Men who receive low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) see greater improvement than those who receive a sham therapy, according to a new report in the Journal of Sexual Medicine.
Li-ESWT is considered an experimental technique for the treatment of ED. Energy from acoustic waves is used to trigger neovascularization – the creation of new blood vessels – which can improve the penile blood flow needed for a firm erection. The treatment is delivered through a specially-designed probe that is applied to different areas of the penis. A typical treatment session may take up to twenty minutes.
The study was a systematic review and meta-analysis of seven randomized controlled trials published between January 2010 and March 2016. All of the studies compared the results of treatment and sham groups using the erectile function domain of the International Index of Erectile Function (IIEF-EF) questionnaire. This domain evaluates erection frequency, firmness, and maintenance along with a man’s ability to penetrate his partner and his confidence in his erections.
Combined, the studies included 602 men with an average age of 61 years residing in Asia, Europe, and North America. Patients were followed for an average duration of 20 weeks. All of them had vasculogenic ED; those with neurogenic ED were excluded.
The researchers looked at the changes in IIEF-EF scores from baseline to follow-up. Overall, the pooled change for those who underwent Li-ESWT was an increase of 6.40 points. For those in the sham therapy groups, the pooled change was 1.65 points.
Several factors may contribute to Li-ESWT outcomes, the authors explained. Age, comorbidities, and duration of ED may all play a role. For example, older men may have less success than younger men. Men who have had ED for a long time may not fare as well as those who have been diagnosed more recently. Other factors include baseline IIEF-EF scores and initial response to oral ED medications.
While these results may be encouraging, the authors noted that further study is necessary. They made several recommendations for future research, such as randomized study design, inclusion of only men with vascular ED, and a follow-up period of over three months.
They also recommended that future studies examine different treatment schedules and report all adverse events.
International Society for Sexual Medicine
“What is shockwave therapy and how might it help men with erectile dysfunction?”
The Journal of Sexual Medicine
Clavijo, Raul I., MD, et al.
“Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis”
(Full-text. Published online: December 13, 2016)