Extracorporeal shockwave therapy in the treatment of erectile dysfunction: A prospective, randomized, double‐blinded, placebo controlled study

Yee, Chi‐Hang; Chan, Eddie Sy; Hou, See‐Ming; Ng, Chi‐Fai

doi:10.1111/iju.12506

Cited by 96 publications

(113 citation statements)

References 11 publications

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“…However, data on the therapeutic benefits of these treatments to restore erectile function are still scarce. Pioneer clinical studies reporting the use of low-intensity extracorporeal shock wave therapy (Li-ESWT) have shown that Li-ESWT could improve erectile function and penile hemodynamics in men with ED who respond to pharmacotherapy and convert PDE5-I non-responders to responders (1)(2)(3)(4). More clinical studies have been conducted since then revealing encouraging results, such as the improvement of International Index of Erectile Function score and/or Erectile Hardness Score and an effect that lasts up to 1 year (5-10).…”

mentioning

confidence: 99%

Low-energy Shock Wave Therapy Ameliorates Erectile Dysfunction in a Pelvic Neurovascular Injuries Rat Model

Matheu

Sun

et al. 2016

The Journal of Sexual Medicine

113

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Introduction Erectile dysfunction (ED) caused by pelvic injuries is a common complication of civil and battlefield trauma with multiple neurovascular factors involved, and no effective therapeutic approach is available. Aims To test the effect and mechanisms of low-energy shock wave (LESW) therapy in a rat ED model induced by pelvic neurovascular injuries. Methods Thirty-two male Sprague-Dawley rats injected with 5-ethynyl-2′-deoxyuridine (EdU) at newborn were divided into 4 groups: sham surgery (Sham), pelvic neurovascular injury by bilateral cavernous nerve injury and internal pudendal bundle injury (PVNI), PVNI treated with LESW at low energy (Low), and PVNI treated with LESW at high energy (High). After LESW treatment, rats underwent erectile function measurement and the tissues were harvested for histologic and molecular study. To examine the effect of LESW on Schwann cells, in vitro studies were conducted. Main Outcome Measurements The intracavernous pressure (ICP) measurement, histological examination, and Western blot (WB) were conducted. Cell cycle, Schwann cell activation-related markers were examined in in vitro experiments. Results LESW treatment improves erectile function in a rat model of pelvic neurovascular injury by leading to angiogenesis, tissue restoration, and nerve generation with more endogenous EdU+ progenitor cells recruited to the damaged area and activation of Schwann cells. LESW facilitates more complete re-innervation of penile tissue with regeneration of neuronal nitric oxide synthase (nNOS)-positive nerves from the MPG to the penis. In vitro experiments demonstrated that LESW has a direct effect on Schwann cell proliferation. Schwann cell activation-related markers including p-Erk1/2 and p75 were upregulated after LESW treatment. Conclusion LESW-induced endogenous progenitor cell recruitment and Schwann cell activation coincides with angiogenesis, tissue, and nerve generation in a rat model of pelvic neurovascular injuries.

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mentioning

confidence: 99%

Low-energy Shock Wave Therapy Ameliorates Erectile Dysfunction in a Pelvic Neurovascular Injuries Rat Model

Matheu

Sun

et al. 2016

The Journal of Sexual Medicine

113

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“…Yee et al (22) reported that there was no significant difference in IIEF and EHS scores between treatment and sham groups 13 weeks after LI-ESWT.…”

Section: Discussionmentioning

confidence: 98%

“…The reason for this may be the application of this treatment without separating ED patients into specific groups and application of different shockwaves for different durations with different protocols during the treatment. Moreover, in different studies, whether or not PDE5i was used before and during treatment may also have resulted in differences (7,17,18,19,20,21,22). Therefore, we tried to specify ED patients in our study and patients in severe ED group found to have arterial insufficiency based on penile Doppler ultrasonography results were included in the study group.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Low Density Linear Shockwave Treatment in Severe Arteriogenic Erectile Dysfunction Patients

