Direct-To-Consumer Internet Prescription Platforms Overlook Crucial Pathology Found During Traditional Office Evaluation of Young Men With Erectile Dysfunction

Beyond the prescription: trends and challenges in erectile dysfunction medications among young adult men

We sought to assess erectile dysfunction (ED) medication use among males aged 18-40. Between June and July 2023, a cross-sectional survey on Qualtrics (Provo, UT) was disseminated via Research Match. Among 210 respondents, ED prevalence was 57.1% with 39.0% reporting prior ED medication use. Black or African American race (OR = 3.54, p < 0.001), Hispanic or Latino ethnicity (OR = 3.32, p = 0.01), and Medicare or Medicaid insurance status (OR = 6.07, p < 0.001) were associated with increased medication utilization. Income >$200,000 was associated with decreased medication usage (OR 0.23, p = 0.04). ED severity significantly correlated with higher medication usage. Primary care providers were the most common source of acquisition (47.6%), followed by online direct to consumer (DTC) platforms (31.7%) and personal connections (19.5%). Privacy (n = 51, 62.2%) and cost (n = 45, 54.9%) were key considerations in obtaining medications. Despite 73.2% of individuals receiving counseling regarding risks/benefits and 84.1% receiving instructions for proper use, only 28.0% correctly identified essential aspects of proper/appropriate use. Overall, we found a high ED prevalence and medication utilization rate. The preference for privacy in procuring medications suggests ongoing stigma around men's sexual health. Despite extensive counseling, a significant knowledge gap remains indicating a pressing need for enhanced patient education.

Sexual Medicine Society of North America (SMSNA)/American Urological Association (AUA) telemedicine and men's health white paper

PURPOSE

The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men's sexual health care.

LITERATURE SEARCH STRATEGY

A literature search focused on the use of TM in urology and men's health was performed through PubMed/MEDLINE, Embase, and Web of Science (January 1, 2012-April 26, 2022). Keywords included all known permutations of the terminology used to refer to virtual health, care as well as the terminology used to refer to urologic diseases, issues specific to men's health, and men's sexual health concerns. Publications that emerged after the literature search that met this criterion also were incorporated. Opinion pieces, letters to the editor, meeting abstracts, and conference proceedings were excluded. Additional resources were retrieved, such as governmental technical reports, legislative updates and reviews, and blogs. This search strategy yielded 1684 records across databases after removal of duplicates. Abstracts from the retrieved records were reviewed for relevance. Relevant publications were defined as those that reported data on any aspect of TM use specific to urology, men's health, and/or men's sexual health. If relevance was unclear from the abstract, then the full text of the article was retrieved for a more detailed review. In addition, the published evidence-based practice guidelines relevant to care for erectile dysfunction, Peyronie's disease, ejaculatory dysfunction, and hypogonadism were retrieved. The most common reasons for article exclusions were a focus on TM use in disciplines other than urology and the absence of data (ie, opinion pieces). After exclusions, a total of 91 publications remained and constituted the evidence base for this paper.

Direct-to-Consumer Telemedicine Practices in the Health and Fertility of Men: A Systematic Review of the Literature

PURPOSE

Men are increasingly turning toward online direct-to-consumer (DTC) men's health platforms to fulfill their health needs. Research surrounding these platforms is lacking and the motivations and predictors underlying this online health-seeking behavior is largely unknown. This review scopes the existing literature concerning DTC men's health and identifies factors influencing engagement, as well as health outcomes of this platform.

MATERIALS AND METHODS

A structured search was performed following PRISMA guidelines. CINAHL via EBSCO, Embase, MEDLINE via Ovid, PsycINFO, PubMed and Web of Science were searched.

RESULTS

Peer-reviewed quantitative and qualitative studies with a focus on demographics and characteristics of those using DTC men's health platforms, as well as studies related to patient outcomes using such platforms, were included. Ten of the 3,003 studies identified met the inclusion and exclusion criteria. Four cross-sectional descriptive studies evaluated the motivations behind men's engagement with DTC platforms. Convenience, embarrassment and health motivation were identified as predominant factors associated with DTC platform use. The review identified a lack of qualitative studies, and major limitations were noted in the quantitative studies that impacted the accuracy of findings. Six further quantitative studies explored the quality of care provided by DTC platforms. DTC platforms were found to have a varying level of adherence to established clinical guidelines, but appeared to provide satisfactory patient outcomes with low levels of patient-reported side effects and adverse events.

