Rizk PJ et al, 2018: Low-Intensity Shockwave Therapy for Erectile Dysfunction.
Rizk PJ, Krieger JR, Kohn TP, Pastuszak AW.
Baylor College of Medicine, Houston, TX, USA.
Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
Abstract
BACKGROUND: Vasculogenic erectile dysfunction (ED) is one of the leading causes of male sexual dysfunction. In the past decade, multiple studies have examined the use of low-intensity extracorporeal shockwave therapy (Li-ESWT) for the treatment of ED.
AIM: Investigate the efficacy of Li-ESWT for the treatment of ED.
METHODS: We reviewed the published literature, including randomized controlled trials (RCTs), meta-analyses, and select single-arm studies on the use of Li-ESWT for the treatment of ED.
OUTCOMES: Changes in International Index of Erectile Function scores were evaluated in patients undergoing Li-ESWT.
RESULTS: There is no consensus from RCTs on the efficacy of Li-ESWT for the treatment of ED. Published meta-analyses have shown significant improvement in International Index of Erectile Function-erectile function domain scores in men undergoing Li-ESWT, especially when compared to men receiving sham treatment. However, differences in treatment protocols limit the generalizability of these findings. Li-ESWT may be more beneficial in cases of mild ED or when combined with phosphodiesterase type 5 inhibitors in men with moderate to severe ED. The role of Li-ESWT in the treatment of non-vasculogenic ED remains poorly defined.
CONCLUSIONS: Li-ESWT could be beneficial in specific sub-sets of men with vasculogenic ED. However, future RCTs should attempt to optimize treatment protocols and have more stringent inclusion criteria to confirm these findings.
Sex Med Rev. 2018 Mar 22. pii: S2050-0521(18)30011-8. doi: 10.1016/j.sxmr.2018.01.002. [Epub ahead of print] Review.
Comments 1
I do not like publications that covertly quote quotations from other papers instead of leading the reader down to the original one (Reference 10).
We are in the days of meta-analyses. I expect a review on the same subject to declare in the introduction what is different or new compared to the existing reviews. Like this I will be warned not to waste my time by reading the same stories again.
There are at least 6 recent meta-analyses or good reviews resp. available, 4 of which the authors briefly mention in the text.
1:Young Academic Urologists Men's Health Group, Fode M, Hatzichristodoulou G, Serefoglu EC, Verze P, Albersen M. Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough? Nat Rev Urol. 2017 Oct;14(10):593-606. doi: 10.1038/nrurol.2017.119.
2: Lu Z, Lin G, Reed-Maldonado A, Wang C, Lee YC, Lue TF. Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis. Eur Urol. 2017 Feb;71(2):223-233. doi: 10.1016/j.eururo.2016.05.050.
3: Zou ZJ, Tang LY, Liu ZH, Liang JY, Zhang RC, Wang YJ, Tang YQ, Gao R, Lu YP. Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis. Int Braz J Urol. 2017 Sep-Oct;43(5):805-821. doi: 10.1590/S1677-5538.IBJU.2016.0245.
4: Clavijo RI, Kohn TP, Kohn JR, Ramasamy R. Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med. 2017 Jan;14(1):27-35. doi: 10.1016/j.jsxm.2016.11.001.
5: Chung E, Wang J. A state-of-art review of low intensity extracorporeal shock wave therapy and lithotripter machines for the treatment of erectile dysfunction. Expert Rev Med Devices. 2017 Dec;14(12):929-934. doi: 10.1080/17434440.2017.1403897.
6: Man L, Li G. Low-Intensity Extracorporeal Shock Wave Therapy for Erectile Dysfunction: a Systematic Review and Meta-Analysis. Urology. 2017 Sep 26. pii: S0090-4295(17)30992-5. doi: 10.1016/j.urology.2017.09.011.
I admit that I only read the introduction carefully.