Introduction
Linear Shock Wave Therapy (LSWT) is a new non-invasive therapy that uses shock waves of low intensity to induce controlled angiogenesis locally, and significantly improves the hemodynamic function of the male sexual organ.
Objective
To report our experience with the use of Linear Shock Wave Therapy as a treatment for Erectile Dysfunction (ED).
To evaluate the possible effectiveness and safety of LSWT treatment in men with vasculogenic ED.
Material & Methods
This was a Pilot, prospective study. 15 men in the ages of 45-70 years old, sexually active with mild and moderate vasculogenic ED, were evaluated with the International Index of Erectile Function (IIEF-EF). The study was conducted in three stages:
- Screening: clinical data and examination
Collected data comprised the following: Age, Body Mass Index (BMI), International Prostate Symptom Score (IPSS), Quality of Life according to urinary Symptoms (QoL), Years with ED, Confidence to achieve and maintain Erection (Q15- IIEF-5), Smoking history, Diabetes Mellitus (DM), Hypertension, Ischemic Heart Disease, Baseline IIEF (ED degree), EHS (Erection Hardness Score), SEP Baseline (Sexual Encounter Profile).
- Treatment: 4 sessions of LSWT and rehabilitation.
Patients received 4 weekly sessions of LSWT (Renova) with 5000 shocks of 0.09 mJ/mm2 intensity, at a rate of 300 shockwaves/min (5Hz), on an area of 60mm long and 40mm deep.
Shockwaves were divided into 4 areas (right and left corpus cavernosum received 900 shockwaves on each side, and right and left crus received 1600 shockwaves on each side).Each session lasted 20 min with one week interval between each session. The treatment was performed on an outpatient basis and without the need of anesthesia.
The second phase of treatment consisted of "Rehabilitation" at home between sessions (sexual activity with a partner or manual stimulation).
3. Follow up: Erectile function was assessed by IIEF, EHS, SEP and GAQ (Global Assessment Questions) one month and three months after treatment completion.
Results
Test | Baseline Score | Score after treatment | p Value |
IIEF | 15 ( 11-18 ) | 20 ( 11-23 ) | p<0.013 |
EHS | 2( 2-3 ) | 4 ( 2- 4) | p<0.01 |
SEP III | 7 patients | 12 patients | p<0.0013 |
GAQ | - | 12 patients |
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Most successful for patients with mild and mild to moderate symptoms.
Higher success for patients with a shorter ED duration
Higher success for patients with a Pack-Years-Index less than 20
Higher success for patients with a BMI of less than 30
Conclusions
Our short-term results are encouraging but demand a long-term evaluation.
Based on our results, LSWT can be an effective and safe alternative for the treatment of vasculogenic ED. The feasibility and tolerability of this treatment, and rehabilitation potential features, make it an attractive new therapeutic option for patients with vasculogenic ED.
The above paper abstract was presented at the 33rd American Confederation of Urology Congress, on November 24th 2014, Punta del Este, Uruguay.