Low-intensity Shock Research Articles

PS-5-3 Management of Erectile Dysfunction Using a Combination Treatment of Low-Intensity Shock Waves (LISW) and Platelet Rich Plasma (PRP) Intracavernosal Injections

It was investigated the efficacy of the combination therapy of Low-intensity shock waves (LISW) and Platelet-rich-plasma (PRP) intracavernosal injection in the treatment of erectile dysfunction (ED).PRP injections have recently been marketed as a form of therapy under the banner of regenerative medicine despite limited scientific evidence on its use for treating ED.LISW have shown encouraging results to treat ED.Combination therapy of LISW and PRP injections can improve erectile function. 112 patients (pts) were enrolled:Group A (53 pts) underwent 6 sessions of LISW (once/week),Group B (59 pts) underwent LISW + 3 intracavernosal injections of PRP (once/every two weeks).From 8 ml of blood, PRP was obtained with two centrifugation, giving 3-4 ml of PRP. The PRP was injected with two shots in both corpora cavernosa. Pts´ erectile function was evaluated at baseline and at 12 weeks post-treatment with the International index of erectile function (IIEF5) and the peak systolic velocity (PSV) of the cavernosal artery.

Low-intensity extracorporeal shock wave therapy for III B chronic pelvic pain syndrome.

BackgroundTo analyze the efficiency of low-intensity shock wave therapy (LI-ESWT) for patients with III B chronic pelvic pain syndrome (CPPS).MethodsThe study included an uncontrolled population of 32 patients who had suffered with CPPS for ≥3 months. LI-ESWT was performed without anesthesia via a perineal approach. The operation was carried out in four weeks by administering 12,000 shock waves. Using the Visual Analog Scale (VAS) and NIH-developed Chronic Prostatitis Symptom Index (NIH-CPSI), subsequent tests were performed at 1, 2, 4, and 12 weeks after the first LI-ESWT session.ResultsAll patients who received the four week course as treatment responded actively on the pain VAS and the NIH-CPSI, and both were significantly improved (P<0.05). Compared with the baseline parameters, the NIH-CPSI total score and VAS exhibited substantial improvement at 4 and 12 weeks, where a total improvement at four weeks was reached. It is easy and safe to perform LI-ESWT without anesthesia on an outpatient basis.ConclusionsLI-ESWT should be regarded as a promising new therapy for CPPS, as it is convenient to perform without any side-effects.

Novel Emerging Therapies for Erectile Dysfunction.

Currently, several treatments exist for the improvement of erectile dysfunction (ED). These include medical therapies such as phosphodiesterase type 5 inhibitors (PDE5-Is), invasive methods such as intracavernosal injection therapy of vaso-active substances, vacuum erection devices, and penile prosthesis implants. However, the percentage of patients that are unresponsive to available treatments and who drop out from treatments remains high. Current evidence reveals that the pathogenesis of ED is related to multiple factors including underlying comorbidities, previous surgery, and psychological factors. Diverse approaches using novel molecular pathways or new technologies have been tested as potential therapeutic options for difficultto-treat ED populations. Melanocortin receptor agonist, a centrally acting agent, showed promising results by initiating erection without sexual stimulation in non-responders to PDE5-Is. Recent clinical and pre-clinical studies using human tissues suggested that new peripherally acting agents including the Max-K channel activator, guanylate cyclase activator, and nitric oxide donor could be potential therapies either as a monotherapy or in combination with PDE5-Is in ED patients. According to several clinical trials, regeneration therapy using stem cells showed favorable data in men with diabetic or post-prostatectomy ED. Low-intensity shock wave therapy also demonstrated promising results in patients with vasculogenic ED. There are growing evidences which suggest the efficacy of these emerging therapies, though most of the therapies still need to be validated by well-designed clinical trials. It is expected that, should their long-term safety and efficacy be proven, the emerging treatments can meet the needs of patients hitherto unresponsive to or unsatisfied by current therapies for ED.

324 Shock Wave Erectile Enhancement Trial (SWEET) Study: A 41 Site Study on the Use of Shock Wave Therapy for the Treatment of Erectile Dysfunction

Shock wave therapy is becoming more prevalent in the treatment of erectile dysfunction (ED). Currently, there are no standard treatment protocols. The Shock Wave Erectile Enhancement Trial (SWEET) is a multi-site observational study on the use of Low-Intensity Shock Wave Therapy (Li-SWT) in the treatment of ED in North America. Adult men engaging in Li-SWT for the treatment of ED at participating study sites will be assessed for eligibility. The primary outcome will be erectile function measured as a continuous variable via the Sexual Health Inventory for Men (SHIM) score. A study questionnaire containing these items as well as items on pertinent demographic and comorbid characteristics will be administered to participants prior to Li-SWT, after treatment, and every three months after completing Li-SWT. Analysis will consist of descriptive statistics of SHIM score, demographic, and comorbid variables at baseline. Change in SHIM score over time will be explored using a multivariate mixed effects model and marginal estimates.

