Jeong HC et al, 2017: Effects of Next-Generation Low-Energy Extracorporeal Shockwave Therapy on Erectile Dysfunction in an Animal Model of Diabetes.
Jeong HC, Jeon SH, Qun ZG, Kim KS, Choi SW, Bashraheel F, Bae WJ, Kim SJ, Cho HJ, Ha US, Hong SH, Lee JY, Moon DG, Kim SW.
Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Department of Urology, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Korea University College of Medicine, Seoul, Korea.
PURPOSE: Gene therapy, stem cell therapy, and low-energy extracorporeal shockwave therapy (ESWT) have been investigated as treatments for refractory erectile dysfunction (ED), but inconclusive evidence has been obtained. We investigated the effect of a next-generation electromagnetic cylinder ESWT device on an animal model of ED.
MATERIALS AND METHODS: Diabetes mellitus (DM)-induced rats were divided into 3 groups: group 1, control; group 2, DM; and group 3, DM+ESWT. Rats were treated with ESWT 3 times a week for 2 weeks. After the treatment course, intracavernous pressure was measured and the corpus cavernosum and cavernous nerve were evaluated.
RESULTS: In the DM group, all parameters predicted to be significantly lower in the ED model had statistically significantly decreased (p<0.01). As a measurement of erectile function, intracavernous pressure was evaluated. The DM+ESWT group exhibited significantly restored erectile function compared to the DM group (p<0.05). Moreover, ESWT treatment restored smooth muscle content, as assessed by Masson's trichrome staining (p<0.05). Finally, corporal tissue and the dorsal nerve were evaluated by immunohistochemistry, Western blotting, and ELISA. After ESWT treatment, vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), platelet endothelial cell adhesion molecule-1, cyclic guanosine monophosphate, and neuronal nitric oxide synthase (nNOS) expression levels were restored to levels in the DM group (p<0.05).
CONCLUSIONS: We confirmed the efficacy of the electromagnetic cylinder ESWT device using a DM-associated ED model. ESWT resulted in increased VEGF, nNOS, and eNOS expression; reduced smooth muscle atrophy; and increased endothelial cell regeneration. Our data suggest that safe and effective application could be possible in future clinical studies.
World J Mens Health. 2017 Nov 20. doi: 10.5534/wjmh.17024. Epub ahead of print. FREE ARTICLE
The effects of ESWT on ED are variable and inconclusive. Patients with ED, as a consequence of DM, comprise a particularly difficult group to treat. The physiological basis is disturbed angiogenesis. This report is an animal experiment based on findings in rats in which DM was induced and treatment carried out with a cylindrical electromagnetic device.
Although positive effects were recorded, most variables were only partially restored.
It is possible that repeated ESWT-sessions during longer periods would result in a more pronounced and sustained effect.