Erectile dysfunction (ED) [1] and Peyronie’s disease (PD) [2] significantly impact quality of life and intimate relationships. ED is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance [1]. PD is a localized fibrotic condition of the penile tunica albuginea, typically arising from abnormal wound-healing, and is associated with curvature, penile pain, and varying degrees of ED [2]. Contemporary management of ED and PD follows guidelines set by major urological associations. The American Urological Association (AUA) and European Association of Urology (EAU) emphasize patient education, risk factor modification, and shared decision-making [3,4,5]. There is growing interest in regenerative therapies such as low-intensity shockwave therapy (LI-SWT) [6] and platelet-rich plasma (PRP) [7] to improve outcomes [7]. However, none of the regenerative therapies are included in the guidelines, except for SWT included as a treatment option in the EAU guideline for mild vasculogenic ED [5].

This comment seeks to establish an algorithm incorporating LI-SWT and PRP into the treatment pathways already established thus far so that patients may benefit from both the current offerings as well as novel approaches. The ultimate goal is to improve functional outcomes for men while preventing disease progression and increasing opportunities for therapy. With the incorporation of regenerative medicine, urologists will possess the knowledge to select the best patients and counsel them appropriately. The algorithms presented here are structured by disease severity (for ED) and phase (acute vs. chronic PD) to guide clinicians in personalized management.

勃起功能障碍（Erectile Dysfunction， ED）[1]和佩罗尼病（Peyronie's disease， PD）[2]显著影响生活质量和亲密关系。ED 是指持续无法达到或维持足以达到令人满意的性能力的勃起[1]。PD 是白膜的局部纤维化疾病，通常由伤口愈合异常引起，并伴有弯曲、疼痛和不同程度的 ED[2]。ED 和 PD 的当代管理遵循主要泌尿外科协会制定的指南。美国泌尿外科协会（American Urological Association， AUA）和欧洲泌尿外科协会（European Association of Urology， EAU）强调患者教育、危险因素修正和共同决策[3,4,5]。人们对低强度冲击波疗法（low-intensity shockwave therapy， LI-SWT）[6]和富血小板血浆（platelet-rich plasma， PRP）[7]等再生疗法越来越感兴趣，以改善结局[7]。然而，除了 SWT 作为轻度血管源性 ED 指南的治疗选择外，指南中没有纳入任何再生疗法[5]。

本评论旨在建立一种将 LI-SWT 和 PRP 纳入迄今为止已经建立的治疗途径的算法，以便患者可以从当前的产品和新方法中受益。最终目标是改善男性的功能结果，同时防止疾病进展并增加治疗机会。随着再生医学的结合，泌尿科医生将拥有选择最佳患者并为他们提供适当咨询的知识。本文介绍的算法按疾病严重程度（ED）和阶段（急性与慢性 PD）进行结构，以指导临床医生进行个性化管理。