GUA-35 - Low intensity shock waves in the treatment of diabetic nephropaty: prospective, phase 1 study, Georgian arm

GUA-35 - Low intensity shock waves in the treatment of diabetic nephropaty: prospective, phase 1 study, Georgian arm

Low Intensity Shock Wave Therapy in Sexual Medicine – Clinical Recommendations From the European Society of Sexual Medicine (ESSM)

Low Intensity Shock Wave Therapy in Sexual Medicine – Clinical Recommendations From the European Society of Sexual Medicine (ESSM)

Low Intensity Shock Wave Therapy in the Management of Erectile Dysfunction

Low Intensity Shock Wave Therapy in the Management of Erectile Dysfunction

A Review of Current and Emerging Therapeutic Options for Erectile Dysfunction.

Contemporary treatment algorithms for erectile dysfunction (ED) involve the use of medical therapies such as phosphodiesterase type 5 (PDE5) inhibitors and intracavernosal injection therapy of vasoactive agents, as well as vacuum erection devices and penile prosthesis implants in medically refractory cases. However, the current therapeutic options only address the symptoms of ED and not the underlying pathogenesis that results in ED. Newer and novel ED therapies aspire to reverse ED conditions by preventing cavernosal fibrosis, promoting endothelial revascularization and modulating various neuro-hormonal pathways. Regenerative therapeutic strategies such as low-intensity shock wave, gene and cellular-based therapies, and penile transplants are designed to improve penile hemodynamics and revitalize the cavernosal smooth muscle to mitigate and/or reverse underlying ED. This state-of-art article evaluates current and emerging therapeutic options for ED.

Low-Intensity Shock Wave Therapy in Sexual Medicine—Clinical Recommendations from the European Society of Sexual Medicine (ESSM)

IntroductionLow-intensity shockwave therapy (LISWT) has been investigated for the treatment of uroandrological disorders including erectile dysfunction (ED), Peyronie’s disease (PD) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with controversial findings. AimTo review the evidence on LISWT for ED, PD, and CP/CPPS and provide clinical recommendations on behalf of the European Society of Sexual Medicine. MethodsMedline and Embase databases were searched for randomized clinical trials (RCTs), meta-analyses and open-label prospective or retrospective studies investigating the effect of LISWT on ED, PD, or CP/CPPS. OutcomesThe panel provided statements on clinically relevant questions concerning LISWT: (i) treatment efficacy, (ii) treatment protocol, (iii) clinical indications, and (iv) safety. The level of evidence was provided according to the Oxford 2011 criteria and graded using the Oxford Centre for Evidence-Based Medicine recommendations. Results11 RCTs and 5 meta-analyses investigated LISWT for ED. RCTs provided controversial results on the efficacy of LISWT and were affected by high heterogeneity and the small number of patients included. Pooled-data analysis showed an overall positive effect in terms of erectile function improvement but reported small estimates and included a largely heterogeneous cohort of patients. 4 RCTs and 1 meta-analysis assessed LISWT for PD. All trials showed positive findings in terms of pain relief but no effect on penile curvature and plaque size. Inclusion criteria vary widely among studies, and further investigation is needed. 5 RCTs investigated LISWT for CP/CPPS. Data showed a possible effect on pain relief, although there is no evidence supporting that pain relief was maintained or any improvement in pain over time. Clinical ImplicationsLISWT needs to be further investigated in the context of sexual medicine and is almost but not yet ready for clinical practice. Strengths and limitationsAll studies have been evaluated by a panel of experts providing recommendations for clinical practice. ConclusionsLISWT is a safe and well-tolerated procedure but its efficacy for the treatment of ED is doubtful and deserves more investigation. Patients reporting pain associated with PD may benefit from LISWT, although no effect is expected on disease progression. LISWT is not a primary treatment for CP/CPPS, but it may be considered as an option to relieve pain.Capogrosso P, Frey A, Jensen CFS, et al. Low-Intensity Shock Wave Therapy in Sexual Medicine—Clinical Recommendations from the European Society of Sexual Medicine (ESSM). J Sex Med 2019;16:1490–1505.

Опыт применения низкоинтенсивной ударно-волновой терапии в амбулаторной урологической практике для пациентов с хроническим простатитом

Опыт применения низкоинтенсивной ударно-волновой терапии в амбулаторной урологической практике для пациентов с хроническим простатитом

Emerging Treatments for Erectile Dysfunction: a Review of Novel, Non-surgical Options.

