Comparison of focused and unfocused ESWT in treatment of erectile dysfunction (original) (raw)
Related papers
International braz j urol : official journal of the Brazilian Society of Urology
The role of low-intensity extracorporeal shock wave therapy (LI-ESWT) in erectile dysfunction (ED) is not clearly determined. The purpose of this study is to investigate the short-term efficacy and safety of LI-ESWT for ED patients. Relevant studies were searched in Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WANFANG and VIP databases. Effective rate in terms of International Index of Erectile Function-Erectile Function Domain (IIEF-EF) and Erectile Hardness Score (EHS) at about 1month after LI-ESWT was extracted from eligible studies for meta-analysis to calculate risk ratio (RR) of effective treatment in ED patients treated by LI-ESWT compared to those receiving sham-treatment. Overall fifteen studies were included in the review, of which four randomized controlled trials (RCTs) were for meta-analysis. Effective treatment was 8.31 [95% confidence interval (CI): 3.88-17.78] times more effective in the LI-ESWT group (n=176) than in the sham-tre...
Low-intensity extracorporeal shockwave therapy for erectile dysfunction
Arab Journal of Urology
Objectives: To review the current evidence of clinical effectiveness of low-intensity extracorporeal shockwave therapy (LI-ESWT) treatment for erectile dysfunction (ED). Methods: A selective database search using Medical Subject Headings (MeSH) terms 'low intensity extracorporeal shock wave therapy' and 'erectile dysfunction' was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta Analyses (PRISMA) guidelines to review the effectiveness of LI-ESWT for ED. We performed a systematic search of publications using the PubMed and Web of Science databases (January 2010-December 2020) for prospective randomised clinical trials (RCTs). The success rate of LI-ESWT associated with ED were recorded and analysed. Results: A total of 106 articles were reviewed after searching for the keywords. Overall, 11 RCTs were included in this systematic review. A total of 920 male patients were treated in 11 RCTs. The patients' ages ranged from 18 to 80 years and they had ≥3 months of ED symptoms. Vasculogenic and neurogenic causes were addressed in 81% and 19% of patients, respectively. Of the 920 patients, 348 patients had a statistically significant improvement in their erectile function after LI-ESWT; however, 572 did not have a statistically significant improvement. Conclusions: The present review found that LI-ESWT has a role in ED treatment in laboratory studies, but its role in human clinical trials is still controversial. Further good quality studies need to be conducted to properly assess its true potential in ED treatment.
Health Technology Assessment in Action, 2019
Background: Erectile dysfunction is a common disease that has a significant negative impact on the quality of life of individuals. Low-intensity shockwave therapy (LI-ESWT) has been considered a new method for treating patients with erectile dysfunction. Objectives: To evaluate the safety and efficacy of LI-ESWT in the treatment of patients with erectile dysfunction. Methods: A systematic review was conducted in the major databases, including PubMed, Cochrane Library, Embase, Scopus, and Web of Science up to February 2018. In order to find more articles, the reference list of the key review articles was searched as well. The quality of the studies was evaluated with the Cochrane Collaboration's tools. The outcomes included The International Index of Erectile Function (IIEF), Erection Hardness Score (EHS), and adverse events. Meta-analysis was performed using RevMan software, version 5.3. Results: Seven randomized clinical trials involving 519 patients met the inclusion criteria. A significant improvement was observed in IIEF (mean difference [MD] = 4.54, 95% CI 0.44-8.63) and EHS (risk ratio [RR] = 2.99, 95% CI 1.16-7.70) in the intervention groups compared to the control groups. Sub-analysis showed that shockwave therapy significantly improved IIEF at 6, 9, and 10 weeks after the treatment (P < 0.05), and the EHS was improved at 5, 6, and 9 weeks (P < 0.05). There was also a significant improvement in the intervention groups in IIEF and EHS for 1500 and 3000 pulses, respectively (P < 0.05). No significant side effects were reported. Conclusions: The findings of this study indicate LI-ESWT improves erectile dysfunction in patients, and it is safe and well-tolerated by patients.
