Patients with erectile dysfunction (ED) who have not improved after using phosphodiesterase type 5 inhibitors (PDE5is) can be tough to treat (PDE5is). LI-ESWT, or low-intensity extracorporeal shockwave therapy, can be used to treat erectile dysfunction (ED) due to its capacity to enhance blood flow to the penis. Patients who did not respond to PDE5is monotherapy were enrolled in the current trial to see if a combination of LI-ESWT and PDE5is could restore erectile function. This was a prospective, single-arm trial with an open-label design.
Positive experiment
The experiment comprised patients with erectile dysfunction (ED) who were taking the maximum dose of PDE5is and had an erection hardness score (EHS) of at least two. Each individual’s medical history and demographic information were meticulously documented. The LI-ESWT protocol required the administration of a total of 3,000 shockwaves weekly for 12 weeks. Throughout the duration of the study, all patients continued to take their usual dosage of PDE5is. We evaluated the improvement in erections 1 and 3 months after LI-ESWT using the EHS and the 5-item version of the International Index of Erectile Function (IIEF-5). There were a total of 52 patients that enrolled in the study.
Low-intensity extracorporeal shock wave therapy
Low-intensity extracorporeal shock wave therapy (also known as LI-ESWT) is increasingly used to treat erectile dysfunction since this noninvasive therapy has been found to increase erectile function by boosting blood flow to the cavernosal tissues (ED). Few studies have evaluated the role of LI-ESWT in patients with severe ED who did not respond to PDE5is, particularly in Asia, despite the majority of published results indicating that LI-ESWT can be an effective treatment for patients with mild to moderate ED, particularly those who respond to PDE5is. Despite the fact that the bulk of research indicates that LI-ESWT can aid those with moderate ED, it has not yet become a conventional treatment.
Only one-third of patients with severe ED were able to employ LI-ESWT following a PDE5i washout to restore an erection powerful enough for sexual activity, according to an initial study. The study reached this conclusion. Recent research suggests that LI-ESWT may improve erectile function independently of the pathway involving nitric oxide (NO) and cyclic guanosine monophosphate (cGMP), and that it may enhance the efficacy of PDE5i when taken in conjunction with it in a rat model of type 2 diabetes. It seems appropriate to combine LI-ESWT with PDE5i to increase the efficacy of treatment in males with severe erectile dysfunction. The purpose of the current study was to examine if a combination therapy consisting of LI-ESWT and PDE5is could restore erectile function in Taiwanese patients who had not responded to PDE5is alone.
The first phase of the selection procedure
All of the individuals were evaluated using a standardised questionnaire that gathered demographic information as well as in-depth medical, surgical, and psychosexual histories. The well-known risk factors for erectile dysfunction, including diabetes mellitus, high blood pressure, high cholesterol, cardiovascular disease, stroke, alcohol consumption, and cigarette smoking, were investigated in depth.
Participants went through with LI-ESWT once weekly for 12 weeks in an outpatient setting. For this surgery, neither local nor general anaesthesia was administered. At each treatment session, a total of 3,000 LI-ESWT shocks were administered at six separate locations, with an energy setting of 0.15 mJ/mm2 intensity and a frequency of 240 shocks per minute. Due to the fact that LI-ESWT can reach the corpus cavernosa on both sides of the body, the treatment intensity was modified for each penile region to get ideal outcomes.
The LI-Success ESWT Requirements
One and three months after completing a full course of LI-ESWT and while continuing to take PDE5is regularly, EHS and IIEF-5 were used to review the erection function of the people. EHS improvement was the primary determinant of LI-efficacy.
