Effectiveness of Shock Wave Therapy: Implementation of a Soft Wide Focus Applicator in Patients With Erectile Dysfunction

Abstract

Low-intensity extracorporeal shock wave therapy (LI-ESWT) is of clinical interest for the treatment of erectile dysfunction (ED). Research in animal and human studies showed that the beneficial effect of LI-ESWT is due to its angiogenic properties. It is thought to stimulate neovascularization by inducing the expression of regeneration and growth related factors. This is a Progress report on LI-ESWT in the treatment of vascular ED using a SWFA (soft wide focused applicator) handpiece for a cohort of patients in a clinical center in Bogotá, Colombia. Clinical records were reviewed during the first half of 2016, with diagnosis of vascular ED and underwent a protocol of LI-ESWT once a week for 5 weeks, energy flux density 0.15mJ and 3000 pulses per session, with the MTS urogold100® and applicator OP155. Outcome measurements: Erection Hardness Score (EHS), International Index of Erectile Function, 5-item version (IIEF-5). 20 patients with a mean age of 53.1 ±12.1 years were included. At admission, 70% of patients had mild / moderate (n = 14), 20% (n = 4) moderate and 10% (n = 2) severe ED according to the IIEF-5 scale. After five sessions 25% (n = 5), and after one month follow-up even 45% (n = 9) of patients showed a clinical important difference (defined as an increase of ≥ 4 points) in the IIEF score with an average increase of 5 points (18 ±4.4). Assessing the EHS, 55.5% of patients at baseline (mean EHS: 3 ±0.6) had an erection insufficient to penetrate, this proportion decreased significantly to 28% after therapy (mean EHS: 4 ±0.7), a beneficial effect that was still persisting after one moth follow-up (mean EHS: 4 ±0.7).