Abstract
ABSTRACTTo evaluate the efficiency of an energy density of 0.05mj/mm2 of low intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) patients.A total of 45 ED patients met the inclusion criteria, including 7 PDE5i responders and 38 nonresponders. All the patients have already been delivered 10000 shockwaves of total seven treatment points twice a week for 4 weeks. Simultaneously, questionnaires of International Index of Erectile Function-Erectile Function (IIEF-EF), Erectile Hard Score (EHS) and Minimal Clinical Important Differences (MCID) were evaluated for the efficiency and safety at 8th and 16th weeks.The changes in the IIEF-EF score by MCID suggested that Li-ESWT treatment was effective in 22 PDE5i nonresponders patients (58%) at 8th week. Then at 16th week the number of patients who were effectively treated increased to 27 (71%). Among PDE5i responders, 5 patients (71%) were effective base on MCID at 16th week. Among PDE5i nonresponders 22 patients (58%) achieved erection hard enough for vaginal penetration and increased to 27 (71%) patients at 16th week (EHS ≥3). Moreover, even 3 patients achieved EHS 4 in PDE5i nonresponders at 16th week. Among PDE5i responders, 4 of 7 patients reached EHS of 4 from EHS 3 at 16th week. Apart from this, Li-ESWT treatment was also effective in 9 patients (24%) in PDE5i nonresponders without follow-up PDE5i.Energy flux density (EFD) of 0.05 of Li-ESWT could improve the erectile function of ED patients with PDE5i response. In addition, EFD of 0.05 of Li-ESWT treatment could turn PDE5i nonresponders to responders.
Highlights
Erectile dysfunction (ED) is a male sexual dysfunction defined as a consistent or recurrent inability to attain or maintain an erection sufficient for sexual intercourse [1]
We evaluated an improvement on Index of Erectile Function-Erectile Function (IIEF-EF) according to Minimal Clinical Important Differences (MCID) criteria, at least 4 points improvement for ED patients [20]
The success rate of the Energy flux density (EFD) of 0.09mj/mm2 of low intensity extracorporeal shockwave therapy (Li-ESWT) treatment for ED patients who do not respond to phosphodiesterase type 5 inhibitor (PDE5i) is largely unsuccessfully [10]
Summary
Erectile dysfunction (ED) is a male sexual dysfunction defined as a consistent or recurrent inability to attain or maintain an erection sufficient for sexual intercourse [1]. The current mainstream treatments are the use of oral phosphodiesterase type 5 inhibitor (PDE5i), low intensity extracorporeal shockwave therapy (Li-ESWT), intracavernous injections of vasodilating agents and penile prostheses [2]. None of them can improve the underlying pathophysiological changes of erectile dysfunction, except for Li-ESWT [3]. Up to 35% of ED patients do not respond with PDE5i and are prone to the most common side effects such as headaches and blushing [4]. Patients using PDE-5i should be warned about a possible link between PDE-5i use and occurrence of hearing impairment [5]. Intracavernous injections are effective but their use requires careful dose titration and some precautions. The treatment of PDE-5i for ED enhance sexual function by improving the quality of single erections. It is quite significant to found a supplement therapy to patients
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Schedule a callMore From: International braz j urol : official journal of the Brazilian Society of Urology
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