To review the evidence of clinical efficacy of low-intensity extracorporeal shock wave therapy (Li-ESWT) for the treatment of erectile dysfunction (ED). A search on PubMed using Medical Subject Headings terms [((low intensity extracorporeal shockwave therapy) OR (Li-ESWT)) AND (erectile dysfunction)] was conducted in August 2022, to obtain studies on the use of Li-ESWT for the treatment of ED. Its success rate in terms of International Index of Erectile Function-5 (IIEF-5) score and Erection Hardness Score (EHS) improvement was recorded and analysed. A total of 139 articles were reviewed. Overall, 52 studies were included in the final review. 17 studies were on vasculogenic ED, 5 on post pelvic surgery ED, 4 specifically on ED in diabetic patients, 24 on non-specified origin ED and 2 on mixed pathophysiological origin ED. The mean age of patients was 55.87±7.91 (standard deviation) years and the duration of ED was 4.36±2.08 years. The mean IIEF-5 score went from 12.04±2.67 at baseline to 16.12±5.72, 16.30±3.26 and 16.85±1.63 respectively at 3, 6 and 12 months. The mean EHS went from 2.00±0.46 at baseline to 2.58±0.60, 2.75±0.46 and 2.87±0.16 respectively at 3, 6 and 12 months. Li-ESWT may be a safe and efficacy option for the treatment and cure of ED. Further studies are needed to assess which patients are more suitable for this procedure and which Li-ESWT protocol can lead to the best outcomes.
Investigative and clinical urology. 2023 Mar [Epub]
Alessia Celeste Bocchino, Marta Pezzoli, Juan Ignacio MartÃnez-Salamanca, Giorgio Ivan Russo, Arturo Lo Giudice, Andrea Cocci
Department of Urology, University of Cagliari, Santissima Trinità Hospital, Cagliari, Italy. ., Department of Urology, University of Florence, Careggi Hospital, Florence, Italy., Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain., Department of Urology, University of Catania, Catania, Italy., Department of Urology, University of Florence, Careggi Hospital, Florence, Italy. .