Huang YP. et al., 2021: Effect of low-intensity extracorporeal shockwave therapy on nocturnal penile tumescence and rigidity and penile haemodynamics
Huang YP, Liu W, Liu YD, Zhang M, Xu SR, Lu MJ.
Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Andrology, Shanghai, China.
The study aims to evaluate the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on nocturnal erection and penile haemodynamics. Patients with erectile dysfunction (ED) were enrolled from January 2018 to March 2019. Self-reported erectile symptoms, the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Scores (EHS), nocturnal penile tumescence and rigidity (NPTR) and cavernous duplex Doppler ultrasound (CDDU) were evaluated. NPTR and CDDU were evaluated by Rigiscan and vascular ultrasound system respectively. Comparisons of NPTR and CDDU parameters were performed before and after Li-ESWT (Renova, once a week, 4 weeks in total). A total of 35 cases (mean age 36.51 ± 11.47 years) were enrolled for analysis. The IIEF-5 (10.60 ± 5.99 vs. 15.13 ± 6.22, p = .003), EHS (p = .016) and self-reported erectile hardness (p = .014) were significantly improved after 1-month treatment. Nocturnal erection frequency (p = .010), duration of total erection (p = .017), duration of erectile rigidity ≥60% at penile tip and base (p = .014 and p = .002) and the best erectile rigidity at penile tip and base (p = .012 and p = .005) improved significantly after treatment. However, no CDDU parameters improved after Li-ESWT (all p > .05). Li-ESWT can effectively improve subjective erectile function and nocturnal erection in ED patients. Large sample and well-designed studies need to be developed for supporting the current findings.
Andrologia. 2020 Nov;52(10):e13745. doi: 10.1111/and.13745. Epub 2020 Jul 21. PMID: 33617020.
Within a year “consecutive ED patients over 18 years of age were enrolled”, who presented “erectile complaint more than 6 months.” The median age was 33 years (Min: 21, Max: 68). Studies like the present one are often criticised for not focussing on selected patients groups with identifiable causes of ED. The inclusion of a large variety of men claiming to suffer from ED does not allow drawing significant conclusions. The patients were obviously otherwise healthy except that 17 % had Peyronie’s disease. Why would one include patients with an age of 18 years in an ED study? A median age of 33 years suggest that psychological ED was a cause despite being an exclusion criterion.
Two question in the self-reported questionnaire, Q2: Do you have an erection when you sleep or get up in the morning? and Q3: Do you have confidence in the erection? were answered like this:
This study of a small patient group and a minimum follow-up does not add anything new.