Wearables for erectile quality: Just a catchy gadget?
The field of men’s health is undergoing a progressive transformation, as it strives to explore and adopt innovative assessment and treatment solutions. On the final day of EAU23, experts Dr. Maarten Albersen (BE) and Prof. Christian Gratzke (DE) led the Plenary Session ‘Men’s health as catchphrase: Evidence vs. marketing in the aging male’.
In his lecture “Medical treatment of BPH: nothing new on the horizon?”, Prof. Martin Michel (DE) stated: “The answer is ‘no’, nothing has made it as far as approval. Several alternative treatments have been tested such as intraprostatic injection of onabotulinum toxin A or fexapotide triflutate, and vasopressin receptor agonists (for nocturia), but there has been insufficient progress. There is little promise in the pipeline for new medical treatments to reach routine use in the next 3-5 years.”
He stated that in the meantime urologists must optimise the use of existing armamentarium, even though existing pharmacotherapy provide relevant symptom relief to many but not all men with LUTS suggestive of BPH.
“Combination treatment (alpha-blocker + ARI) is not more effective that alpha-blocker monotherapy for symptoms (within 1 year) but provides greater attenuation of progression if taken for more that one year. An earlier start of combination leads to better long-term effects on symptoms and progression but this is an added cost and could cause more side effects.”
Michel concluded: “Candidates for combination treatment must have large prostates (>30-40 ml) and realistic commitment to use combination treatment for more than one year. Benefits of the combination treatment must also be weighed individually against AE (adverse event) risks”.
Telemedicine care
Prof. Giovanni Cacciamani (US) delivered his lecture on “Telemedicine in urology: Here to stay?” with great enthusiasm about the progression of telemedicine care that evolved from the COVID-19 pandemic. “Prior to the pandemic there were limited resources and knowledge for telemedicine, but during the pandemic it became a much needed solution and the medical industry embraced the technology to serve their patients. Now telemedicine health care has grown significantly in the United States and will remain an integral part of medical care, with over 60 major healthcare companies providing services.”
He shared recent findings that indicated both the patient and the physician showed a positive response to telemedicine care, but services did remain more accessible to certain groups of patients than others. Study results also showed telemedicine care can be equivalent to in-person care for certain acute and chronic conditions.
“Future clinicians and all level of learners within health care will require more specific training on how to logistically manage telemedicine technology and how to clinically navigate a remote consultation”.
Wearables
Ass. Prof. Faysal Yafi (US) presented his lecture on “Wearables for erectile quality: Catchy gadget or valuable clinical instrument?”, with a summary of what is on the market and what is planned for the market in the near future.
“Wearable (electronic) devices/gadgets are gaining popularity amongst consumers and investigators for sexual function tracking, erectile dysfunction (ED) and premature ejaculation (PE). The prevalence of male sexual dysfunction increases with age, with over 50% of men aged 40 to 70 years reporting some degree of ED. Prevalence has also become increasingly common in young men as well, with 14.1% of males aged 18-31 reporting a diagnosis of ED and growing trends show reliance on PDE5i for erectile function in younger men.”
According to Ass. Prof. Faysal, the most common sexual function tracking device, Rigiscan, has robust evidence but is outdated because it is not compatible with new IT devices. The monitoring is also prone to false negatives and may be less useful in men with impaired sleep schedules. He did share details on many new devices being presented to the market, but there was little to no evidence that they were useful.
“FirmTech presents a more modern approach but more evidence is needed. For ED, Xialla is supported by smaller retrospective studies but also in this case, more evidence is needed. For PE, the vPatch is the only device with level 1 evidence and is soon to be available as a DTC (direct to consumer) option.”
This article provides a short overview of three state-of-the-art lectures which took place during the session, but there were also several insightful patient scenarios presented. Other topics included: Minimising ejaculatory dysfunction in BPH surgery; ejaculation-sparing enucleation/resection; and regenerative injectables for erectile dysfunction. You can (re)watch the full presentations via EAU On Demand on the Virtual Platform.