Low intensity shock wave treatment (LIST) for erectile dysfunction (ED) appears to be effective in the short term, but positive results may fade over time, according to new research.
LIST uses acoustic wave energy to stimulate tissue. It is believed that this could promote the formation of new blood vessels in the penis, allowing more blood to flow for an erection. Past studies have had encouraging results, but the follow-up periods were short. Scientists questioned how long the effects would last.
The current study looked at data from 156 men (median age 59 years) who had received LIST for ED over the course of 5 years. The group included responders and non-responders.
Each man received a total of 12 treatment sessions on the same schedule: 2 sessions weekly for the first 3 weeks, then 3 weeks of no treatment, then another 3 weeks of twice-weekly sessions. At baseline, 55% of the men had severe ED, 31% had moderate ED, and 14% had mild ED. About 47% had diabetes.
During each session, shock waves were applied to 5 different treatment points. The men’s progress was evaluated one month later with the erectile function domain of the International Index of Erectile Function (IIEF-EF) questionnaire.
The IIEF-EF was again administered at 6-, 12-, 18, and 24-month follow-up points.
About 64% of the original group responded to treatment after 1 month. Just over half of this subgroup was still responding at 24 months.
Men who had severe ED at baseline were less likely to have long-term success with LIST. In addition, none of the men who had both diabetes and severe ED at baseline were still responding at the 24-month mark.
However, men with mild ED at baseline had a 76% chance of responding throughout the two years.
It’s possible that treatment effects waned because the underlying causes of ED progressed over time.
“The future of LIST as a reliable modality depends on our ability to improve its long-term efficacy mainly in patients with severe ED,” the authors wrote. They recommended further research on protocol adjustments, such as changing the amount of energy used or the number or duration of treatment sessions. They also suggested investigating whether additional shock wave sessions should be used as maintenance therapy or as a “booster therapy” as needed.
Experts also caution that shockwave therapy remains an experimental treatment at the current time with inconsistent protocols and outcomes. Patients considering shockwave therapy should understand that studies have not consistently shown benefits with therapy. See the following link for the official statement by the Sexual Medicine Society of North America on shock wave and other experimental therapies here: http://www.smsna.org/V1/news/433-smsna-position-statement-on-restorative-therapies-for-ed
The study was published online in February in the Journal of Urology.
International Society for Sexual Medicine
“What is shockwave therapy and how might it help men with erectile dysfunction?”
The Journal of Urology
Kitrey, Noam D., et al.
“Low Intensity Shock Wave Treatment for Erectile Dysfunction—How Long Does the Effect Last?”
(Full-text. Published online: February 22, 2018)