Ruffo A et al, 2015: Safety and efficacy of low intensity shockwave (LISW) treatment in patients with erectile dysfunction.
Ruffo A, Capece M, Prezioso D, Romeo G, Illiano E, Romis L, Di Lauro G, Iacono F.
Department of Urology, Federico II University, Naples, Italy.
Department of Urology, Hospital Santa Maria delle Grazie, Naples, Italy.
The primary goal in the management strategy of a patient with ED would be to determine its etiology and cure it when possible, and not just to treat the symptoms alone. One of the new therapeutic strategies is the use of low intensity extracorporeal shockwave (LISW) therapy. The mechanism of shockwave therapy is not completely clear. It is suggested that LISW induces neovascularization and improvement of cavernosal arterial flow which can lead to an improvement of erectile function by releasing NO, VEGF and PCNA.
MATERIALS AND METHODS: 31 patients between February and June 2013 with mild to severe ED and non-Phosphodiesterase 5 inhibitors responders were enrolled. Patients underwent four weekly treatment sessions. During each session 3600 shocks at 0.09mJ/ mm2 were given, 900 shocks at each anatomical area (right and left corpus cavernosum, right and left crus). Improvement of the erectile function was evaluated using the International Index of Erectile Function (IIEF-EF), the Sexual Encounter Profile (SEP) diaries (SEP-Questions 2 and 3) and Global Assessment Questions (GAQ-Q1 and GAQ-Q2).
RESULTS: At 3-month follow-up IIEF-EF scores improved from 16.54±6.35 at baseline to 21.03±6.38. Patients answering 'yes' to the SEP-Q2 elevated from 61% to 89% and from 32% to 62% in the SEP-Q3. A statistically significant improvement was reported to the Global Assessment Questions (GAQ-Q1 and GAQ-Q2).
CONCLUSION: In conclusion, we can affirm that LISW is a confirmed therapeutic approach to erectile dysfunction that definitely needs more long-term trials to be clarified and further verified.
Int Braz J Urol. 2015 Sep-Oct;41(5):967-74. doi: 10.1590/S1677-5538.IBJU.2014.0386.
Again a study on ESWT with good results for erectile dysfunction.
Some call it LISW, LI-ESWT other LIST and the machines and treatment protocols differ but the results are similar. It is sometimes difficult to differentiate a treatment effect from a placebo effect. But an increase of the positive response rate on question SEP-Q2: Were you able to insert your penis into your partner's vagina? from 61% to 89% and on question SEP-Q3: Did your erection last long enough for you to have successful intercourse? from 32% to 62% is not bad regardless if it is a placebo effect or not.
In the present study the authors listed the limitations as “…the lack of a sham controlled arm and the relatively low number of participants.” There is a study with sham control: Kitrey ND, et al. Penile low-intensity shockwave treatment is able to shift PDE5i non-responders to responders: A double-blind sham-controlled study. J Urol. 2015 Dec 13