CONCLUSIONS

There is a lack of research within the DTC men's health space given the infancy of the field. Important predictors and motivations underlying men's choices in accessing these platforms have been noted across several studies. However, further studies need to be conducted to investigate the psychosocial underpinnings of this behavior. Studies across a wider variety of male health conditions treated by these platforms will also help to provide insights to guide patient-centered care within the DTC landscape.

Characteristics of men who use direct-to-consumer men's health telemedicine services

The characteristics of men who use direct-to-consumer (DTC) men's health services are not well understood. We conducted an online survey of adult men via ResearchMatch, assessing sociodemographic data, health behaviors, and concern for low testosterone and infertility. Logistic regression estimated the association between participant characteristics and familiarity with and reported use of DTC services such as Hims® and Roman®. Among 1276 men surveyed, 62.2% were concerned about low testosterone. While almost half (48.5%) were familiar with men's DTC health services, only 37 (2.9%) reported using these services. On multivariable analysis, men who used DTC men's health services were more likely to be younger (age 18-39: odds ratio [OR] 2.94, 95% confidence interval [CI] 1.03-8.38, p = 0.04; age 40-59: OR 3.26, CI 1.17-9.10, p = 0.02; referent age ≥60), have annual income between $75k and $100k (OR 5.25, CI 1.39-19.87.45, p = 0.02), and be concerned about low testosterone (OR 3.81, CI 1.46-9.96, p = 0.01). In conclusion, younger men and those with mid-range incomes were more likely to use online DTC men's health services compared to older or wealthier men. Likewise, men with concerns about low testosterone were more likely to use DTC services, but other health-conscious behaviors and frequency of doctor visits did not predict use.

Platelet-rich plasma for erectile dysfunction: a review of the current research landscape

INTRODUCTION

Erectile dysfunction (ED) is the inability to achieve or maintain erection for satisfactory sexual performance. ED drastically reduces the quality of life for men and their partners and is commonly linked to comorbid conditions such as diabetes and cardiovascular disease. As a result, clinicians and researchers are working to improve treatments for ED. Current guideline-approved ED treatments include oral phosphodiesterase type 5 inhibitors, intraurethral alprostadil, penile intracavernosal injections, and penile prosthesis surgery. Today, there is increasing interest in restorative therapies such as intracavernosal platelet-rich plasma (PRP) for the management of ED.

OBJECTIVES

This narrative review describes the current trials investigating intracavernosal PRP for ED and proposes future directions to increase the strength of evidence to support use of PRP in this population.

METHODS

A comprehensive literature search of PubMed, Science Direct, and Scopus was performed to identify all randomized clinical trials using PRP for the treatment of ED.

RESULTS

We identified 4 randomized clinical trials investigating the safety and efficacy of PRP for ED. We found significant heterogeneity among study protocols, including collection of PRP, dosing of PRP, and follow-up.

CONCLUSION

While intracavernosal PRP is considered safe, its efficacy for the management of ED remains unknown due to variability among clinical trials.

Assessment of Patient Risk Profiles by a Male Sexual Health Direct-to-Consumer Prescription Platform: A Cross-Sectional Study

Background

Direct-to-consumer (DTC) online prescription platforms (OPP) for sexual health represent a potential paradigm shift in the diagnosis and treatment for sexual dysfunctions in the way men seek care. Knowledge of patients' risk profile using these platforms is limited.

Aim

To assess risk profiles of patients reaching out to health care professionals through their DTC.

Methods

Anonymized data originally collected between February 2021 to May 2022 by a DTC platform in the men's health care space were retrospectively analyzed. Data included the content of patient requests through a communication function, as well as the corresponding responses by the attending physician on staff. Each request was then assessed by two independent urologists and categorized by the level of the risk profile as well as the need to refer the patient to further medical evaluation.

Results

Of 585 patient requests, 531 (90.8%) were classified as low risk. In the high-risk group, 32 patients were recommended to schedule an urgent appointment at a specialist. Only three patients (0.5%) were advised to seek emergency care. The overall referral rate for both risk groups was 52.3%. The requests of 279 patients (47.7%) were assessed as digitally treatable. Almost all patients who were digitally treatable were low risk. Side effects accounted for only 9.6% of all requests in the low-risk group, compared with 46.3% in the high-risk group.

Conclusion

Overall, low-risk levels in the requests of patients using a DTC platform were reported, with almost half of them suitable to be solved digitally, whereas the other half required referral to an in-person specialist.

