Efficacy of Low Density Linear Shockwave Treatment in Severe Arteriogenic Erectile Dysfunction Patients

Abstract

Objective: The aim of this study was to evaluate the efficacy of low-intensity linear shockwave treatment (LI-ESWT) in patients with severe arteriogenic erectile dysfunction (ED) by comparing LI-ESWT combined with daily use of phosphodiesterase type 5 inhibitors (PDE5i) with the daily use of PDE5i alone. Materials and Methods: A total of 23 patients were included in the study. The patients were separated into two groups: LI-ESWT + tadalafil 5 mg (n=10) group and tadalafil 5 mg only group (n=13). LI-ESWT was applied once a week for four weeks. Oral tadalafil 5 mg once a day was started and continued for three months in both groups. The patients were evaluated with the International Erectile Function Index Questionnaire Erectile Function Domain (IIEF-EF), Erection Hardness Score (EHS) and Sexual Encounter Profile (SEP) 2 and 3 before treatment and the 1 and 3 months after treatment. Results: No statistically significant difference was detected among IIEF-EF scores measured before and 1 and 3 months after treatment (p=0.091, p=0.198). At the end of the third month, IIEF score increased 4 points in LI-ESWT + tadalafil 5 mg group and 3.2 points in tadalafil 5 mg only group. No statistically significant difference was detected in EHS, and the rate of positive responses to SEP2 and SEP3 questions at the 1st and 3rd months between the groups. Conclusion: LI-ESWT is easily applicable without any significant side effects and it has positive effects on the outcomes, however, it is not an effective treatment method in patients with severe arteriogenic ED.