Adeldaeim HM. et al., 2020: Prognostic indicators for successful low intensity extracorporeal shock wave therapy treatment of erectile dysfunction
Adeldaeim HM, Abouyoussif T, Gebaly OE, Assem A, Wahab MMA, Rashad H, Sakr M, Zahran AR.
Department of Urology, Alexandria University, Alexandria, Egypt.
Department of Urology, Alexandria University, Alexandria, Egypt.
Family and Community Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
Abstract
Objective: To assess prognostic factors affecting successful low-intensity extracorporeal shockwave therapy (Li-ESWT) treatment of erectile dysfunction (ED) in patients with vasculogenic ED and to report 30-month follow-up.
Methods: This study was conducted upon 425 patients with vasculogenic ED. Assessment of ED was done using Sexual Health Inventory for Men (SHIM) score. Patients were treated by Li-ESWT using PiezoWave2 (Richard Wolf) device. Successful Li-ESWT was defined as 6-month SHIM score of 22-25. Patients with successful treatment were followed for 30 months.
Results: Mean Baseline SHIM scores for the total population studied was 11.8 with a range from 5 to 20. After 6 months from treatment, 220 (51.8%) patients reported satisfactory sexual intercourse. Age, diabetes, hypertension, smoking, obesity, hyperlipidemia, pretreatment SHIM score, and the duration of ED were all found to be significant factors affecting the success of Li-ESWT. At 30-month follow-up, 168 (76.3%) patients from those who responded to Li-ESWT still reported satisfactory sexual intercourse with a SHIM score of 22-25 without using PDE5i.
Conclusion: Li-ESWT is safe and effective treatment of ED with 30 months success in 39.5% of patients treated. Li-ESWT should be offered to patients with mild-to-moderate ED and not to those with severe ED.
Urology. 2020 Dec 26:S0090-4295(20)31516-8. doi: 10.1016/j.urology.2020.12.019. Online ahead of print. PMID: 33373703
Comments 1
Interesting and clinically relevant article on the effectiveness of Li-ESWL on erectile dysfunction (ED). The specific value of this report is that the presented treatment protocol was associated with 51.8% success after 6 months and 39.5% after 30 months.
The treatment protocol:
6 sessions for a period of 6 weeks
6000 shockwaves at each session distributed on 5 sites.
8 Hz
Energy range: 0.16-0.20 mJ/mm2
The most important observations were that diabetes, hypertension, smoking, obesity and hyperlipidaemia were associated with low response.
The bottom-line was that success with Li-ESWL according to these principles was noted in younger patients with mild to moderate ED whereas the method was useless for patients with severe ED.
Hans-Göran Tiselius