Guideline-Nonconformant Investigational Treatments for Erectile Dysfunction: What are Patients Learning?

OBJECTIVE

To evaluate the validity of YouTube content on shockwave, platelet-rich plasma, and stem cell therapies for erectile dysfunction (ED). The consumerization of men's health is particularly notable among regenerative ED treatments, and the popularity of these treatments has been amplified by social media sites such as YouTube.

METHODS

We searched YouTube utilizing the following terms: "shockwave therapy-," "platelet-rich plasma- and "stem cell therapy-" "-for erectile dysfunction." The first 50 resulting videos per query were screened (inclusion criteria: relevant title/content, English language, >100 views) and judged by 2 independent graders using the validated DISCERN instrument for consumer health information. Regression analysis assessed association of video characteristics with DISCERN score.

RESULTS

Seventy-one unique videos met criteria. More content featured non-physicians (37%) or non-urologist physicians (35%) than urologists (28%). Mean DISCERN score was low at 42.8 of 80. DISCERN score significantly differed by video category and characteristics. Educational and urologist-featuring videos were associated with higher score. News reports were associated with lower score. Only 3 videos mentioned investigational/experimental status of the therapies. Only 2 cited society guidelines.

CONCLUSION

Most YouTube videos on regenerative ED therapies are unreliable and from non-urologists. The misrepresentation of proven efficacy may be encouraging patients to seek these still investigational treatments at high fiscal costs to the patient. Videos with urologists were more likely to be higher quality and guideline based. The urological and academic communities should continue to leverage the power of social media to provide evidence-backed consumer health information in this space.

Long vs Short Acting Testosterone Treatments: A Look at the Risks

Prescriptions for testosterone therapy (TT) to treat testosterone deficiency have increased in recent years. The purpose of this review was to evaluate the risks of several treatment modalities to better counsel patients. Both short-acting and long-acting TT has been shown to restore normal serum testosterone levels and improve symptoms of testosterone deficiency. Short-acting pharmacology mimics normal physiology more closely than long-acting TT but requires multiple doses per day. Long-acting TT has a higher rate of patient adherence but is more likely to create supraphysiologic serum testosterone and pathologic sequelae.

Cannabis and male sexual health: contemporary qualitative review and insight into perspectives of young men on the internet

INTRODUCTION

Cannabis use is increasing across the United States, yet its short- and long-term effects on sexual function remain controversial. Currently, there is a paucity of studies exploring the relationship between cannabis and men's health.

OBJECTIVES

To summarize the available literature on cannabis and men's health and provide insight into lay perceptions of this topic.

METHODS

We performed a qualitative PubMed review of the existing literature on cannabis and men's health according to the PRISMA guidelines. Separately, we analyzed relevant themes in online men's health forums. We utilized a Google cloud-based platform (BigQuery) to extract relevant posts from 5 men's health Reddit forums from August 2018 to August 2019. We conducted a qualitative thematic analysis of the posts and quantitatively analyzed them using natural language processing and a meaning extraction method with principal component analysis.

RESULTS

Our literature review revealed a mix of animal and human studies demonstrating the negative effects of cannabis on semen parameters and varying effects on erectile function and hormone levels. In our analysis of 372 686 Reddit posts, 1190 (0.3%) included relevant discussion on cannabis and men's health. An overall 272 posts were manually analyzed, showing that online discussions revolve around seeking answers and sharing the effects of cannabis on various aspects of sexual health and quality of life, often with conflicting experiences. Quantitative analysis revealed 1 thematic cluster related to cannabis, insecurity, and mental/physical health.

CONCLUSIONS

There is a limited number of quality human studies investigating the effects of cannabis on men's health. Men online are uncertain about how cannabis affects their sexual health and seek more information. As the prevalence of cannabis use increases, so does the need for research in this area.

Increase in Direct-to-Consumer Telemedicine in Urology

Purpose of Review

Direct-to-consumer telemedicine has vastly expanded in recent years, and urologic conditions are a common target for these companies. We aim to identify the urologic conditions being treated by direct-to-consumer telemedicine platforms and review the feasibility of adherence to evidence-based practice guidelines via this relatively new healthcare model.

Recent Findings

Erectile dysfunction, premature ejaculation, testosterone deficiency, and male infertility are being treated with direct-to-consumer telemedicine. Such platforms treating erectile dysfunction perform modestly in practice guideline adherence. Guidelines-based treatment of other urologic conditions via telemedicine is feasible, however, the treatment of these conditions through popular direct-to-consumer telemedicine platforms is largely unstudied.