To review novel, non-surgical therapies for erectile dysfunction (ED). Recently, a landmark study identified the SIM1 locus, involved in the leptin-melanocortin pathway, as an independent risk factor for ED and a potential target for novel therapies. The recent literature otherwise has focused on low-intensity shock wave therapy (LiSWT), with several randomized trials and meta-analyses suggesting therapeutic efficacy. There are few novel oral agents for ED. There is growing evidence suggesting efficacy of intracavernosal stem cells therapy and low-intensity shock wave therapy (LiSWT), although these therapies are still investigational. A better understanding of the pathophysiologic spectrum of ED will offer new opportunities for novel, non-surgical therapies for ED.

Emotional enhancement of memory for neutral information: The complex interplay between arousal, attention, and anticipation

It can be challenging to explain why certain mundane details circumstantial to an emotional event are nonetheless remembered long after the experience. Here, we examined how attention selectively shapes memory for neutral objects that happen to coincide with either an unexpected or anticipated emotional event. Pictures of neutral objects were presented for 2 s and terminated with either a high-intensity shock, a low-intensity shock, or no shock. Recognition memory was tested 24 -hs later in a surprise test. Results showed no effect of shock intensity on memory for attended objects when shocks were unpredictable (Experiment 1). Similarly, there was no effect of shock intensity for attended objects when shock delivery was signaled before the object appeared (Experiment 2). There was a reduction in memory for unattended objects paired with an anticipated high-intensity shock (Experiment 3). Finally, subjects recognized slightly more attended objects paired with a high-intensity shock if shock intensity was signaled one second after the object was encoded (Experiment 4). We conclude that simply pairing objects with high-intensity shocks is insufficient to drive episodic memory enhancements for neutral information. But anticipation of an impending source of arousal can induce bidirectional effects: attending to an impending emotional event interferes with encoding of neutral information, but encoding an object just prior to anticipation of an emotional event can sometimes benefit memory. Overall, these results highlight a complex interplay between arousal, attention, and anticipation on emotion-induced memory for neutral information.

PO-01-055 Low intensity shock waves to treat erectile dysfunction: Is it safe for patients treated with anticoagulants?

PO-01-055 Low intensity shock waves to treat erectile dysfunction: Is it safe for patients treated with anticoagulants?

PD21-07 LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY IMPROVES ERECTILE DYSFUNCTION IN KIDNEY TRANSPLANT RECIPIENTS. RESULTS OF A PROSPECTIVE, RANDOMIZED, DOUBLE BLINDED, SHAM CONTROLLED STUDY

INTRODUCTION AND OBJECTIVES:Erectile dysfunction (ED) in kidney transplant patients is not uncommon. The ideal treatment modality should not interfere with the graft function. Low-intensity Shock W...

PD21-04 PATIENT-OFFICE PRACTICE DYNAMICS IN THE INQUIRY REGARDING RESTORATIVE THERAPIES FOR ED

INTRODUCTION AND OBJECTIVES:Platelet-rich plasma (PRP) and low-intensity shock wave therapy (LiSWT) are being touted as treatments for erectile dysfunction (ED) without data on long-term safety and...

Key comparison in the field of acceleration on low intensity shock sensitivity

This is the final report for CIPM key comparison CCAUV.V-K4 in the area of 'vibration' (quantity of acceleration). The aim of this comparison was to measure the voltage shock sensitivity of an accelerometer measuring chain including a standard accelerometer with a charge amplifier and the charge shock sensitivity of an accelerometer at different peak acceleration values with associated pulse durations. Nine Metrology Institutes from five RMOs have participated in the comparison with National Institute of Metrology, P.R. China as pilot lab and National Metrology Institute of Japan as co-pilot lab. For voltage shock sensitivity, all the participating laboratories provided their calibration results, which were all consistent within their declared expanded uncertainties. All participants contributed to the KCRVs calculated for six peak acceleration comparison values. For charge shock sensitivity, one participant failed to contribute to the calculation of the KCRV at 5 000 m/s2 and two participating laboratories were not consistent within their declared expanded uncertainties at a total of five peak acceleration comparison values. Further improvements of their calibration devices and uncertainty evaluations will provide more accurate and reliable measurement results in the future.KEY WORDS FOR SEARCHKey comparison; shock acceleration; low intensity shockMain textTo reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.The final report has been peer-reviewed and approved for publication by the CCAUV, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Methodological validation of a vertical ladder with low intensity shock stimulus for resistance training in C57BL/6 mice: Effects on muscle mass and strength, body composition, and lactate plasma levels

