Can Low-Intensity Extracorporeal Shockwave Therapy Improve Erectile Function? A 6-Month Follow-up Pilot Study in Patients with Organic Erectile Dysfunction
There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Low-intensity extracorporeal shockwave therapy (LI-ESWT) is currently under investigation
regarding its ability to promote neovascularization in different organs.
To evaluate the effect of LI-ESWT on men with erectile dysfunction (ED) who have previously
responded to oral phosphodiesterase type 5 inhibitors (PDE5-I).
We screened 20 men with vasculogenic ED who had International Index of Erectile Function
ED (IIEF-ED) domain scores between 5-19 (average: 13.5) and abnormal nocturnal penile
tumescence (NPT) parameters. Shockwave therapy comprised two treatment sessions per
week for 3 wk, which were repeated after a 3-wk no-treatment interval.
LI-ESWT was applied to the penile shaft and crura at five different sites.
Assessment of erectile function was performed at screening and at 1 mo after the end
of the two treatment sessions using validated sexual function questionnaires, NPT
parameters, and penile and systemic endothelial function testing. The IIEF-ED questionnaire
was answered at the 3- and 6-mo follow-up examinations.
We treated 20 middle-aged men (average age: 56.1 yr) with vasculogenic ED (mean duration:
34.7 mo). Eighteen had cardiovascular risk factors. At 1 mo follow-up, significant
increases in IIEF-ED domain scores were recorded in all men (20.9 +/- 5.8 vs 13.5+/-
4.1, p<0.001); these remained unchanged at 6 mo. Moreover, significant increases in
the duration of erection and penile rigidity, and significant improvement in penile
endothelial function were demonstrated. Ten men did not require any PDE5-I therapy
after 6-mo follow-up. No pain was reported from the treatment and no adverse events
were noted during follow-up.
This is the first study that assessed the efficacy of LI-ESWT for ED. This approach
was tolerable and effective, suggesting a physiologic impact on cavernosal hemodynamics.
Its main advantages are the potential to improve erectile function and to contribute
to penile rehabilitation without pharmacotherapy. The short-term results are promising,
yet demand further evaluation with larger sham-control cohorts and longer follow-up.
Copyright (c) 2010 European Association of Urology. Published by Elsevier B.V. All
rights reserved.