Summary

The impact of direct-to-consumer telemedicine on the field of urology is vast and likely to continue to grow. Future studies should inspect direct-to-consumer telemedicine companies’ practice patterns and treatment outcomes to ensure the field’s standards of care are being met. Guidelines specific to the treatment of various urologic conditions via telemedicine are needed.

Contemporary cost-analysis comparison of direct-to-consumer vs. traditional prescriptions of phosphodiesterase-5 inhibitors

After a focused telehealth visit, patients can now access phosphodiesterase-5 inhibitor (PDE5 inhibitor) prescriptions through online direct-to-consumer (DTC) healthcare companies. This study seeks to quantify the cost of DTC PDE5 inhibitor treatment compared to a traditional physician visit and local pharmacy prescription. Two DTC companies, two compounding pharmacies with national reach, three online Canadian pharmacies, and sixteen American pharmacy chains were queried for prices of 90-day regimens of common PDE5 inhibitors. Prices for chains were determined using their publicly available price on GoodRx^® with coupon. Cost of physician visit was determined using 2020 Center for Medicare and Medicaid Services reimbursement for a level 3 new patient visit. For sildenafil 20 mg, a physician visit and local prescription cost a low of $125.45 compared to $144.35 for compounding, $169.34 for Canadian, and $195.00 for DTC. For sildenafil 100 mg, a physician visit and local prescription cost a low of $137.16 compared to $289.35 for compounding, $200.36 for Canadian, and $900.00 for DTC. For tadalafil 5 mg, a physician visit and local prescription cost a low of $125.80 compared to $169.35 for compounding, $195.34 for Canadian, and $720.00 for DTC. For tadalafil 20 mg, a physician visit and local prescription cost a low of $161.00 compared to $289.35 for compounding, $229.00 for Canadian, and $2880.00 for DTC. Thus, local pharmacies, in conjunction with online coupons, consistently provide a markedly less-expensive option for fulfillment of PDE5 inhibitor prescriptions than online DTC services.

Trends in testosterone prescription amongst medical specialties: a 5-year CMS data analysis

Testosterone Therapy (TTh) trends have changed as a result of clinical research and market forces over the past several years. Understanding the trends or preferences regarding testosterone prescriptions remains unknown. Our objective was to assess both regional and national trends in TTh prescriptions amongst medical specialties within the United States between 2013 and 2017. Publicly available data from the Center for Medicare and Medicaid Services (CMS) Part D Prescriber database with regards to TTh prescriptions across a 5-year span (January 1, 2013-December 31, 2017) were analyzed. TTh therapies were consolidated into four categories: Topical, Oral, Injection and Pellet. Statistical analysis utilizing R 4.0.2 was performed on the resulting data. Trends in prescription modality claim count and cost were plotted over the study period while statistical analysis evaluated associations between TTh modality and medical specialist. We found that Endocrinologists and Urologists prescribed topical testosterone more than all other specialties (60.4% and 53.5%, respectively), while Family and Internal medicine physicians were more likely to prescribe injections (59.82% and 50.69%, respectively). Oral and pellet testosterone were rarely prescribed across all specialties. In conclusion, the wide variation in modalities of testosterone prescriptions illustrates an opportunity for treatment guidelines to be streamlined across all specialists to improve patient outcomes.

Testosterone replacement therapy in the era of telemedicine

The events of the 2019 SARS-CoV2 virus pandemic have all but ensured that telemedicine will remain an important aspect of patient care delivery. As health technologies evolve, so must physician practices. Currently, there is limited data on the management of testosterone replacement therapy (TRT) in the era of telemedicine. This review aims to explore the potential benefits and pitfalls of TRT management via telemedicine. We also propose a theoretical framework for TRT management via telemedicine. Telemedicine provides patients and physicians with a new mechanism for American Urological Association guideline-concordant TRT management that can increase patient access to care and provide a safe space for men who may otherwise not have been comfortable with in-person evaluation. However, there are significant limitations to the use of telemedicine for the management of TRT, including the inability to perform a physical exam, inability to administer specific medications, technological barriers, data security, and medical-legal considerations, and both patients and providers should engage in shared decision making before pursuing this approach. Understanding and acknowledging the potential pitfalls of telemedicine for TRT management will enable both patients and providers to achieve optimal outcomes and satisfaction.

