Low intensity shock waves to treat erectile dysfunction: Is it safe for patients treated with anticoagulants?

Although several reports have documented the subjective improvement of erectile function after low-intensity extracorporeal shockwave therapy (LI-ESWT) in patients with vasculogenic erectile dysfunction (ED), objective assessment data of penile hemodynamics are lacking. The aim of this research is to detect the Change in peak systolic velocity of cavernous artery in response to low intensity shock waves therapy in diabetic patients with erectile dysfunction. This study is a randomized controlled trial. Overall forty male individuals with mean age (48.6±5.52 years)who have erectile dysfunction after diabetes were equally divided into two separate groups. 1st Group received low intensity extracorporeal shock wave therapy (ESWT). 2nd Group received shame therapy by put head of shock wave while machine is turned off. 1st Group received low intensity extracorporeal shock wave with the following parameters: - 3000 SWs (energy intensity of 0.09mJ/mm2) to each of five different sites of application: three areas along the penile shaft and two areas at the crural level for six weeks as a total period of treatment. Measurements of peak systolic velocity by penile duplex were performed before the treatment and after 3months. There were change in peak systolic velocity of the right and left cavernous arteries were low at baseline, indicating arterial insufficiency. After treatment, PSV significantly in the two groups; however, the post-treatment PSV was significantly higher in the SW group compared to the PFE group (p < 0.001, for both arteries).LIESWT is lead to significant changes in patients suffering from erectile dysfunction after diabetes as evidenced by increase in the peak systolic volume of the both right and left cavernous arteries of the shock wave group.

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Penile Low-Intensity Shock Wave Therapy for Erectile Dysfunction: Personal Experience

Klinička psihologija ◽

10.21465/2016-kp-p-0023 ◽

2016 ◽

Vol 9 (1) ◽

pp. 156-156

Author(s):

P. Letizia ◽

◽

G. Alei ◽

A. Rossi ◽

F. De Marco ◽

...

Keyword(s):

Shock Wave ◽

Blood Flow ◽

Erectile Dysfunction ◽

Shock Waves ◽

Endothelial Function ◽

Erectile Function ◽

Power Doppler ◽

Shock Wave Therapy ◽

Low Intensity ◽

Intracavernosal Injections

Objective: Penile extracorporeal low-intensity shock wave therapy (LIST) to the penis has recently emerged as a novel and promising modality in the treatment of erectile dysfunction. LIST can improve penile blood flow and endothelial function by stimulating angiogenesis in the penis. Design and Method: We applied LIST to patients with mild to moderate vasculogenic ED who responded well to the use of PDE5i. The treatment protocol consisted of one treatment sessions per week for 6 weeks, a 6 -week no-treatment interval. Each session comprised the application of 3000 shock waves (energy intensity of 4 mJ/mm3) to each penile shaft and 1000 shock waves for each crura. Results: The results showed that 6 weeks after treatment, erectile function improved in the 85% of the cases, good result was achieved in 10% and no results in 5% of the patients. The average increase in the IIEF-EF domain score was 8.8 points. Furthermore, erectile function and penile blood flow were measured using nocturnal penile tumescence (NPT) and color-power Doppler of the penis. All NPT parameters improved as recorded by significant increases in the duration of the erections and penile rigidity. Conclusions: The treatment options for ED have greatly expanded and include PDE5i, intracavernosal injections, and penile prostheses. Our experience presented here demonstrate that LIST of the corpora cavernosa is a novel therapeutic option for ED. LIST may have a fundamental effect on penile endothelial function, increasing penile blood flow, and improving erectile function and consequently sexual satisfaction.

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