Erectile Dysfunction Research

Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study

This is the first randomized, double-blind, sham controlled study to our knowledge that shows that low intensity extracorporeal shock wave therapy has a positive short-term clinical and physiological effect on the erectile function of men who respond to oral phosphodiesterase type 5 inhibitor therapy. The feasibility and tolerability of this treatment, coupled with its potential rehabilitative characteristics, make it an attractive new therapeutic option for men with erectile dysfunction.

Vardi Y, Appel B, Kilchevsky A, et al. Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol. 2012 May;187(5):1769-1775.

Retrospective Review of Improvement of Erectile Function after Low Intensity Shockwave
Treatment with Urogold 100™

“In this US-based LiSWT retrospective study, the Urogold 100™ shockwave device has shown clinically relevant improvement in 63% of men with ED, based on self-report. Preliminary studies show that minimal erectile tissue homogeneity has a higher likelihood of positive treatment outcome with shockwave therapy. Only 1 patient with severe inhomogeneity showed improvement.
An IRB approved sham-controlled prospective 2 arm 40-week clinical trial using Urogold 100™ shockwave device with all subjects undergoing baseline and post-treatment Grayscale and Doppler ultrasound to assess objective erectile function changes is currently underway.”

Yih, J; Goldstein, S; Georgeon, L; Ramirez, R; Goldstein,  Retrospective Review of Improvement of Erectile Function after Low Intensity Shockwave
Treatment with Urogold 100™,  Thursday, October 24, 2019, 03:35 p.m. – 04:00 p.m., Location: Broadway Ballroom Foyer, E-poster Session 3 – Erectile Dysfunction Medical

Effect of Low-Intensity Extracorporeal Shock Wave on the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis

“Low-intensity extracorporeal shockwave therapy (Li-ESWT) has been reported as a useful and noninvasive treatment for erectile dysfunction (ED). Systematic review and meta-analysis are utilized to evaluate the efficacy of Li-ESWT by comparing the changes in the International Index of Erectile Function erectile function domain (IIEF-EF) and the Erection Hardness Score (EHS) versus sham therapy in men with ED. A systematic search of the MEDLINE, EMBASE, ClinicalTrials.gov, CBM, CNKI, WANGFANG, and VIP was conducted to obtain randomized controlled trials (RCTs) published in peer-reviewed journals or presented in abstract forms of Li-ESWT for ED treatment from January 2010 to June 2018. If RCTs are published in peer-reviewed literature and IIEF-EF scores and EHS are used to assess erectile function outcomes, they are eligible for inclusion. A meta-analysis was used to summarize the estimates. The meta-analysis included seven RCTs involving 522 participants. The data revealed that men treated with Li-ESWT showed significant improvement in pooled mean IIEF-EF scores from baseline to follow-up compared with sham therapy (MD: 1.99 points; 95% CI [1.35, 2.63]; p < .00001). Changes in the IIEF-EF score increased significantly in the treatment group (MD: 3.62; 95% CI [2.99, 4.25]; p < .00001). The EHS increased significantly in the treatment group in four studies (OR: 16.02; 95% CI [7.93, 32.37]; p < .00001). Patients with moderate and/or severe ED reported better results in mean IIEF scores (MD: 3.95; 95% CI [2.44, 5.46]; p < .00001). In meta-analysis of seven RCTs with men who received Li-ESWT for ED, there was evidence that the IIEF-EF and EHS experienced improvements following Li-ESWT.”

“The Erection Hardness Score (EHS) and International Index of Erectile Functioning (IIEF) score in men receiving low-intensity shockwave therapy improved significantly… Low-Intensity Shockwave Therapy may have the potential to become the first choice of non-invasive treatment for vasculogenic erectile dysfunction.”

Dong, L., Chang, D., Zhang, X., Li, J., Yang, F., Tan, K., Yang, Y., Yong, S., & Yu, X. (2019). Effect of Low-Intensity Extracorporeal Shock Wave on the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis. American journal of men’s health, 13(2), 1557988319846749. https://doi.org/10.1177/1557988319846749

Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction after Radical Prostatectomy: A Review of Preclinical Studies 

“Pro-Neurogenic changes, such as Schwann cell activation, release of neurotrophic factors, and penile stem or progenitor cell recruitment and activation were observed in penile tissue after Li-ESWT.  It’s ability to improve erectile functioning has been shown in patients with vasculogenic erectile dysfunction by many randomized controlled trials.

Zou, Z., Liang, J., Liu, Z. et al. Low-intensity extracorporeal shock wave therapy for erectile dysfunction after radical prostatectomy: a review of preclinical studies. Int J Impot Res 30, 1–7 (2018). https://doi.org/10.1038/s41443-017-0002-6

Low Intensity Extracorporeal Shock Wave Therapy Improves Erectile Function in a Model of Type II Diabetes Independently of NO/cGMP Pathway

“Results support Li-ESWT not only as an effective, alternative, noninvasive therapeutic option for erectile dysfunction in diabetic patients but also its use in combination with PDE5 inhibitors.”

Assaly-Kaddoum, R., Giuliano, F., Laurin, M., Gorny, D., Kergoat, M., Bernabé, J., Vardi, Y., Alexandre, L., & Behr-Roussel, D. (2016). Low Intensity Extracorporeal Shock Wave Therapy Improves Erectile Function in a Model of Type II Diabetes Independently of NO/cGMP Pathway. The Journal of urology196(3), 950–956. https://doi.org/10.1016/j.juro.2016.03.147

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