Paul J Rizk1, Jordan R Krieger1, Taylor P Kohn1, Alexander W Pastuszak2. 1. Baylor College of Medicine, Houston, TX, USA. 2. Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: pastusza@bcm.edu.
Abstract
BACKGROUND: Vasculogenic erectile dysfunction (ED) is one of the leading causes of male sexual dysfunction. In the past decade, multiple studies have examined the use of low-intensity extracorporeal shockwave therapy (Li-ESWT) for the treatment of ED. AIM: Investigate the efficacy of Li-ESWT for the treatment of ED. METHODS: We reviewed the published literature, including randomized controlled trials (RCTs), meta-analyses, and select single-arm studies on the use of Li-ESWT for the treatment of ED. OUTCOMES: Changes in International Index of Erectile Function scores were evaluated in patients undergoing Li-ESWT. RESULTS: There is no consensus from RCTs on the efficacy of Li-ESWT for the treatment of ED. Published meta-analyses have shown significant improvement in International Index of Erectile Function-erectile function domain scores in men undergoing Li-ESWT, especially when compared to men receiving sham treatment. However, differences in treatment protocols limit the generalizability of these findings. Li-ESWT may be more beneficial in cases of mild ED or when combined with phosphodiesterase type 5 inhibitors in men with moderate to severe ED. The role of Li-ESWT in the treatment of non-vasculogenic ED remains poorly defined. CONCLUSIONS: Li-ESWT could be beneficial in specific sub-sets of men with vasculogenic ED. However, future RCTs should attempt to optimize treatment protocols and have more stringent inclusion criteria to confirm these findings. Rizk PJ, Krieger JR, Kohn TP, et al. Low-Intensity Shockwave Therapy for Erectile Dysfunction. Sex Med Rev 2018;6:624-630.
BACKGROUND:Vasculogenic erectile dysfunction (ED) is one of the leading causes of male sexual dysfunction. In the past decade, multiple studies have examined the use of low-intensity extracorporeal shockwave therapy (Li-ESWT) for the treatment of ED. AIM: Investigate the efficacy of Li-ESWT for the treatment of ED. METHODS: We reviewed the published literature, including randomized controlled trials (RCTs), meta-analyses, and select single-arm studies on the use of Li-ESWT for the treatment of ED. OUTCOMES: Changes in International Index of Erectile Function scores were evaluated in patients undergoing Li-ESWT. RESULTS: There is no consensus from RCTs on the efficacy of Li-ESWT for the treatment of ED. Published meta-analyses have shown significant improvement in International Index of Erectile Function-erectile function domain scores in men undergoing Li-ESWT, especially when compared to men receiving sham treatment. However, differences in treatment protocols limit the generalizability of these findings. Li-ESWT may be more beneficial in cases of mild ED or when combined with phosphodiesterase type 5 inhibitors in men with moderate to severe ED. The role of Li-ESWT in the treatment of non-vasculogenic ED remains poorly defined. CONCLUSIONS: Li-ESWT could be beneficial in specific sub-sets of men with vasculogenic ED. However, future RCTs should attempt to optimize treatment protocols and have more stringent inclusion criteria to confirm these findings. Rizk PJ, Krieger JR, Kohn TP, et al. Low-Intensity Shockwave Therapy for Erectile Dysfunction. Sex Med Rev 2018;6:624-630.