(233) Perceptions and Use of Penile Regenerative and Aesthetic Therapy Among SMSNA Members
Authors: Nam CS , Bieniek JM , Halpern JA , Hillelsohn J , Hsieh TM , Campbell KJ , Mishra K , Salter CA , Yee A , Lundy SD , Bajic P , Bernie HL 
Published: February 2024

Abstract

Introduction
Wave therapy (WT) and platelet rich plasma (PRP) have been evaluated in multiple medical contexts, but there is paucity of long-term data to support their applications in erectile dysfunction (ED) and Peyronie’s disease (PD). Despite the American Urological Association and Sexual Medicine Society of North America (SMSNA) recommending against the use of these therapies for ED and PD outside of a clinical trial, many practices offer WT and PRP as penile regenerative therapies.

Objective
We aim to understand current perceptions and practice patterns of SMSNA members in offering penile regenerative and aesthetic therapies.

Methods
An anonymous online survey was deemed IRB exempt and administered to current members of SMSNA electronically from 4/2023 to 6/2023 asking practitioner’s demographics, practice information, their familiarity and offering of various types of penile regenerative therapy (focused shockwave therapy [fSWT], radial wave therapy [RWT], PRP, stem cell therapy [SCT], penile botulinum toxin [Botox] injection) and penile aesthetic procedures including girth and length-enhancement. We included current SMSNA members who are physicians in practice or Advance Practice Providers (APPs) that practice in the US. We excluded those who are trainees and practice outside the US. We conducted descriptive statistics using RedCap.

Results
Of the 500 active SMSNA members, 46 completed the survey (response rate 9%). Participants were predominantly male (N=42, 91%), physician (N=43, 93%), fellowship-trained (N=39, 85%), and in practice for a median of 5 years. Participants mostly practiced in academic settings (N=33, 72%), and saw 10 or more patients with ED weekly (N=35, 76%). Most respondents reported being comfortable describing the differences between types of wave therapy (N=28, 61%). A minority of respondents offered RWT (N=3, 7%) and most indicated that there was no to low evidence to support its use (N=31, 67%). Ten respondents offered fSWT (N=10, 22%) and only a minority reported no to low evidence to support the use of fSWT (N=18, 39%). Five respondents (11%) offered PRP and most reported that there was no or low evidence to support use of PRP (N=31, 67%). None of the respondents offered SCT and most reported that there was no to low evidence to support the use of SCT (N=26, 57%). One respondent (2%) reported offering penile botox treatment while 19 (41%) reported that there was no to low evidence to support its use. A minority of survey respondents offered girth-enhancement procedures with three respondents (7%) offering hyaluronic acid. For length-enhancing procedures, eight respondents (17%) offered cosmetic scrotoplasty and three (7%) offered suprapubic lipectomy.

Conclusions
Penile regenerative and aesthetic therapies are not common practice among SMSNA members. With the notable exception of fSWT, majority of survey respondents felt that there was little to no evidence supporting penile regenerative and aesthetic therapies. Further understanding the practice patterns of SMSNA members will help identify future opportunities for multi-institutional collaborations to further evaluate the efficacy of these experimental therapies.

Disclosure
No.