Efficacy of Low Density Linear Shockwave Treatment in Severe Arteriogenic Erectile Dysfunction Patients
Journal of Urological Surgery
Objective: The aim of this study was to evaluate the efficacy of low-intensity linear shockwave treatment (LI-ESWT) in patients with severe arteriogenic erectile dysfunction (ED) by comparing LI-ESWT combined with daily use of phosphodiesterase type 5 inhibitors (PDE5i) with the daily use of PDE5i alone. Materials and Methods: A total of 23 patients were included in the study. The patients were separated into two groups: LI-ESWT + tadalafil 5 mg (n=10) group and tadalafil 5 mg only group
... g only group (n=13). LI-ESWT was applied once a week for four weeks. Oral tadalafil 5 mg once a day was started and continued for three months in both groups. The patients were evaluated with the International Erectile Function Index Questionnaire Erectile Function Domain (IIEF-EF), Erection Hardness Score (EHS) and Sexual Encounter Profile (SEP) 2 and 3 before treatment and the 1 and 3 months after treatment. Results: No statistically significant difference was detected among IIEF-EF scores measured before and 1 and 3 months after treatment (p=0. 091, p=0.198). At the end of the third month, IIEF score increased 4 points in LI-ESWT + tadalafil 5 mg group and 3.2 points in tadalafil 5 mg only group. No statistically significant difference was detected in EHS, and the rate of positive responses to SEP2 and SEP3 questions at the 1 st and 3 rd months between the groups. Conclusion: LI-ESWT is easily applicable without any significant side effects and it has positive effects on the outcomes, however, it is not an effective treatment method in patients with severe arteriogenic ED. Keywords: Low-intensity linear shockwave treatment, phospodiesterase type 5 inhibitors, erectile dysfunction Amaç: Bu çalışmanın amacı, şiddetli arteriyojenik erektil disfonksiyona (ED) sahip hastalarda, fosfodiesteraz tip 5 (PDESİ) inhibitörünün (Tadalafil 5 mg) günlük kullanımı ile kombine edilen düşük dansiteli lineer şok dalga tedavisini (LI-ESWT), sadece PDESİ'nin günlük kullanımı ile kıyaslayarak LI-ESWT'nin etkinliğini değerlendirmektir. Gereç ve Yöntem: Toplam 23 hasta çalışmaya dahil edildi. Bu hastalar LI-ESWT + tadalafil 5 mg tedavisi (n=10) uygulanan, sadece tadalafil 5 mg tedavisi uygulanan (n=13) hastalar şeklinde iki gruba ayrıldı. LI-ESWT, 4 hafta boyunca haftada bir kez uygulandı. Her iki gruptaki hastalara da Abstract Öz What's known on the subject? and What does the study add? There are studies showing that low-intensity linear shockwave treatment (LI-ESWT) was effective and successful in erectile dysfunction (ED) due to vascular disorders, especially in arteriogenic ED. It has been claimed that LI-ESWT caused neovascularization by stimulating angiogenesis and increased endothelial cell proliferation. The efficacy of LI-ESWT + phosphodiesterase type 5 inhibitors (PDE5i) was compared with PDE5i treatment only in patients with severe ED who were diagnosed with penile arteriogenic ED based on penile Doppler ultrasonography.