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Low-intensity shockwave therapy in the management of erectile dysfunction in Singapore

2021; Academy of Medicine, Singapore; Volume: 50; Issue: 8 Linguagem: Inglês

10.47102/annals-acadmedsg.202151

0304-4602

Weida Lau, Cheuk Fan Shum, Hui Chung Alex Lua, Chang Peng Colin Teo,

Hormonal and reproductive studies

Erectile dysfunction (ED) is a distressing condition that affects up to half of men aged 30 and above in Singapore. 1 The prevalence is higher among men with cardiovascular risk factors, and it was reported that up to 63% of uraemic patients had severe ED in Singapore. 2Low-intensity shockwave therapy (LiST) is a relatively new technology that is indicated for the treatment of ED. 3 The mechanisms involved in LiST include stimulation of mechano-sensors, activation of the neo-angiogenesis processes, recruitment and activation of progenitor cells, improvement in microcirculation, nerve regeneration, remodelling of erectile tissue, and reduction of inflammatory and cellular stress responses. 4In this study, we prospectively evaluated the outcomes of our patients who received LiST as an adjunct to existing medical therapy for the management of ED.Recruitment and assessment.The study was approved by the National Healthcare Group Domain Specific Review Board (Reference 2016/01010).Patients who presented to our Urology specialist outpatient clinic for ED were screened.All men above 21 years of age, who selected LiST as one of the modalities for treatment of ED and had a stable relationship with their sexual partner for more than 3 months, were recruited and gave written informed consent.Exclusion criteria included prior treatment with LiST, steroid therapy up to 6 weeks before first treatment, coagulation disorder and testosterone deficiency (total testosterone <8nmol/L).The patients were recruited from April 2017 to December 2017, and followed up from April 2017 to October 2018.Eligible patients underwent 6 or 12 sessions of LiST.Patients who selected 6 sessions underwent 1 session a week, while patients who selected 12 sessions underwent 2 sessions a week.Shockwaves were delivered using the Duolith SD1 ultra machine (Storz Medical AG, Tägerwilen, Switzerland) in a similar protocol described by Chung and Cartmill. 5 During the treatment period, the patients continued to receive other medical therapies for ED, including phosphodiesterase type 5 inhibitors (PDE5is) and testosterone replacement therapy (TRT) when indicated.The patients' baseline demographics, data on