Effect of Low-Intensity Extracorporeal Shock Wave on the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis

Abstract

Low-intensity extracorporeal shockwave therapy (Li-ESWT) has been reported as a useful and noninvasive treatment for erectile dysfunction (ED). Systematic review and meta-analysis are utilized to evaluate the efficacy of Li-ESWT by comparing the changes in the International Index of Erectile Function erectile function domain (IIEF-EF) and the Erection Hardness Score (EHS) versus sham therapy in men with ED. A systematic search of the MEDLINE, EMBASE, ClinicalTrials.gov, CBM, CNKI, WANGFANG, and VIP was conducted to obtain randomized controlled trials (RCTs) published in peer-reviewed journals or presented in abstract forms of Li-ESWT for ED treatment from January 2010 to June 2018. If RCTs are published in peer-reviewed literature and IIEF-EF scores and EHS are used to assess erectile function outcomes, they are eligible for inclusion. A meta-analysis was used to summarize the estimates. The meta-analysis included seven RCTs involving 522 participants. The data revealed that men treated with Li-ESWT showed significant improvement in pooled mean IIEF-EF scores from baseline to follow-up compared with sham therapy (MD: 1.99 points; 95% CI [1.35, 2.63]; p < .00001). Changes in the IIEF-EF score increased significantly in the treatment group (MD: 3.62; 95% CI [2.99, 4.25]; p < .00001). The EHS increased significantly in the treatment group in four studies (OR: 16.02; 95% CI [7.93, 32.37]; p < .00001). Patients with moderate and/or severe ED reported better results in mean IIEF scores (MD: 3.95; 95% CI [2.44, 5.46]; p < .00001). In meta-analysis of seven RCTs with men who received Li-ESWT for ED, there was evidence that the IIEF-EF and EHS experienced improvements following Li-ESWT.

Clinical Practice Guideline Recommendation on the Use of Low Intensity Extracorporeal Shock Wave Therapy and Low Intensity Pulsed Ultrasound Shock Wave Therapy to Treat Erectile Dysfunction: The Asia-Pacific Society for Sexual Medicine Position Statement

“…Published systematic review and meta-analyses showed encouraging clinical outcomes in men with ED [ 31 32 34 39 40 41 42 ]. Clavijo et al [ 40 ] who extracted data from 7 clinical trials, reported a statistically significant improvement in pooled change in International Index of Erectile Function (IIEF) score compared to sham group (6.40 points; 95% confidence interval [CI]=1.78–11.02; I 2 =98.7%; p<0.001 vs. 1.65 points; 95% CI=0.92–2.39; I 2 =64.6%; p<0.001; between-group difference, p=0.047) with significant between-group differences were found for total treatment shocks received by patients (p<0.001).…”

Extracorporeal shock wave therapy in the supportive care and rehabilitation of cancer patients

“…Erectile dysfunction is another condition of interest in cancer rehabilitation [9–11]. This indication can also be treated with ESWT, but has to be managed in an interdisciplinary setting [2].…”

Is Acupuncture Another Good Choice for Physicians in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Review of the Latest Literature

“…NIH-funded studies show that the efficacy of drug treatment for CPPS is negative [41,42]. Phytotherapy, such as low-energy shock wave, has also been reported in recent years for pelvic floor diseases, such as CP/CPPS [43] and erectile dysfunction [44]. erefore, many alternative therapies have been proposed, including phytotherapy, lifestyle changes, physical therapy, diet, cognitive behavioral therapy, and acupuncture [45].…”