Erectile dysfunction (ED) is a well-known complication of radical prostatectomy (RP). Oral 5-phosphodiesterase inhibitors are currently the most widely used penile rehabilitation treatment for ED following RP, but they are less effective than for those with general ED. Low-intensity extracorporeal shock wave treatment (LI-ESWT), causing a biological change that induces neovascularization, has recently been used as a treatment for ED. Therefore, we conducted a systematic review and meta-analysis to investigate the efficiency of LI-ESWT in ED following RP. PubMed, Embase, and the Cochrane Library were searched up until December 2021. The endpoint was the change in IIEF scores after LI-ESWT. Five papers (460 patients) were included in the final analysis. In IIEF scores performed 3-4 months after LI-ESWT, the group receiving LI-ESWT showed statistically significantly better results than the control (WMD = -2.04; 95% CI, -3.72 to -0.35; p = 0.02). However, there were a total of two studies that measured the results after 9-12 months. There was no statistical difference between the two groups (WMD = -5.37; 95% CI, -12.42 to 1.69; p = 0.14). The results of this analysis indicate that LI-ESWT showed a statistically significant effect on early recovery in penile rehabilitation of ED following RP. However, the level of evidence was low. Therefore, careful interpretation of the results is required.
Journal of clinical medicine. 2022 May 14*** epublish ***
Beom Yong Rho, Si Hyeon Kim, Ji-Kan Ryu, Dong Hyuk Kang, Jong Won Kim, Doo Yong Chung
Department of Urology, Inha University School of Medicine, Incheon 22212, Korea.