Sönmez¹,

Kara²

2017

jus

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Objective: The aim of this study was to evaluate the efficacy of low-intensity linear shockwave treatment (LI-ESWT) in patients with severe arteriogenic erectile dysfunction (ED) by comparing LI-ESWT combined with daily use of phosphodiesterase type 5 inhibitors (PDE5i) with the daily use of PDE5i alone. Materials and Methods: A total of 23 patients were included in the study. The patients were separated into two groups: LI-ESWT + tadalafil 5 mg (n=10) group and tadalafil 5 mg only group (n=13). LI-ESWT was applied once a week for four weeks. Oral tadalafil 5 mg once a day was started and continued for three months in both groups. The patients were evaluated with the International Erectile Function Index Questionnaire Erectile Function Domain (IIEF-EF), Erection Hardness Score (EHS) and Sexual Encounter Profile (SEP) 2 and 3 before treatment and the 1 and 3 months after treatment. Results: No statistically significant difference was detected among IIEF-EF scores measured before and 1 and 3 months after treatment (p=0. 091, p=0.198). At the end of the third month, IIEF score increased 4 points in LI-ESWT + tadalafil 5 mg group and 3.2 points in tadalafil 5 mg only group. No statistically significant difference was detected in EHS, and the rate of positive responses to SEP2 and SEP3 questions at the 1 st and 3 rd months between the groups. Conclusion: LI-ESWT is easily applicable without any significant side effects and it has positive effects on the outcomes, however, it is not an effective treatment method in patients with severe arteriogenic ED. Keywords: Low-intensity linear shockwave treatment, phospodiesterase type 5 inhibitors, erectile dysfunction Amaç: Bu çalışmanın amacı, şiddetli arteriyojenik erektil disfonksiyona (ED) sahip hastalarda, fosfodiesteraz tip 5 (PDESİ) inhibitörünün (Tadalafil 5 mg) günlük kullanımı ile kombine edilen düşük dansiteli lineer şok dalga tedavisini (LI-ESWT), sadece PDESİ'nin günlük kullanımı ile kıyaslayarak LI-ESWT'nin etkinliğini değerlendirmektir. Gereç ve Yöntem: Toplam 23 hasta çalışmaya dahil edildi. Bu hastalar LI-ESWT + tadalafil 5 mg tedavisi (n=10) uygulanan, sadece tadalafil 5 mg tedavisi uygulanan (n=13) hastalar şeklinde iki gruba ayrıldı. LI-ESWT, 4 hafta boyunca haftada bir kez uygulandı. Her iki gruptaki hastalara da There are studies showing that low-intensity linear shockwave treatment (LI-ESWT) was effective and successful in erectile dysfunction (ED) due to vascular disorders, especially in arteriogenic ED. It has been claimed that LI-ESWT caused neovascularization by stimulating angiogenesis and increased endothelial cell proliferation. The efficacy of LI-ESWT + phosphodiesterase type 5 inhibitors (PDE5i) was compared with PDE5i treatment only in patients with severe ED who were diagnosed with penile arteriogenic ED based on penile Doppler ultrasonography.

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“…Three out of the four studies showed positive efect of ESWT on EHS scale compared to sham group. Only one study reported negative efect of ESWT on both EHS scale and IIEF score [30]. Hence, the efect of ESWT on ED is still inconclusive, although according to EHS scale, it is proven to have some potential in the treatment of ED [16].…”

Section: Eswt In the Treatment Of Erectile Dysfunction (Ed)mentioning

confidence: 99%

Extracorporeal Shock Wave Therapy: Non‐Urological Indications and Recent Trends

Maraie¹,

Osman²,

Salem³

2017

Updates and Advances in Nephrolithiasis - Pathophysiology, Genetics, and Treatment Modalities

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Extracorporeal shockwave lithotripsy (ESWL) was introduced in 1980 as the preferred tool by the urologist for the treatment of renal stones and or upper ureteral stones. ESWL is minimally invasive procedures, exposes patients to fewer anesthesias, and has equivalent stone-free rates comparable to open surgery and endourology interventions for the treatment of renal stones. Urolithiasis is not the only application for extracorporeal shock waves but there are also other applications for it. Extracorporeal shock wave is used for the treatment of gall bladder stones, common bile duct stone clearance, pancreatic calculi, salivary stones, erectile dysfunction, and refractory angina pectoris chronic wound healing. This chapter gives full review about ESWL as minimally invasive procedures in the following items: (i) ESWL l in treatment of gall stones; (ii) ESWL for common bile duct (CBD) stones; (iii) ESWL for pancreatic stones associated with pancreatic pseudo cysts and chronic pancreatitis; (iv) ESWL in the treatment of salivary stones; (v) ESWL in the treatment of erectile dysfunction (ED); (vi) Cardiac shock wave therapy (ESWL) in treatment of refractory angina (RA); (vii) ESWL and chronic wound healing; (viii) Recent trends in extracorporeal shockwave lithotripsy (ESWL); (ix) Post ESWL complementary therapy; and (x) The future of ESWL in the year 2038.

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Extracorporeal shockwave therapy in the treatment of erectile dysfunction: A prospective, randomized, double‐blinded, placebo controlled study

Cited by 96 publications

References 11 publications

Low-energy Shock Wave Therapy Ameliorates Erectile Dysfunction in a Pelvic Neurovascular Injuries Rat Model

Low-energy Shock Wave Therapy Ameliorates Erectile Dysfunction in a Pelvic Neurovascular Injuries Rat Model

Efficacy of Low Density Linear Shockwave Treatment in Severe Arteriogenic Erectile Dysfunction Patients

Extracorporeal Shock Wave Therapy: Non‐Urological Indications and Recent Trends

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