Fode M et al, 2017: Low-Intensity Extracorporeal Shockwave Therapy in Sexual Medicine: A Questionnaire-Based Assessment of Knowledge, Clinical Practice Patterns, and Attitudes in Sexual Medicine Practitioners.
Fode M, Lowenstein L, Reisman Y.
Department of Urology, Zealand University Hospital, Roskilde, Denmark; Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark.
Department of Family Medicine, Ruth and Bruce Rappaport Faculty of Medicine, Clalit Health Services and Neuro-urology Unit, Rambam Medical Center, Haifa, Israel.
Department of Urology, Amstelland Hospital, Amstelveen, The Netherlands.
INTRODUCTION: Low-intensity extracorporeal shockwave therapy (LI-ESWT) has emerged as a treatment option for male sexual dysfunction. However, results have been contradictory.
AIM: To investigate the knowledge, practice patterns, and attitudes regarding LI-ESWT among experts in sexual medicine.
METHODS: A study-specific questionnaire was handed out at the 18th Congress for the European Society for Sexual Medicine. Participants were queried on their knowledge about LI-ESWT and about their use of the equipment.
MAIN OUTCOME MEASURES: Descriptive data on the knowledge of LI-ESWT and perception of treatment effects.
RESULTS: One hundred ninety-two questionnaires were available for analysis. Most respondents were physicians (79.7%) and most of these specialized in urology (58.9%). Overall, 144 of 192 (75%) reported that they were familiar with LI-ESWT in sexual medicine. Twenty-seven (14.1%) had performed the treatment. Of the 117 non-users who were familiar with LI-ESWT, 37 sometimes referred patients for the treatment. Nevertheless, 103 of 144 (71.5%) stated that they considered LI-ESWT an effective treatment for erectile dysfunction (ED) and 10 of 144 (6.9%) considered it an effective treatment for Peyronie disease. Of participants who regarded LI-ESWT an effective ED treatment, 91.2% would consider the treatment specifically for vasculogenic ED and 81.6% would combine it with phosphodiesterase type 5 inhibitors. Most participants (83.7%) regarded LI-ESWT as safe. A urology background (odds ratio = 2.4; 95% CI = 1.3-4.8; P = .0093) and working in a private setting (odds ratio = 2.8; 95% CI = 1.5-5.3; P = .0084) were significant predictors of familiarity with LI-ESWT in sexual medicine and of being an LI-ESWT user. Likewise, urologists were significantly more likely than non-urologists to consider the treatment effective (odds ratio = 2.8; 95% CI = 1.1-7.1; P = .033).
CONCLUSION: LI-ESWT is well known among experts in sexual medicine and the treatment is perceived as safe and effective against vasculogenic ED when combined with phosphodiesterase type 5 inhibitors. The treatment is mainly offered by urologists. Fode M, Lowenstein L, Reisman Y. Low-Intensity Extracorporeal Shockwave Therapy in Sexual Medicine: A Questionnaire-Based Assessment of Knowledge, Clinical Practice Patterns, and Attitudes in Sexual Medicine Practitioners. Sex Med 2017;X:XX-XX.
Sex Med. 2017 Mar 4. pii: S2050-1161(17)30013-2. doi: 10.1016/j.esxm.2016.12.002. [Epub ahead of print]. FREE ARTICLE
This report is based on a questionnaire that was handed out to participants of a congress on sexology. Although a major part of the responders were urologists it is doubtful how extensive this technique is known and/or used by urologists in general. My personal impression is that knowledge of LI-ESWT for treating patients with erectile dysfunction is limited. There is also insufficient data in the literature to suggest a standardized treatment strategy. A lot more research seems necessary for identification of patients particularly suited for this form of treatment.