MP79-19 INDIRECT ASSESSMENT OF LOW INTENSITY SHOCKWAVE THERAPY’S ENERGY DENSITY AND PULSE FREQUENCY FOR ERECTILE DYSFUNCTION: A BAYESIAN NETWORK META-ANALYSIS AND META-REGRESSION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP79-19 INDIRECT ASSESSMENT OF LOW INTENSITY SHOCKWAVE THERAPY’S ENERGY DENSITY AND PULSE FREQUENCY FOR ERECTILE DYSFUNCTION: A BAYESIAN NETWORK META-ANALYSIS AND META-REGRESSION David E. Hinojosa-Gonzalez, Alejandro Talamas-Mendoza, Karla Diaz-Garza, Mauricio Torres-Martinez, Beatriz S. Hernandez, and Roberto Gonzalez-Oyervides David E. Hinojosa-GonzalezDavid E. Hinojosa-Gonzalez More articles by this author , Alejandro Talamas-MendozaAlejandro Talamas-Mendoza More articles by this author , Karla Diaz-GarzaKarla Diaz-Garza More articles by this author , Mauricio Torres-MartinezMauricio Torres-Martinez More articles by this author , Beatriz S. HernandezBeatriz S. Hernandez More articles by this author , and Roberto Gonzalez-OyervidesRoberto Gonzalez-Oyervides More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003356.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Erectile dysfunction (ED) is the persistent inability to achieve and maintain penile rigidity necessary for sexual activity. Emerging alternative therapies such as Low – intensity shockwave therapy (LiST) are a possible therapeutic alternative, these are hypothesized to activate regenerative pathways, enhancing endothelial function, angiogenesis and neuroplasticity. This study aims to employ a network meta-analysis framework to compare LiSWT energy density and pulse frequency’s effectiveness. METHODS: In May 2022 a systematic search of online databases PubMed, MEDLINE, Scopus, Web of Science and Google Scholar was performed. Search terms included keywords “Erectile dysfunction”, “Management of Erectile Dysfunction”, “Shock wave therapy for Erectile Dysfunction”. Abstracted RCTs were used to model data for IIEF networks analyzed through a Bayesian Network framework. RESULTS: A total of 1,207 patients were included. Treatment stratification by energy delivery as measured by joules, which included 0.09, 0.15, and 0.20 as well as radial waves revealed LiST to be effective regardless of intensity while radial waves were found to have non-significant differences with placebo groups. Out of these interventions, 0.15 joules had the greatest increase in IIEF at a MD vs Placebo of 4.9[2.8,7.2] and the highest ranking at SUCRA=0.983. Treatment stratification by number of pulses per session, which included 500, 1500, and >3000 as well as radial waves revealed all of the aforementioned interventions except radial waves to have a significant increase in IIEF. Out of these, 1500 pulses/session had the highest ranking with a MD vs Placebo of 4.6[3.9,5.4] SUCRA=0.996. CONCLUSIONS: Our network meta-analysis suggests LI-SWT to be an effective intervention for ED as measured by increases in IIEF compared to placebo. Sessions featuring 1,500 shocks and energy density of 0.15 joules appear to be the most effective while radial waves did not seem to be an effective intervention. Further high quality studies such as randomized controlled clinical trials are needed to validate these findings. Source of Funding: No funding was received © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1149 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information David E. Hinojosa-Gonzalez More articles by this author Alejandro Talamas-Mendoza More articles by this author Karla Diaz-Garza More articles by this author Mauricio Torres-Martinez More articles by this author Beatriz S. Hernandez More articles by this author Roberto Gonzalez-Oyervides More articles by this author Expand All Advertisement PDF downloadLoading ...