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Does Low Intensity Extracorporeal Shock Wave Therapy Have a Physiological Effect on Erectile Function? Short-Term Results of a Randomized, Double-Blind, Sham Controlled Study

2012; Lippincott Williams & Wilkins; Volume: 187; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2011.12.117

1527-3792

Yoram Vardi, Boaz Appel, Amichai Kilchevsky, Ilan Gruenwald,

Hormonal and reproductive studies

No AccessJournal of UrologyAdult Urology1 May 2012Does Low Intensity Extracorporeal Shock Wave Therapy Have a Physiological Effect on Erectile Function? Short-Term Results of a Randomized, Double-Blind, Sham Controlled Study Yoram Vardi, Boaz Appel, Amichai Kilchevsky, and Ilan Gruenwald Yoram VardiYoram Vardi Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel Financial interest and/or other relationship with Medispec, Ltd. More articles by this author , Boaz AppelBoaz Appel Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel More articles by this author , Amichai KilchevskyAmichai Kilchevsky Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel Department of Urology, Yale-New Haven Hospital, New Haven, Connecticut More articles by this author , and Ilan GruenwaldIlan Gruenwald Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.12.117AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated the clinical and physiological effect of low intensity extracorporeal shock wave therapy on men with organic erectile dysfunction who are phosphodiesterase type 5 inhibitor responders. Materials and Methods: After a 1-month phosphodiesterase type 5 inhibitor washout period, 67 men were randomized in a 2:1 ratio to receive 12 sessions of low intensity extracorporeal shock wave therapy or sham therapy. Erectile function and penile hemodynamics were assessed before the first treatment (visit 1) and 1 month after the final treatment (followup 1) using validated sexual function questionnaires and venoocclusive strain gauge plethysmography. Results: Clinically we found a significantly greater increase in the International Index of Erectile Function-Erectile Function domain score from visit 1 to followup 1 in the treated group than in the sham treated group (mean ± SEM 6.7 ± 0.9 vs 3.0 ± 1.4, p = 0.0322). There were 19 men in the treated group who were initially unable to achieve erections hard enough for penetration (Erection Hardness Score 2 or less) who were able to achieve erections sufficiently firm for penetration (Erection Hardness Score 3 or greater) after low intensity extracorporeal shock wave therapy, compared to none in the sham group. Physiologically penile hemodynamics significantly improved in the treated group but not in the sham group (maximal post-ischemic penile blood flow 8.2 vs 0.1 ml per minute per dl, p <0.0001). None of the men experienced discomfort or reported any adverse effects from the treatment. Conclusions: This is the first randomized, double-blind, sham controlled study to our knowledge that shows that low intensity extracorporeal shock wave therapy has a positive short-term clinical and physiological effect on the erectile function of men who respond to oral phosphodiesterase type 5 inhibitor therapy. 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Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKalyvianakis D, Mykoniatis I, Pyrgidis N, Kapoteli P, Zilotis F, Fournaraki A and Hatzichristou D (2022) The Effect of Low-Intensity Shock Wave Therapy on Moderate Erectile Dysfunction: A Double-Blind, Randomized, Sham-Controlled Clinical TrialJournal of Urology, VOL. 208, NO. 2, (388-395), Online publication date: 1-Aug-2022.Weinberger J, Shahinyan G, Yang S, Shahinyan R, Mills J and Eleswarapu S (2022) Reply by AuthorsUrology Practice, VOL. 9, NO. 3, (219-219), Online publication date: 1-May-2022.Weinberger J, Shahinyan G, Yang S, Shahinyan R, Mills J and Eleswarapu S (2022) Shock Wave Therapy for Erectile Dysfunction: Marketing and Practice Trends in Major Metropolitan Areas in the United StatesUrology Practice, VOL. 9, NO. 3, (212-219), Online publication date: 1-May-2022.Burnett A, Nehra A, Breau R, Culkin D, Faraday M, Hakim L, Heidelbaugh J, Khera M, McVary K, Miner M, Nelson C, Sadeghi-Nejad H, Seftel A and Shindel A (2018) Erectile Dysfunction: AUA GuidelineJournal of Urology, VOL. 200, NO. 3, (633-641), Online publication date: 1-Sep-2018.Kitrey N, Vardi Y, Appel B, Shechter A, Massarwi O, Abu-Ghanem Y and Gruenwald I (2018) Low Intensity Shock Wave Treatment for Erectile Dysfunction—How Long Does the Effect Last?Journal of Urology, VOL. 200, NO. 1, (167-170), Online publication date: 1-Jul-2018.Assaly-Kaddoum R, Giuliano F, Laurin M, Gorny D, Kergoat M, Bernabé J, Vardi Y, Alexandre L and Behr-Roussel D (2016) Low Intensity Extracorporeal Shock Wave Therapy Improves Erectile Function in a Model of Type II Diabetes Independently of NO/cGMP PathwayJournal of Urology, VOL. 196, NO. 3, (950-956), Online publication date: 1-Sep-2016.Chuang Y, Huang T, Tyagi P and Huang C (2015) Urodynamic and Immunohistochemical Evaluation of Intravesical Botulinum Toxin A Delivery Using Low Energy Shock WavesJournal of Urology, VOL. 196, NO. 2, (599-608), Online publication date: 1-Aug-2016.Kitrey N, Gruenwald I, Appel B, Shechter A, Massarwa O and Vardi Y (2015) Penile Low Intensity Shock Wave Treatment is Able to Shift PDE5i Nonresponders to Responders: A Double-Blind, Sham Controlled StudyJournal of Urology, VOL. 195, NO. 5, (1550-1555), Online publication date: 1-May-2016. Volume 187Issue 5May 2012Page: 1769-1775 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordspenishigh-energy shock waveserectile dysfunctionhemodynamicsAcknowledgmentsElliot Sprecher assisted with the statistical analysis and Dr. Arieh Bomzon provided assistance.Metrics Author Information Yoram Vardi Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel Financial interest and/or other relationship with Medispec, Ltd. More articles by this author Boaz Appel Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel More articles by this author Amichai Kilchevsky Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel Department of Urology, Yale-New Haven Hospital, New Haven, Connecticut More articles by this author Ilan Gruenwald Neuro-Urology Unit, Rambam Healthcare Campus, and the Rappaport Faculty of Medicine, Technion – IIT, Haifa, Israel More articles by this author Expand All Advertisement PDF downloadLoading ...