were not associated with treatment response.

CONCLUSION

Regenerative therapies, particularly Li-ESWT and PRP, were associated with favorable outcomes in ED management. Combination therapy was associated with greater improvement than monotherapy; however, these findings should be interpreted cautiously because of the retrospective design and the imbalance in treatment subgroup sizes.