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Fode M et al, 2017: Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough?

Fode M, Hatzichristodoulou G, Serefoglu EC, Verze P,Albersen M on behalf of the Young Academic Urologists Men’s Health Group Young Academic Urologists Men's Health Group.

Abstract

Erectile dysfunction (ED) affects ∼30% of all men above the age of 40 years and its prevalence steadily increases with age. Current nonsurgical treatment options, including phosphodiesterase type 5 inhibitors (PDE5I), provide temporary relief but have failed to provide a permanent improvement of the condition. Low-intensity extracorporeal shockwave therapy (Li-ESWT) is noninvasive and uses acoustic waves, which can pass through tissue and be focussed to target specific areas or organs to induce the desired effects. The use of Li-ESWT has previously been described in other disease contexts, such as ischaemic heart disease, bone fractures, and burns, in which it improves neoangiogenesis; similar principles seem to apply in the erectile tissue. The major potential advantage of the treatment, therefore, is the possibility to restore natural erectile function. Thus, Li-ESWT is the only currently marketed treatment for ED that might offer a cure, which is the most desired outcome for most men with ED. Li-ESWT has also been suggested to improve the effect of PDE5I in nonresponders, reducing the need for more invasive treatments. Several single-arm trials have shown benefit of Li-ESWT on patient-reported erectile function scores, but data from randomized trials are conflicting, and many questions remain to be answered before we can routinely offer this treatment to patients. Thus, the search for the true clinical value of Li-ESWT for ED represents a dynamic and continuing field of enquiry.

Nat Rev Urol. 2017 Jul 25. doi: 10.1038/nrurol.2017.119. [Epub ahead of print] Review.

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Commentaires 1

Peter Alken le lundi 26 février 2018 13:14

One decisive sentence is: “Thus, Li‑ESWT is the only currently marketed treatment for ED that might offer a cure, which is the most desired outcome for most men with ED” This seems to suggest that aging is a disease that can be cured.

See also: Kalyvianakis D, Hatzichristou D. Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients With Vasculogenic Erectile Dysfunction: A Triplex Ultrasonography-Based Sham-Controlled Trial. J Sex Med. 2017 Jul;14(7):891-897. doi: 10.1016/j.jsxm.2017.05.012.

One decisive sentence is: “Thus, Li‑ESWT is the only currently marketed treatment for ED that might offer a cure, which is the most desired outcome for most men with ED” This seems to suggest that aging is a disease that can be cured. See also: Kalyvianakis D, Hatzichristou D. Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients With Vasculogenic Erectile Dysfunction: A Triplex Ultrasonography-Based Sham-Controlled Trial. J Sex Med. 2017 Jul;14(7):891-897. doi: 10.1016/j.jsxm.2017.05.012.
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