Document Detail


Low-intensity extracorporeal shock wave therapy--a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy.
MedLine Citation:
PMID:  22008059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Low-intensity shock wave therapy (LI-ESWT) has been reported as an effective treatment in men with mild and moderate erectile dysfunction (ED).
AIM: The aim of this study is to determine the efficacy of LI-ESWT in severe ED patients who were poor responders to phosphodiesterase type 5 inhibitor (PDE5i) therapy.
METHODS: This was an open-label single-arm prospective study on ED patients with an erection hardness score (EHS) ≤ 2 at baseline. The protocol comprised two treatment sessions per week for 3 weeks, which were repeated after a 3-week no-treatment interval. Patients were followed at 1 month (FU1), and only then an active PDE5i medication was provided for an additional month until final follow-up visit (FU2). At each treatment session, LI-ESWT was applied on the penile shaft and crus at five different anatomical sites (300 shocks, 0.09 mJ/mm(2) intensity at 120 shocks/min). Each subject underwent a full baseline assessment of erectile function using validated questionnaires and objective penile hemodynamic testing before and after LI-ESWT.
MAIN OUTCOME MEASURES: Outcome measures used are changes in the International Index of Erectile Function-erectile function domain (IIEF-ED) scores, the EHS measurement, and the three parameters of penile hemodynamics and endothelial function.
RESULTS: Twenty-nine men (mean age of 61.3) completed the study. Their mean IIEF-ED scores increased from 8.8 ± 1 (baseline) to 12.3 ± 1 at FU1 (P = 0.035). At FU2 (on active PDE5i treatment), their IIEF-ED further increased to 18.8 ± 1 (P < 0.0001), and 72.4% (P < 0.0001) reached an EHS of ≥ 3 (allowing full sexual intercourse). A significant improvement (P = 0.0001) in penile hemodynamics was detected after treatment and this improvement significantly correlated with increases in the IIEF-ED (P < 0.05). No noteworthy adverse events were reported.
CONCLUSIONS: Penile LI-ESWT is a new modality that has the potential to treat a subgroup of severe ED patients. These preliminary data need to be reconfirmed by multicenter sham control studies in a larger group of ED patients.
Authors:
Ilan Gruenwald; Boaz Appel; Yoram Vardi
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2011-10-18
Journal Detail:
Title:  The journal of sexual medicine     Volume:  9     ISSN:  1743-6109     ISO Abbreviation:  J Sex Med     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-05-07     Revised Date:  2012-05-18    
Medline Journal Info:
Nlm Unique ID:  101230693     Medline TA:  J Sex Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-64     Citation Subset:  IM    
Copyright Information:
© 2011 International Society for Sexual Medicine.
Affiliation:
Neuro-urology Unit, Rambam Healthcare Campus, Haifa, Israel. I_Gruenwald@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Erectile Dysfunction / therapy*
Humans
Male
Middle Aged
Penile Erection
Penis / blood supply,  ultrasonography
Treatment Outcome
Ultrasonic Therapy / methods
Comments/Corrections
Comment In:
J Urol. 2012 May;187(5):1789-90   [PMID:  22494747 ]
Nat Rev Urol. 2011 Dec;8(12):645   [PMID:  22105321 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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