Background and Objective Erectile dysfunction (ED) is a prevalent and impactful complication post definitive management of prostate cancer. The mechanism of ED is thought to be secondary to vascular and neural injury as well as corporal smooth muscle damage with resultant fibrosis. The use of penile rehabilitation in ED following treatment for prostate cancer has been studied. Low-intensity extracorporeal shockwave therapy (Li-ESWT) is a novel treatment for ED thought to stimulate neovascularization and nerve regeneration, and as such, has gained interest in treatment of ED related to radical prostatectomy or radiation therapy. Herein, we performed a narrative review on the use of Li-ESWT in management of ED following treatment for prostate cancer. Methods A literature review was performed using PubMed and Google Scholar. Studies evaluating Li-ESWT following prostate cancer treatment were included. Key Content and Findings We identified three randomized controlled trials and two observational studies that assessed use of Li-ESWT for ED after prostate surgery. Use of Li-ESWT across most studies showed improvements in the International Index of Erectile Function-erectile function (IIEF-EF) domain scores, but this improvement was not statistically significant. Additionally, use of Li-ESWT in an early versus delayed fashion does not appear to affect changes in long-term sexual function scores. No data on use of Li-ESWT after radiotherapy were identified. Conclusions There is a paucity of data regarding use of Li-ESWT for penile rehabilitation in treatment of ED post-prostate cancer therapy. Current protocols for Li-ESWT are not standardized and have a limited number of participants with short duration of follow-up. Additional evaluation is needed to determine optimal Li-ESWT protocols. Ideally, studies should have longer follow-up to truly evaluate the clinical significance of Li-ESWT in the treatment of post-prostatectomy ED. Furthermore, the role of Li-ESWT after radiotherapy remains elusive.

Introduction and Objectives: Urodynamics are the accepted gold standard for the evaluation of multiple forms of voiding dysfunction. However, the tests are expensive, invasive, poorly reproducible, and often prone to artifacts. Therefore, there is a pressing need to develop next-generation urodynamics.The purpose of this study was to develop a novel ex vivo porcine bladder urodynamics model with afferent pelvic nerve signaling that can be used as a preclinical surrogate for bladder sensation.Methods: Porcine bladders including the ureters and vascular supply were harvested from local abattoirs using an established protocol in both male and How to cite this article: Moore RH, Ghatas MP, Rogers D, et al. A porcine bladder model of preclinical urodynamics demonstrates increased afferent nerve activity during filling.

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voiding states. Spinal cord regions that yielded a significant hemodynamic response during the filling and voiding events were determined.CONCLUSIONS: Robust methods for assessment of spinal cord function in relation to micturition were lacking prior to this study. We employed a novel urodynamic-functional imaging model to illustrate the changes in fUSI signal in response to bladder filling and voiding, which revealed the spatiotemporal correlations between the spinal cord hemodynamics and micturition. The present model enables functional imaging of the spinal cord during voiding, and simultaneously captures multiple spinal cord levels across the sagittal plane. fUSI offers unique insights into the neural correlates of bladder function within the spinal cord, bridging a current gap in neuro-urology.