Lund M. et al., 2023: Placebo-Controlled Study of Effects of Low-Energy Shockwave Therapy (LE-ESWT) on Erectile Tissue in a Diabetic Animal Model.
Department of Urology, Odense University Hospital, Odense, Denmark.
Department of Urology, Viborg Hospital, Viborg, Denmark.
Department of Urology, Imperial College National Health Service Trust, London, UK.
Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
Clinical Institute, University of Southern Denmark, Odense, Denmark.
Objective: Low-energy extracorporeal shockwave therapy (LE-ESWT) has been shown to induce organ repair and neo-vascularization. The ability of LE-ESWT to improve erectile function in rodents as measured by improvements in intracavernosal pressure is well-established in various pathological situations. The underlying molecular mechanism are unclear and likely vary between different disorders, making rational drug design for synergetic effects with LE-ESWT difficult, without further research. In this placebo-controlled study, we aim to establish whether LE-ESWT can activate neovascularization biomarkers in diabetic tissues.
Material and methods: Forty Wistar rats, aged 8 weeks, were randomly divided into 4 groups: 8 untreated controls, 12 controls that underwent LE-ESWT treatment, 8 controls with induced diabetes mellitus (DM) and 12 with DM underwent LE-ESWT treatment. DM was induced by streptozotocin. LE-ESWT treatment was performed with a Duolith SD1 machine (Storz), with a total amount of energy of 6.4 J per treatment. The rats received a total of three LE-ESWT treatments with 2-week intervals between treatments.
Results: Diabetic rats had significantly elevated blood glucose concentrations compared to control rats (P < 0.001) and experienced significant weight loss compared to controls (P < 0.001). Diabetic rats had elevated creatinine and urea and lower albumin (P < 0.001). Histologic analysis of penile tissue showed significant levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) expression in the LE-ESWT groups compared to controls (P< 0.01).
Conclusion: LE-ESWT induces neo-angiogenesis as expressed by VEGF and FGF in erectile tissue in normal and diabetic rats.
Res Rep Urol. 2023 Mar 31;15:123-129. doi: 10.2147/RRU.S366601. eCollection 2023.PMID: 37025398
This article discusses the potential benefits of low-energy extracorporeal shockwave therapy (LE-ESWT) in inducing tissue repair and neovascularization in normal and diabetic penile tissue. The study was conducted on Wistar rats, with some groups receiving LE-ESWT treatment and others serving as controls. The researchers measured various parameters such as blood glucose levels, weight, serum metabolites, and growth factor expression. Diabetes Mellitus was induced by streptozotocin. LE-ESWT treatment was performed with a Duolith SD1 machine (Storz-Medical, Tägerwilen, Switzerland)), with a total amount of energy of 6.4 J per treatment. The rats received a total of three LE-ESWT treatments with 2-week intervals between treatments.
The results showed that LE-ESWT treatment led to higher expression levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) in the treated groups compared to the control groups. Additionally, diabetic rats exhibited elevated blood glucose levels, weight loss, and altered serum metabolite levels.
Vascular endothelial growth factor score in treated and sham-treated animals
The study suggests that LE-ESWT has the potential to activate tissue repair mechanisms and neovascularization even in the presence of ongoing diabetes-associated degeneration. Other studies mentioned in the article also support the idea that LE-ESWT can improve erectile function and tissue regeneration in animal models of diabetes and obesity-induced erectile dysfunction.
LE-ESWT is considered a non-invasive, low-cost, and potentially synergistic treatment option for erectile dysfunction. However, the study acknowledges the need for further research, including investigating the non-responder rate and exploring potential combination therapies.
Overall, the findings highlight the potential of LE-ESWT as a therapeutic regenerative approach for delaying or reversing tissue degeneration associated with diabetes and other lifestyle-related diseases, particularly in the context of erectile tissue.