368 Clinical Safety and Efficacy of Penile Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction in Non-Responders to PDE5 Inhibitors

Abstract

Erectile dysfunction (ED) in men is associated with vascular risk factors such as diabetes, hypercholesterolemia and aging. Low-intensity extracorporeal shock wave therapy (LI-ESWT) is currently being developed for the treatment of ED. The present study investigates the safety and efficacy of penile LI-ESWT in men with ED who could not achieve satisfactory intercourse even after treatment with phosphodiesterase type 5 inhibitors (PDE5i). A prospective study of LI-ESWT was conducted in 50 patients with vasculogenic ED initially treated with PDE5i (singly or in combination) for a minimum of three months. The subjects were treated with shock waves of intensity 0.09 mJ/mm (1500 pulses/session, 10 sessions spread over 5 weeks). All of the patients were evaluated at baseline, and at 5 weeks and 12 weeks post-treatment using the International Index of Erectile Function - Erectile Function (IIEF-EF) questionnaire. Forty eight patients aged 40.1 ± 10.2 years (Mean ± SD) included into the study were categorized, based on IIEF score at baseline, into ‘Severe ED’ group (IIEF score ≤ 11, n = 32) and ‘Moderate ED’ group (IIEF score > 11, n = 16). The mean IIEF scores improved significantly for the ‘Severe ED’ group (8.56 ± 2.42 to 17.53 ± 5.09, P < 0.0001) as well as for the ‘Moderate ED’ group (13.63 ± 1.02 to 21.56 ± 1.55, P < 0.0001) after 12 weeks of LI-ESWT treatment, without any adverse events.