Shendy WS. et al., 2021: Effect of low-intensity extracorporeal shock wave therapy on diabetic erectile dysfunction: Randomised control trial
Shendy WS, Elsoghier OM, El Semary MM, Ahmed AA, Ali AF, Saber-Khalaf M.
Faculty of physical therapy, Cairo University, Giza, Egypt.
Department of Urology, South Valley University, Qena, Egypt.
Faculty of physical therapy, South Valley University, Qena, Egypt.
Urology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.
This study aimed to assess the effectiveness of low-intensity extracorporeal shockwave therapy (Li-ESWT) in the management of erectile dysfunction in diabetic patients with mixed vasculogenic and neurogenic causes as confirmed by nerve conduction and Doppler studies. This randomised controlled trial included 42 patients 41-55 years of age with a confirmed diagnosis of erectile dysfunction and diabetic polyneuropathy. They were randomly allocated to one of two groups: shock wave group (n = 21) treated with Li-ESWT plus pelvic floor muscle training and control Group (n = 21) treated with pelvic floor muscle exercise and sham therapy by a shock wave. The erectile function was scored according to the five-item version of the International Index of Erectile Function (IIEF-5). Colour-coded duplex sonography was used for the evaluation of penile perfusion of the two cavernous arteries. The assessment was done before and three months after treatment. IIEF-EF increased significantly in the study group (p < .001), but not in the control group (p = .194). Peak systolic velocity increased significantly in the two groups; however, the post-treatment peak systolic velocity was significantly higher in the study group compared to the control group (p < .001, for both arteries).
Andrologia. 2021 Feb 8:e13997. doi: 10.1111/and.13997. Online ahead of print. PMID: 33559168
The IIEF-5 score ranges from 1 to 25 and classifies moderate to mild ED with 12–16 and mild ED with 17–21 points. The treatment group changed from 12,75 to 17,05 points.
The last sentence of this paper is: “Larger studies with longer follow-up are needed to confirm the effectiveness of Li-ESWT to be approved for the treatment of DM-related
ED. The first paper on L-ESWT for ED was published 11 years ago (1). Why is still time, effort and paper wasted in small short-term studies?
1 Vardi, Y, et al. (2010). Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. European Urology, 58(2), 243–248. https://doi.org/10.1016/j.eururo.2010.04.004