Low-intensity extracorporeal shockwave therapy (LI-ESWT) may be helpful in treating erectile dysfunction (ED) of organic origin, Danish and British researchers report.
The technique, which uses electromagnetic energy to spur neovascularization, has been used in other medical capacities, including the treatment of kidney stones, gallstones, and Peyronie’s disease. As ED can be caused by vascular damage, LI-ESWT could be a viable treatment, research suggests.
For this prospective, randomized, blinded, placebo-controlled study, the scientists looked at the effectiveness of LI-ESWT over time.
They recruited 112 men between the ages of 37 and 80 from Denmark. The median age was 60 years. On average, the men had had ED of organic origin (not psychogenic) for a range of 57 – 64 months.
The researchers assessed the men’s erectile function with the Erection Hardness Scale (EHS) and the erectile function domain of the International Index of Erectile Function (IIEF-EF). Men with an EHS score of 3-4 can usually have intercourse without any medication. For this study, men were included if their EHS score was less than 2.
The men were randomly assigned to receive LI-ESWT or a placebo treatment for five weeks. LI-ESWT was performed on six areas of the penis. The placebo treatment was similar in delivery, but the device was capped to prevent any shock waves from reaching the penis.
The men’s erectile function was re-evaluated after five weeks. Ten weeks after the study began, the men in the placebo group were given the option to receive LI-ESWT, thus becoming the “active placebo” group. Erectile function was again assessed at 12 and 24 weeks after treatment.
At the 5-week mark, 57% of the men in the treatment group had an EHS score of 3-4. Only 9% of the placebo group had this score at this time.
However, as time went on, these results diminished. In the treatment group, the percentage of men with EHS scores of 3-4 declined from 28% at week 12 to 19% at week 24. Rates for the active placebo group fell from 28% to 23%.
IIEF-EF scores were not significantly different between the two groups after week 5.
The researchers were concerned that many men did not fully understand the IIEF-EF questionnaires. “It was the IIEF-15 that caused problems,” they wrote, “which became clear when the researchers calculated the results and talked to the participants.”
Still, they added that the changes in EHS scores showed that “something had clearly changed for these men.” Future research may give greater attention to the questionnaires used, they said.
They also noted that the decline in EHS scores over time indicated the possible need for follow-up treatments, larger doses of LI-ESWT, or added ED medication for better results. This is another angle for future research, they suggested.
The study was first published online in December in the Scandinavian Journal of Urology.
Scandinavian Journal of Urology (via Informa Healthcare)
Olsen, Anne B., et al.
“Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study”
(Abstract. First published online December 3, 2014)
Full-text accessed via StorzMedical.com