1.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
2.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
3.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
4.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
5.Regenerative Therapy in Erectile Dysfunction:A Survey on Current Global Practice Trends and GAF Expert Recommendations
Manaf Al HASHIMI ; Germar-M PINGGERA ; Taymour MOSTAFA ; Amarnath RAMBHATLA ; Taha HAMODA ; Rupin SHAH ; Eric CHUNG ; Ahmed HARRAZ ; Mohamed ARAFA ; Tuncay TOPRAK ; Omer RAHEEM ; Carlo GIULIONI ; Ponco BIROWO ; Luca BOERI ; Yassir JASSIM ; Priyank KOTHARI ; Ranjit VISHWAKARMA ; Bahadir SAHIN ; Widi ATMOKO ; Safar GAMIDOV ; Cesar ROJAS-CRUZ ; Darren KATZ ; Adriano FREGONESI ; Nazim GHERABI ; Armand ZINI ; Christopher Chee Kong HO ; Mohamed S. AL-MARHOON ; Marlon MARTINEZ ; Giorgio Ivan RUSSO ; Ayman RASHED ; Gian Maria BUSETTO ; Edmund KO ; Hyun Jun PARK ; Selahittin CAYAN ; Ramadan SALEH ; Osvaldo RAJMIL ; Dong Suk KIM ; Giovanni COLPI ; Ryan SMITH ; Maged RAGAB ; Ates KADIOGLU ; Quang NGUYEN ; Kadir BOCU ; Ahmed EL-SAKKA ; Charalampos THOMAS ; Hussain M ALNAJJAR ; Hiva ALIPOUR ; Ashok AGARWAL
The World Journal of Men's Health 2025;43(2):359-375
Purpose:
This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines.
Materials and Methods:
A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method.
Results:
Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support.
Conclusions
This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
6.The new 2023 FIGO staging system for endometrial cancer: what is different from the previous 2009 FIGO staging system?
Kyung Hee HAN ; NohHyun PARK ; Maria LEE ; Cheol LEE ; Hyojin KIM
Journal of Gynecologic Oncology 2024;35(5):e59-
Objective:
The International Federation of Gynecology and Obstetrics committee modified the endometrial cancer (EC) staging system based on the histopathological feature and molecular profile. The aim is to evaluate the clinical implications of the new 2023 system compared with the previous 2009 system.
Methods:
We retrospectively identified 161 patients with EC who underwent primary surgical treatment between 2014 and 2018 at Seoul National University Hospital. The droplet-digital polymerase chain reaction for POLE mutations and immunohistochemistry for MLH1, PMS2, MS2, MSH6, and p53 were performed using tissues from formalin-fixed, paraffin-embedded blocks. All patients were categorized according to the 2009 and 2023 staging systems.
Results:
The median follow-up period was 62.9 months (range, 0.3–110.9), and the median age was 57.2 years old (range, 28.0–85.9). The 5-year progression-free survival (PFS) for the 2023 system with molecular classification was 80.3% for stage I, 75.2% for stage II, 61.2% for stage III, and 22.2% for stage IV (p<0.001). Patients with the 2009 stage I and II disease were restaged using the 2023 system. In contrast, patients with stage III and IV disease were fixed in the 2009 and 2023 systems. Molecular classification downstaged 10 patients (71.4%) to IAm POLEmut and upstaged 6 patients (37.5%) to IICm p53abn . The 2023 system with molecular classification was associated with PFS and overall survival (p<0.001 and p=0.038).
Conclusion
The 2023 staging system for EC subdivided stages I and II compared to the 2009 system. The 2023 system with molecular classification is a good predictor of survival.
7.The new 2023 FIGO staging system for endometrial cancer: what is different from the previous 2009 FIGO staging system?
Kyung Hee HAN ; NohHyun PARK ; Maria LEE ; Cheol LEE ; Hyojin KIM
Journal of Gynecologic Oncology 2024;35(5):e59-
Objective:
The International Federation of Gynecology and Obstetrics committee modified the endometrial cancer (EC) staging system based on the histopathological feature and molecular profile. The aim is to evaluate the clinical implications of the new 2023 system compared with the previous 2009 system.
Methods:
We retrospectively identified 161 patients with EC who underwent primary surgical treatment between 2014 and 2018 at Seoul National University Hospital. The droplet-digital polymerase chain reaction for POLE mutations and immunohistochemistry for MLH1, PMS2, MS2, MSH6, and p53 were performed using tissues from formalin-fixed, paraffin-embedded blocks. All patients were categorized according to the 2009 and 2023 staging systems.
Results:
The median follow-up period was 62.9 months (range, 0.3–110.9), and the median age was 57.2 years old (range, 28.0–85.9). The 5-year progression-free survival (PFS) for the 2023 system with molecular classification was 80.3% for stage I, 75.2% for stage II, 61.2% for stage III, and 22.2% for stage IV (p<0.001). Patients with the 2009 stage I and II disease were restaged using the 2023 system. In contrast, patients with stage III and IV disease were fixed in the 2009 and 2023 systems. Molecular classification downstaged 10 patients (71.4%) to IAm POLEmut and upstaged 6 patients (37.5%) to IICm p53abn . The 2023 system with molecular classification was associated with PFS and overall survival (p<0.001 and p=0.038).
Conclusion
The 2023 staging system for EC subdivided stages I and II compared to the 2009 system. The 2023 system with molecular classification is a good predictor of survival.
8.The new 2023 FIGO staging system for endometrial cancer: what is different from the previous 2009 FIGO staging system?
Kyung Hee HAN ; NohHyun PARK ; Maria LEE ; Cheol LEE ; Hyojin KIM
Journal of Gynecologic Oncology 2024;35(5):e59-
Objective:
The International Federation of Gynecology and Obstetrics committee modified the endometrial cancer (EC) staging system based on the histopathological feature and molecular profile. The aim is to evaluate the clinical implications of the new 2023 system compared with the previous 2009 system.
Methods:
We retrospectively identified 161 patients with EC who underwent primary surgical treatment between 2014 and 2018 at Seoul National University Hospital. The droplet-digital polymerase chain reaction for POLE mutations and immunohistochemistry for MLH1, PMS2, MS2, MSH6, and p53 were performed using tissues from formalin-fixed, paraffin-embedded blocks. All patients were categorized according to the 2009 and 2023 staging systems.
Results:
The median follow-up period was 62.9 months (range, 0.3–110.9), and the median age was 57.2 years old (range, 28.0–85.9). The 5-year progression-free survival (PFS) for the 2023 system with molecular classification was 80.3% for stage I, 75.2% for stage II, 61.2% for stage III, and 22.2% for stage IV (p<0.001). Patients with the 2009 stage I and II disease were restaged using the 2023 system. In contrast, patients with stage III and IV disease were fixed in the 2009 and 2023 systems. Molecular classification downstaged 10 patients (71.4%) to IAm POLEmut and upstaged 6 patients (37.5%) to IICm p53abn . The 2023 system with molecular classification was associated with PFS and overall survival (p<0.001 and p=0.038).
Conclusion
The 2023 staging system for EC subdivided stages I and II compared to the 2009 system. The 2023 system with molecular classification is a good predictor of survival.
9.Clinical outcomes of preimplantation genetic testing for aneuploidy in high-risk patients: a retrospective cohort study
Jun Woo KIM ; So Young LEE ; Chang Young HUR ; Jin Ho LIM ; Choon Keun PARK
Clinical and Experimental Reproductive Medicine 2024;51(1):75-84
Objective:
The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients.
Methods:
This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF).
Results:
PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups.
Conclusion
PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

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