Lessa PF. et al., 2025: Penile rehabilitation after radical prostatectomy using low-intensity shockwave therapy for erectile function: late results findings from a randomized clinical trial.

Monday, 14 July 2025

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Pedro Fernandes Lessa 1, Willy Baccaglini 1, Matheus Pascotto de Salles 1, Reuli Cordeiro da Silva 1, Cristiano Linck Pazeto 1, Leonardo Seligra Lopes 1, Sidney Glina 1
1Department of Urology, Faculdade de Medicina do ABC, Santo André, 09060-650 Brazil.

Abstract

No abstract available

J Sex Med. 2025 Feb 5:qdaf012. doi: 10.1093/jsxmed/qdaf012. Online ahead of print.
PMID: 39907270

Comments 1

Jens Rassweiler on Monday, 14 July 2025 11:00

The article discusses a study assessing the long-term efficacy of low-intensity shockwave therapy (LI-ESWT) for erectile dysfunction (ED) in patients following radical prostatectomy (RP). ED can result from nerve and vascular damage during RP, affecting patients’ quality of sexual life. The study aimed to evaluate whether LI-ESWT could improve erectile function over time after surgery.

Methods: The researchers previously reported promising short-term results indicating that LI-ESWT could enhance erectile function post-RP. In the current follow-up study, they evaluated 35 patients over a median follow-up of 45 months, after excluding those who were not sexually active or had undergone additional treatments. The patients were divided into two groups: one receiving phosphodiesterase type 5 inhibitors (PDE5i) alone, and the other receiving PDE5i plus LI-ESWT.

Results: While the LI-ESWT group had a higher mean score on the International Index of Erectile Function (IIEF-5) than the control group, the difference was not statistically significant. Moreover, the primary endpoint—a difference of at least four points in IIEF-5 score favoring the LI-ESWT group—was not achieved. The study identified limitations including a significant loss of participants to follow-up and variability in shockwave therapy protocols.

Conclusions: While LI-ESWT did not demonstrate a statistically significant impact on long-term erectile function recovery after RP, the study contributes to the understanding of this therapy's potential role. The authors call for further research with larger sample sizes and standardized treatment protocols to better define LI-ESWT's effectiveness in penile rehabilitation post-surgery.
In summary, the article contributes to the field of sexual medicine and oncology by exploring innovative treatments for post-prostatectomy erectile dysfunction. It emphasizes the need for ongoing research and dialogue among healthcare professionals to improve care for patients facing the long-term consequences of their treatment.

Jens Rassweiler

Methods: The researchers previously reported promising short-term results indicating that LI-ESWT could enhance erectile function post-RP. In the current follow-up study, they evaluated 35 patients over a median follow-up of 45 months, after excluding those who were not sexually active or had undergone additional treatments. The patients were divided into two groups: one receiving phosphodiesterase type 5 inhibitors (PDE5i) alone, and the other receiving PDE5i plus LI-ESWT.

Results: While the LI-ESWT group had a higher mean score on the International Index of Erectile Function (IIEF-5) than the control group, the difference was not statistically significant. Moreover, the primary endpoint—a difference of at least four points in IIEF-5 score favoring the LI-ESWT group—was not achieved. The study identified limitations including a significant loss of participants to follow-up and variability in shockwave therapy protocols.

Conclusions: While LI-ESWT did not demonstrate a statistically significant impact on long-term erectile function recovery after RP, the study contributes to the understanding of this therapy's potential role. The authors call for further research with larger sample sizes and standardized treatment protocols to better define LI-ESWT's effectiveness in penile rehabilitation post-surgery.
In summary, the article contributes to the field of sexual medicine and oncology by exploring innovative treatments for post-prostatectomy erectile dysfunction. It emphasizes the need for ongoing research and dialogue among healthcare professionals to improve care for patients facing the long-term consequences of their treatment.

Jens Rassweiler

The article discusses a study assessing the long-term efficacy of low-intensity shockwave therapy (LI-ESWT) for erectile dysfunction (ED) in patients following radical prostatectomy (RP). ED can result from nerve and vascular damage during RP, affecting patients’ quality of sexual life. The study aimed to evaluate whether LI-ESWT could improve erectile function over time after surgery. Methods: The researchers previously reported promising short-term results indicating that LI-ESWT could enhance erectile function post-RP. In the current follow-up study, they evaluated 35 patients over a median follow-up of 45 months, after excluding those who were not sexually active or had undergone additional treatments. The patients were divided into two groups: one receiving phosphodiesterase type 5 inhibitors (PDE5i) alone, and the other receiving PDE5i plus LI-ESWT. Results: While the LI-ESWT group had a higher mean score on the International Index of Erectile Function (IIEF-5) than the control group, the difference was not statistically significant. Moreover, the primary endpoint—a difference of at least four points in IIEF-5 score favoring the LI-ESWT group—was not achieved. The study identified limitations including a significant loss of participants to follow-up and variability in shockwave therapy protocols. Conclusions: While LI-ESWT did not demonstrate a statistically significant impact on long-term erectile function recovery after RP, the study contributes to the understanding of this therapy's potential role. The authors call for further research with larger sample sizes and standardized treatment protocols to better define LI-ESWT's effectiveness in penile rehabilitation post-surgery. In summary, the article contributes to the field of sexual medicine and oncology by exploring innovative treatments for post-prostatectomy erectile dysfunction. It emphasizes the need for ongoing research and dialogue among healthcare professionals to improve care for patients facing the long-term consequences of their treatment. Jens Rassweiler

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