title: Innovative trends and perspectives for erectile dysfunction treatment: A systematic review.
abstract: OBJECTIVE
  To review contemporary knowledge concerning the innovative trends and perspectives in the treatment of erectile dysfunction (ED).
  
  
  METHODS
  Medline was reviewed for English-language journal articles between January 2000 and March 2016, using the terms 'erectile dysfunction treatments', 'new trends' and 'perspectives'. In all, 114 original articles and 16 review articles were found to be relevant. Of the 76 cited papers that met the inclusion criteria, 51 papers had level of evidence of 1a-2b, whilst 25 had level of evidence of 3-4. Criteria included all pertinent review articles, randomised controlled trials with tight methodological design, cohort studies, and retrospective analyses. We also manually reviewed references from selected articles.
  
  
  RESULTS
  Several interesting studies have addressed novel phosphodiesterase type 5 inhibitors (PDE5Is), orodispersible tablets, their recent chronic use, and combination with other agents. A few controlled studies have addressed herbal medicine as a sole or additional treatment for ED. Experimental studies and exciting review papers have addressed stem cells as novel players in the field of ED treatment. Other recent articles have revised the current status of low-intensity extracorporeal shockwave therapy in the field of ED. A few articles without long-term data have addressed new technologies that included: external penile support devices, penile vibrators, tissue engineering, nanotechnology, and endovascular tools for ED treatment.
  
  
  CONCLUSIONS
  The current treatment of ED is still far from ideal. We expect to see new drugs and technologies that may revolutionise ED treatment, especially in complex cases.
authors: Department of Urology, Suez Canal University, Ismailia, Egypt.
authors: Ezzat A
authors: EA
authors: Ismail
authors: Department of Urology, Suez Canal University, Ismailia, Egypt.
authors: Ahmed I
authors: AI
authors: El-Sakka
keywords: (hUCB-)MSCs, (human umbilical cord blood) mesenchymal stem cells; ADSCs, adipose tissue-derived stem cells; ED, erectile dysfunction; Erectile dysfunction; FDA, USA Food and Drug Administration; Herbal treatment; ICI, intracavernosal injection; LI-ESWT, low-intensity extracorporeal shockwave therapy; NO, nitric oxide; PDE5 inhibitors; PDE5Is, phosphodiesterase type 5 inhibitors; RP, radical prostatectomy; SC, stem cell; Shockwave therapy; Stem cells; VED, vacuum erectile device; VEGF, vascular endothelial growth factor; cGMP, cyclic guanosine monophosphate; cNOS, constitutive nitric oxide synthase; sGC, soluble guanylate cyclase