Scroppo FI. et al., 2021: Li-Eswt improves hemodynamic parameters thus suggesting neoangiogenesis in patients with vascular erectile dysfunction
Scroppo FI, Pezzoni F, Gaeta F, Pastore LA, Malfatto M, Cai T, Capogrosso P, Dehò F, Zucchi A.
Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy.
Centro Medico Unisalus, Milano, Italy.
Surgery Department, Urology and Andrology Unit; Military Hospital of Milan, Milano, Italy.
"La Sapienza" University of Rome; Faculty of Pharmacy and Medicine; Department of Medico-Surgical Sciences and Biotechnologies; Urology Univ, Latina, Italy.
University of Insubria, Varese, Italy.
Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
Department of Translationals Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Extracorporeal treatment with low intensity shock-wave therapy (LI-ESWT) is a recently introduced non-invasive method which purposes the restoration of the pathophysiological alterations at the base of vasculogenic ED in male patients. The evidence in favour of the neoangiogenic potential of this treatment derived from in vitro studies and on animal models. The purpose of this study, in which the Power Doppler method was applied, is to demonstrate 'objectively' the real efficacy of LI-ESWT at the level of the microcirculation of the corpora cavernosa (neoangiogenesis) in patients affected by vasculogenic ED. Data from this study show, for the first time, that LI-ESWT treatment promotes neovascularisation of the functional arteries in patients affected by vasculogenic ED.
Int J Impot Res. 2021 Feb 18. doi: 10.1038/s41443-021-00411-0. Online ahead of print. PMID: 33603243 Review.
Numerous clinical studies have shown that Li-ESWT can improve erectile function, particularly in patients with vasculogenic ED. But how is this effect accomplished?
In previous studies as well as in this study the effect of Li-ESWT was evaluated with IIEF (international index of erectile dysfunction) and EHS (erectile hardness score). In the current report 30 patients were treated with Li-ESWT, using the Duolith SD1 device (Storz Medical AG). Two treatment sessions each comprising 3000 shockwaves were given every second week for six weeks. Shockwaves with an energy of 0.25 mJ/mm2 were directed towards the distal penis (1000), penis shaft (1000) and perineum (1000; 500 to the right and 500 to the left crus).
Interestingly, the power Doppler measurements showed increased number of helicine arteries, increased peak systolic velocity and increased penile brachial pressure index corresponding to IIEF recordings,
The authors concluded that power Doppler ultrasound measurements can be used for accurately selecting patients for ESWT.
Importantly, there is still no consensus on how Li-ESWT best should be carried out.