Stem Cell and Gene-Based Therapy for Erectile Dysfunction: Current Status and Future Needs

Erectile dysfunction affects an increasing number of men. The mainstays of management include oral medications, local erectogenic agents, and surgical placement of prosthetic devices. Newer technologies such as stem cell and gene therapy have been investigated as a means to restore spontaneous erectile capacity. Mesenchymal stem cells are thought to produce a local immunomodulatory and pro-repair milieu at the area of injury or needed repair. Gene therapy involves targeting the erectogenic pathway to augment factors involved in producing a natural erection. Such therapies are considered experimental and should be used in the setting of a clinical trial with appropriate oversight.

Perceptions of Infertility and Semen Analysis Testing Among American Men Without Children

OBJECTIVE

To determine whether health-conscious men are more likely to be concerned about infertility and self-initiate semen analysis at a laboratory/clinic or through a direct-to-consumer at-home product without a health care provider recommendation.

METHODS

Cross-sectional survey conducted online via ResearchMatch.org between November 2019 and January 2020. Men age 18 and older without children (n = 634) were included for analysis. Outcomes were likelihood of self-initiating a semen analysis, prevalence of infertility concern.

RESULTS

Of the 634 participants, 186 expressed concern about infertility but only 29% were likely to discuss these concerns with a health care provider. More men would self-initiate a semen analysis using an at-home product than through a traditional laboratory/clinic (14.2% vs 10.4%, P = .04). Odds of self-initiating a traditional semen analysis were higher for men concerned about low testosterone (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.12-4.74, P = .023) and infertility (OR 3.91, 95% CI 2.14-7.15, P <.001). Self-initiating an at-home semen analysis was associated with concern for low testosterone and infertility as well as middle age (age 40-59: OR 3.02, 95% CI 1.16-7.88, P = .024) and fitness tracker use (OR: 1.95, 95% CI 1.12-3.39, P = .018).

CONCLUSION

Many men were unlikely to discuss infertility concerns with a health care provider. Middle aged men and those who used fitness trackers were more likely to self-initiate fertility evaluation through at-home semen analysis. Concern about low serum testosterone was pervasive and strongly associated with concern for being infertile and self-initiating a semen analysis of any kind.

Socioeconomic Disparities and Risk Factors in Patients Presenting With Ischemic Priapism: A Multi-Institutional Study

OBJECTIVES

To evaluate contemporary clinical presentations of priapism, their association with socioeconomic characteristics, and the role of prescribing providers in priapism episodes in a large cohort of patients managed at 3 major academic health systems.

METHODS

We identified all consecutive patients presenting with ischemic priapism to the emergency departments of three major academic health systems (2014 -2019). Demographic characteristics, priapism etiologies, and clinical management were evaluated. Univariable and multivariable analyses were used to assess the contribution of socioeconomic characteristics and the role of prescribing providers in priapism episodes.

RESULTS

We identified 102 individuals with a total of 181 priapism encounters. Hispanic race, lower income quartile, sickle-cell disease, and illicit drug use were associated with increased risk of recurrent episodes. Of ICI users, 57% received their prescriptions from non-urological medical professionals (NUMPs); the proportion with recurrent episodes was higher for NUMPs compared to urologists (24% vs 0%, P = 0.06) with no demographic differences identified between patients treated by either group.

CONCLUSION

Socioeconomic disparities exist among patients presenting with recurrent episodes of priapism, potentially highlighting systemic issues with access to care and patient education. With most patients who developed ischemic priapism from ICI being prescribed these medications by NUMPs, further investigation is required to elucidate the prescribing and counseling patterns of these providers. Increased awareness of disparities and complications may improve patient safety.

Examining Online Traffic Patterns to Popular Direct-To-Consumer Websites for Evaluation and Treatment of Erectile Dysfunction

BACKGROUND

Direct-to-consumer (DTC) Internet-based prescription and pharmacy platforms offer electronic consultation for evaluation and pharmacologic treatment of erectile dysfunction (ED) without a physical exam or in-person visit, presenting a potentially dramatic shift in care for this condition.

AIM

To characterize the extent to which DTC prescribing sites for ED generate traffic and attract individual users.

METHODS

Using SEMRush, a marketing software platform that provides analytics regarding website traffic, we examined online site visits to 6 major DTC prescribing websites offering ED evaluation and treatment from October 2017 through December 2019.

OUTCOMES

We recorded trends in the number of unique visitors over time, visitor referral patterns, and the proportion of overall visitors to individual sites.