The objective of this study was to evaluate the effects of a vertical ladder device for resistance exercises with or without electrical shock stimulus on muscle strength, body composition, limb volume, muscle fibres and plasma lactate and glycemia of female mice. This device is represented by a vertical ladder with electrostimulation. It was analysed in groups of C57BL/6 mice practicing spontaneous physical activity in enriched environment, practicing resisted climbing exercises, practicing resistance exercises with the utility model in question and controls. The acute effects of blood lactate and dark light-box behaviour, and the short-term chronic effects of muscle strength, limb volume, body composition, muscle fibre area, and central and light-dark quantification were verified. According to the findings, the vertical electrostimulation ladder model presented acute effects on lactate levels, similar to other experimental models of resistance exercise and physical activity. The behaviour in the light-dark box test showed no difference between the groups. Regarding the short-term chronic response, the best results were obtained in the impact-stimulated resistive exercise in the limb traction muscle variables, greater brown adipose tissue weight, greater quadriceps femoral muscle structure, limb and greater weight number of nuclei in the skeletal striated muscle fibres. The use of the prototype showed similarities in the acute and chronic adaptations expected in resistance training. However, new study proposals should be encouraged, as the data presented here are the first notes on the use of this utility model.

Возможности применения ударно-волновой терапии в комплексной коррекции сексуальных дисфункций у женщин

In recent decades, interest in the quality of sexual life has significantly increased all over the world, not only among men but also among women, especially in low-birth-rate European countries. Improving this quality will not only resolve health issues in men and women, but will also improve the demographic situation in these countries. Scientific research in the field of both male and female sexual dysfunction is developing at a rapid pace. Both men and women go through the same phases of sexual reactions cycle: sexual desire, sexual arousal, and, as a result, orgasm and resolution phase. During the phase of sexual arousal, in both men and women, the blood flow to pelvic organs increases, but in the event of erectile dysfunction in men and frigidity in women, this process weakens or does not occur at all. Furthermore, the innervation of genital organs in male and female organisms is identical. Activation, which enables genital innervation, launches the activation of blood circulation in the target organs. Therefore, in case of ED in men, and in case of female sexual arousal disorder in women, along with other specific treatment methods, it is useful to perform non-invasive stimulation of insufficiently active physiological mechanisms of sexual arousal. However, for the treatment of ED in men, such stimulation has already been successfully used for a long time – that is the low-intensity extracorporeal shock wave therapy, which allows to restore the erection mechanism itself. Studies from throughout the world, including those conducted by Ukrainian scientists, have established that low-intensity extracorporeal shock wave therapy induces neovascularization and therefore improves blood circulation. The intensity of the basal and sexually stimulated genital blood flow is a necessary physiological tool of sexual arousal and orgasmic discharge, which makes the subject of artificial stimulation of this indicator by means of shock wave therapy in both men and women particularly important. The use of shock wave therapy can have a number of advantages not only due to the increased blood and lymph flow in the genitals, but also due to the powerful stimulation of the release of neurotransmitters and hormones which provide emotional coloring to the sexual feeling and increase libido (serotonin, dopamine, endorphins etc.). Therefore, along with combined therapy, the method of low-intensity extracorporeal shock wave therapy can be successfully used in the treatment of female sexual dysfunction. Key words: shock wave therapy, sexual dysfunction, female sexual arousal disorder, erectile dysfunction, DSM-5.

Low-intensity shock wave therapy ameliorates erectile dysfunction in men with pelvic fractures associated with urethral injury.

Erectile dysfunction (ED) is common in patients with pelvic fractures associated with urethral injury (PFUI). We aim to assess the efficacy and safety of low-intensity shock wave therapy (LiSWT) in ED treatment related to PFUI. Forty-three consecutive patients with PFUI who underwent surgical repair between January 2014 and March 2017 were sampled in Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. ED onset following surgical repair was initially treated with oral phosphodiesterase type 5 inhibitors (PDE5i) for six months. PDE5i non-responders were referred for LiSWT of six weekly sessions. Erectile function was evaluated by the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS). Forty-three consecutive patients were enrolled in our study. ED was observed in 79.1% (34/43) patients following surgical repair. These 34 patients were given oral PDE5i (Tadalafil® 5 mg) daily treatment, 64.7% (22/34) patients restored erectile function to normal range (EHS: 3.4 ± 1.3, IIEF-5: 21.7 ± 1.0). The other twelve PDE5i non-responders were referred for LiSWT. Seven patients (58.3%, 7/12) remained unable to maintain the rigidity for full sexual intercourse. The other five patients reported allowing full sexual intercourse. Based on our results, LiSWT may ameliorate the ED in men with PFUI and shift PDE5i non-responders to responders.

73 - Low intensity shock waves to treat erectile dysfunction: Is it safe for patients treated with anticoagulants?

73 - Low intensity shock waves to treat erectile dysfunction: Is it safe for patients treated with anticoagulants?