Lei Q. et al., 2021: Comparison of the efficacy and safety of low-intensity extracorporeal shock wave therapy versus on-demand sildenafil for erectile dysfunction
Lei Q, Wang D, Liu C, Ji Z, Yan S.
Department of Urology, Peking Union Medical College Hospital, Beijing, China.
Abstract
Background: Low-intensity extracorporeal shock wave therapy (Li-ESWT) is an effective therapy for erectile dysfunction (ED) but is not widely recognized and applied. This prospective nonrandomized study aimed to investigate the efficacy and safety of Li-ESWT.
Methods: After a 4-week washout period of past ED treatment, patients entered one of 2 active treatment groups, either 9-week Li-ESWT or 100 mg on-demand sildenafil. Patients were evaluated in the first- and third-month following initiation of treatment. The Li-ESWT protocol comprised 2 sessions per week for 3 weeks, which were repeated after a 3-week interval. Patients in the drug group took self-administered sildenafil at a dose of 100 mg before intercourse. The primary outcome was the effectiveness of Li-ESWT measured by the International Index of Erectile Function-5 (IIEF-5) scores. Other measurements included erection hardness score (EHS) and Self-Esteem And Relationship (SEAR).
Results: A total of 78 participants completed the study (46 in the Li-ESWT group and 32 in the sildenafil group). Overall, 26.9% of the participants (21/78) included were psychogenic. In the third month, the outcome measured by IIEF-5 was 21.52 in the Li-ESWT group and 21.26 in the sildenafil group (P>0.05). Proportion of improvement defined by minimal clinically important difference (MCID) criteria was 52.2% in the Li-ESWT group and 59.4% in the sildenafil group (P>0.05). The EHS and SEAR improvement was similar in the 2 groups (P>0.05 at baseline and third month). Transient and mild adverse events were observed in both groups.
Conclusions: In our study, a similar treatment efficacy and safety was shown by the application of Li-ESWT as on demand sildenafil.
Transl Androl Urol. 2021 Feb;10(2):860-868. doi: 10.21037/tau-20-1069. PMID: 33718087. FREE ARTICLE
Comments 1
In this report on ED the authors have compared Li-ESWT and on-demand sildenafil. The conclusion from this non-randomized study was that the two treatment alternatives were similarly effective. This is an interesting finding.
It is so far no consensus on how the optimal Li-ESWT should be carried out. In this study Li-ESWT was given as follows:
3-minute sessions x 5 with direction of shockwave to five different locations on the penis.
In each location 300 shockwaves were administered, in total = 1500 sw
Energy: 0.09 mJ/mm2
Shockwaves were delivered by Omnispec ED1000 at a frequency of 2 Hz and carried out twice a week for 3 weeks
Hans-Göran Tiselius