When erectile dysfunction, or Erectile Dysfunction (ED), is spoken of, the important question clinically may not be only "which method gives the best result", but rather "which method suits the cause of the symptoms in each individual".
This article compares the approaches to caring for ED that men usually study and bring to compare with one another, namely medicines in the group of PDE5 inhibitors, Focused Shockwave Therapy, and the injection of Growth Factor, explaining the differences in the mechanism of action, the aim of each approach, the limitations that should be known, and the reason why assessment by a doctor is an important step before deciding to choose an approach to treatment.
This is so that the reader understands that caring for ED does not have a single answer for everyone, but should be considered from the cause, the severity of the symptoms, health overall, the results of the diagnostic examination, and the goals of restoration specific to the individual, together with the doctor.
The basis that must be understood before the comparison
ED is not a state that has a single cause, but may have several factors together — vascular (Vasculogenic ED), hormonal, such as a state of the male hormone decreasing according to age (Andropause), of the nervous system (Neurogenic ED), and abnormality of the muscles of the pelvic floor.
For this reason, choosing the approach to care should begin with diagnosing the cause, not merely comparing prices, the reputation of a procedure, or the outcomes from the experience of others. The Penile Color Doppler Ultrasonography (PCDU) examination together with assessment of the hormones and of health overall is therefore important information that helps the doctor plan the treatment suitably for each individual.
Medicines in the group of PDE5 Inhibitors: the role and the scope
Medicines in the group of Phosphodiesterase Type 5 Inhibitors work by dilating the blood vessels in the spongy shaft only during the period in which they act. The user takes them before sexual activity according to the doctor's advice. The advantage of this group of medicines is that the result begins to be seen in the short term and they are convenient to use. The limitation that should be understood is that this group of medicines does not put right the root factors of the symptoms, and in those who have degeneration of the blood vessels at a deep level, the effect of the medicine may decrease as time passes.
Focused Shockwave Therapy (f-ESWT): the structural aim
Focused Shockwave Therapy uses focused low-energy sound waves to stimulate the release of VEGF in order to create new capillaries in the spongy shaft and restore the lining of the wall of the blood vessels. This procedure is not directed at giving a result in the short term, but is directed at supporting restoration at the cell level throughout the 2–3 months of the programme. Shockwave is usually considered in cases with vascular factors as well, where the response to medicine has decreased, or where an approach that does not rely on medicine in the long term is wanted.
The injection of Growth Factor: biological intervention
The procedure of injecting Superdose Activated Purified Growth Factor is directed at sending a biological substance extracted at high concentration into the tissue of the spongy shaft at the position wanted, under the guidance of ultrasound, in order to support the process of creating new blood vessels and repairing the tissue at the cell level. This procedure is usually considered in cases with structural change of the tissue, or is used together with Shockwave in a programme requiring integrated restoration.
A comparison by mechanism
| Dimension | PDE5 medicines | Focused Shockwave | Growth Factor injection |
|---|---|---|---|
| Aim | Dilating the blood vessels only during the period of action | Stimulating the creation of new blood vessels in the tissue | Supporting the repair of the tissue at the cell level |
| Period of response | Within the hour of taking it | 2–3 months of continuous stimulation | According to the cycle of response of the tissue |
| Form of use | As needed before the activity | A procedure at the clinic according to the schedule set | A procedure at the clinic according to the plan specific to the individual |
| Angle of care | Relieving the symptoms at that moment | Restoring the vascular factors | Restoring the structure of the tissue |
Do these choices conflict with one another?
Clinically, the three approaches do not always have to be choices of which one or another must be chosen. In some cases the doctor may consider using them together under a plan of care specific to the individual, according to the cause of the ED and the result of the assessment.
For example, Focused Shockwave may be used as the main axis of the programme of restoration, while the injection of Growth Factor may help reinforce the response of the tissue at the cell level. In some cases with suitable indications, the doctor may consider another Regenerative Medicine approach, such as Stem Cell Therapy, as well, including considering the Advanced Pelvic Neuro-Vascular Protocol for those who have factors from the muscles of the pelvic floor.
Therefore, designing the plan of care should begin with diagnosis and assessment of the cause specific to the individual, not from the popularity of a procedure, or from choosing one technology or another apart from the clinical context.
The PYONG MEN approach: designing a plan specific to the individual
At PYONG MEN, considering the choices of treatment for ED begins with assessing the cause systematically, with the Penile Color Doppler Ultrasonography (PCDU) examination, assessment of the level of the hormones and the metabolic state, as well as examination and assessment of the muscles of the pelvic floor that may be connected with erection.
Once the doctor understands the root factors of the symptoms, a plan of care specific to the individual is then designed, considering the suitability of the procedures, the intensity of the treatment, and the combining of the various technologies so that they correspond to the character of each case.
In brief
- Comparing the approaches to caring for ED should begin with understanding the cause of the symptoms, not with ranking which method is best
- PDE5 inhibitor medicines are directed at helping the symptoms improve during the period in which the medicine is wanted, while Focused Shockwave is directed at restoring the vascular factors, and Growth Factor is directed at supporting the process of repair of the tissue
- The three approaches do not conflict with one another, and in some cases they may be used together under a programme of restoration specific to the individual
- The Penile Color Doppler Ultrasonography (PCDU) examination together with clinical assessment is important information in choosing the suitable approach
- At PYONG MEN, the plan of care is designed from the result of the diagnosis, the cause of the symptoms, and what is suitable specifically for the individual
Frequently asked questions (FAQ)
1. Between PDE5 medicines, Shockwave, and Growth Factor, which choice gives the best result? There is no approach that is "the best" in every case. The suitability depends on the cause of the symptoms, the level of severity, and the accompanying factors. Clinical assessment will help the doctor choose the approach that corresponds most closely to your case.
2. Can PDE5 medicines be used together with Shockwave? In many cases, using them together is a choice that the doctor considers. Adjusting the medicine should be under the advice of the doctor only.
3. Which approach comes first, Shockwave or Growth Factor? The order of the procedures depends on the condition of the tissue and the cause of the symptoms. In some cases Shockwave will be used as the main axis; in some cases the injection of Growth Factor will be included in the programme from the outset.
4. If PDE5 medicine still gives a result, is it necessary to consider Shockwave? If the response to the medicine is still good, the patient and the doctor may discuss whether structural restoration should be considered alongside. The decision depends on the long-term goals and the results of the diagnostic examination.
5. How do the costs of each approach compare? Comparing the costs should be considered in the context of the whole plan of treatment, not the price per session of a single procedure. At PYONG MEN the budget is assessed according to Plan A, B, C, which is a preliminary assessment and depends on the case.