International Journal of Impotence Research, 2019
The efficacy of low intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED) has received hard criticism and recently published meta-analyses were not able to provide further insights, nor specific recommendations. The aim of this systematic review and meta-analysis is to evaluate the efficacy of LI-ESWT for ED, identify the ideal treatment population and treatment protocol, and provide recommendations for future research in the field. A systematic research for relevant clinical studies published from January 2010 to September 2018 was performed, using the following databases: Medline, Embase, The Cochrane Library, Scopus, and Web of Science. Only clinical studies that investigated the efficacy of LI-ESWT for ED only, and reported primary outcomes using IIEF-EF scores/questionnaires were included. Both, randomised controlled trials (RCTs) and cohort studies were included, but the meta-analysis was performed only for shamcontrolled RCTs. Ten RCTs including 873 patients were selected for the meta-analysis. Pooling data of these studies showed that LI-ESWT could significantly improve erectile function in men with ED regarding both patient-subjective outcomes (IIEF-EF: +3.97; 95% CI [2.09-5.84]; p < 0.0001, EHS ≥ 3: OR: 4.35; 95% CI [1.82-10.37]; p = 0.0009) and patientobjective outcomes (peak systolic velocity: +4.12; 95% CI [2.30-5.94]; p < 0.00001). In conclusion, the present metaanalysis provided results showing that LI-ESWT significantly improves erectile function in patients with vasculogenic ED.
The Journal of Sexual Medicine, 2019
Introduction Despite recent promising clinical results, the underlying mechanism of action of low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) is mostly unclear and currently under investigation. Aim To systematically identify and evaluate evidence regarding the basic science behind Li-ESWT for ED, discuss and propose a putative mechanism of action, address the limitations, and imply insights for further investigation in the field. Methods Using Cochrane’s methodologic recommendations on scoping studies and systematic reviews, we conducted a systematic scoping review of the literature on experimental research regarding Li-ESWT for ED and other pathologic conditions. The initial systematic search was carried between January and November 2017, with 2 additional searches in April and August 2018. All studies that applied shockwave treatment at an energy flux density >0.25 mJ/mm2 were excluded from the final analysis. Main Outcome Measure We prim...
Bangladesh Journal of Urology
Introduction: Oral 5-phosphodiesterase inhibitors (PDE5-I) is the main therapeutical options in erectile dysfunction (ED). It shows good results, but non-responders lack other effective options and its effect is also not long lasting. Since last few years, low-intensity extracorporeal shockwave therapy (Li-ESWT) in the corpora cavernosa showing promising results. This article presents our early experiences in Advanced Center of Kidney disease and Urology (ACKU) with the aim to evaluate clinical efficacy of Li-ESWT. Materials and methods: Thirty four patients with ED were prospectively included in the study during the period of January 2018 to Jun 2019.Treatment was performed using the PiezoWave2 (Richard Wolf, Germany) device with a linear probe. Treatment protocol included a weekly session for four weeks. Each session delivered 2000 shocks on the perineum plus 4000 shocks on dorsum penis with an energy flux density (EFD) of 0.160 mJ/mm2. Every patient has been re-evaluated 1.5 and ...
International braz j urol
Objectives: To provide an overview of low-intensity extracorporeal shockwave therapy (LIEST) for erectile dysfunction (ED), pointing out which concepts are already consolidated and which paths we still need to advance. Materials and Methods: We performed a narrative review of the literature on the role of shockwave therapies in erectile dysfunction, selecting publications in PUBMED, including only relevant clinical trials, systematic reviews and meta-analyses. Results: We found 11 studies (7 clinical trials, 3 systematic review and 1 meta-analysis) that evaluated the use of LIEST for the treatment of erectile dysfunction. One clinical trial evaluated the applicability in Peyronie's Disease and one other clinical trial evaluated the applicability after radical prostatectomy. Conclusions: The literature presents little scientific evidence but suggests good results with the use of LIEST for ED. Despite a real optimism since it is a treatment modality capable of acting on the pathophysiology of ED, we must remain cautious, until a larger volume of higher quality studies allows us to establish which patient profile, type of energy and application protocol will achieve clinically satisfactory results.