RESULTS

During the study period, the total number of unique, quarterly visitors increased by 1,688% from 655,733 in the 4th quarter (Q4) 2017 to over 11 million in Q4 2019. In 2019, there were on average 4,971,674 visits to all sites combined each month. For the 2 largest sites (Hims and Roman), visitors predominantly reached the site via direct web address (27.3%) or search engine referral (27.3%).

CLINICAL IMPLICATIONS

An increasingly large number of potential patients are utilizing DTC prescribing platforms for the diagnosis and treatment of ED, which do not require physical exams or treatment of other comorbid conditions.

STRENGTH & LIMITATIONS

Demonstrates high demand for ED DTC prescribing services using independent market research software and characterizes the number of visits for the first time. Limitations include the lack of individual demographics and lack of information regarding what proportion of unique visits lead to evaluation and treatment using the services.

CONCLUSION

The dramatic increase in visits to DTC prescribing sites that treat ED represents a paradigm shift in ED care, and it is imperative that clinicians and researchers work to understand how patients utilize online telemedicine, the safety and efficacy of online management of ED, and the potential downstream implications of its widespread use. Wackerbarth JJ, Fantus RJ, Darves-Bornoz A, et al. Examining Online Traffic Patterns to Popular Direct-To-Consumer Websites for Evaluation and Treatment of Erectile Dysfunction. Sex Med 2021;9:100289.

Epidemiology and Diagnosis of Erectile Dysfunction by Urologists Versus Non-Urologists in the United States: An Analysis of the National Ambulatory Medical Care Survey

OBJECTIVES

To evaluate the extent to which erectile dysfunction (ED) is managed by urologists versus non-urologists. We sought to characterize the epidemiology, diagnosis, and outpatient treatment of ED using a nationally representative cohort.

METHODS

We examined all male patient visits between 2006 and 2016 in the National Ambulatory Medical Care Survey, a survey designed to provide a nationally representative estimate of ambulatory visits in the United States. Distribution of ED diagnoses among physician specialties was determined. Demographic, clinical, and treatment characteristics of men with ED seeing urologists versus non-urologists were compared using chi-squared tests.

RESULTS

Among the 170,499 patient visits analyzed, 1.2% were associated with a diagnosis of ED, which translated into 3,409,244 weighted visits annually. Visits for ED were predominantly seen by urologists (58.0%) and family practitioners (26.2%). Men visiting non-urologists for ED were more likely to be younger than 65 (77.4% vs 52.9%, P < .05). Men seeing urologists for ED more frequently had an active cancer diagnosis (24.2% vs 2.8%, P < .05). Non-urologists more readily ordered or reordered phosphodiesterase-5 inhibitors for men with ED (66.62% vs 50.77%, P < .05). Advanced therapies such as intracavernosal injections and intra-urethral agents were almost exclusively ordered by urologists compared to non-urologists (2.72% vs 0.25%, P < .05).

CONCLUSION

Almost half of all ED visits were seen by non-urologist providers, who were much less likely than urologists to order advanced pharmacologic therapies. This difference in prescribing patterns presents an opportunity for interdisciplinary collaboration and education to ensure that all patients seeking treatment for ED are receiving guideline-based care.

Platelet-Rich Plasma and Cellular Therapies for Sexual Medicine and Beyond

INTRODUCTION

Efforts to understand and unlock the body's potential for regeneration have increased dramatically in recent years. So-called "biohacking" hopes to improve functionality and reverse disease processes.

OBJECTIVES

This review will seek to summarize the available data for the use of platelet-rich plasma, cellular therapies, and other novel therapeutics within sexual medicine.

METHODS

The PubMed database search was performed using the keywords "Stem cell therapy in Erectile dysfunction (ED)", "Gene therapy in ED", "Novel therapeutics for ED", and "Biohacking". Popular news articles for regulation of stem cell therapy were reviewed.

RESULTS

Research efforts have managed to produce an array of novel therapeutics, including stem cell therapy and platelet-rich plasma. Although the use of these items has been largely focused within specialties other than urology, applications involving sexual medicine have been documented and appear to be increasing.

CONCLUSION

Despite evidence of these technologies being adopted within clinical practices as revenue-generators, quality data to support efficacy are quite limited. Matz EL, Scarberry K, Terlecki R, Platelet-Rich Plasma and Cellular Therapies for Sexual Medicine and Beyond. Sex Med Rev 2020;XX:XXX-XXX.