Linear Low-Intensity Extracorporeal Shockwave Therapy as a Method for Penile Rehabilitation in Erectile Dysfunction Patients after Radical Prostatectomy: A Randomized, Single-Blinded, Sham-Controlled Clinical Trial

Motil, Igor; Macík, Daniel; Šrámková, Kateřina; Jarkovský, Jiří; Šrámková, Taťána

doi:10.1159/000525973

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…This suggests that despite the limited e cacy of penile rehabilitation, there is still a focus on it rather than taking a holistic approach to addressing patient sexuality. Other physiological methods of sexual rehabilitation, such as penile vibratory stimulation, stretching devices, and low-intensity extracorporeal shock wave therapy, were not utilized in our study, which is reasonable considering the limited available literature [31][32][33][34].…”

Section: Discussionmentioning

confidence: 95%

Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers

Fode

Nolsøe²,

Holm³

et al. 2023

Preprint

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We aimed to describe the clinical practice regarding erectile dysfunction (ED) and urinary incontinence (UI) after radical prostatectomy (RP) in the Nordic countries. A 37-item survey about pre- and post-RP evaluation and rehabilitation of sexual and urinary function was sent to 42 uro-oncology centers. Twenty-seven centers in Denmark (n = 6), Norway (n = 8), Finland (n = 7), and Sweden (n = 6) responded (64.3%). Post-RP sexual function was evaluated by 25 centers. The majority used validated questionnaires with significant variations across centers. Post-RP urinary function was evaluated by 24 centers. Again, the majority used a variety of validated questionnaires, while were 9 centers used objective measures including as uroflowmetry, residual urine volume, and daily pad usage. Twenty-one centers reported to offer sexual rehabilitation and 12 of these described their protocols. All centers administered PDE5Is and seven centers offered 2nd or 3rd line options. Two centers offered a consultation with a sexologist. Twenty-three centers provided pelvic floor muscle training via a physiotherapist and one center used medical support with duloxetine. Our study indicates a need for standardized evaluation and management of ED and UI following RP. Especially, there is a need for an increased focus on sexual rehabilitation with utilization of options other than a simple PDE5I.

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Section: Discussionmentioning

confidence: 95%

Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers

Fode

Nolsøe²,

Holm³

et al. 2023

Preprint

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“…Given the lack of consensus of a “best” treatment protocol, we reviewed the literature for randomized, sham-controlled trials of LiSWT for ED published in the last 10 years. Table 1 [ 24 25 26 27 28 29 30 31 32 33 34 35 36 37 ] -summarizes the treatment protocols used, specifically distinguishing device settings, shock number, treatment sessions, and shock location (a practical variable not reported in prior LiSWT reviews). We included studies regardless of patient population, origin of ED, or concurrent medication use.…”

Section: Main Bodymentioning

confidence: 99%

Variations in Low Intensity Shockwave Treatment Protocols for Erectile Dysfunction: A Review of the Literature and Guide to Offering Treatment

Hayon,

Panken,

Bennett

2024

World J Mens Health

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Low-intensity shockwave therapy (LiSWT) for erectile dysfunction (ED) continues to gain popularity in both clinical practice and the academic literature. The majority of trials and meta-analysis studies have shown LiSWT to be low risk with a trend toward positive improvements in International Index of Erectile Function (IIEF) scores. However, there is still debate over the clinical utility of LiSWT and there is no agreed upon optimal treatment protocol. In this review article we summarize published meta-analysis studies of LiSWT for ED, and review the treatment protocols from randomized sham-control trials published in the last 10 years. We found the most common device settings were an energy of 0.09 mJ/mm 2 and a frequency of 5 Hz. Shock number and location varied, but the most common protocol was 1,500 shocks per session, with 900 shocks to the penis (shaft, base, or hilum) and 600 shocks to the proximal corpora/crura. Protocols ranged from 4 to 12 treatment sessions. We also describe our institutional experience with LiSWT, including patient counseling and treatment protocol.

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“…Motil et al recently showed some promising data with early Li-ESWT intervention and combination therapy with PDE5i for penile rehabilitation ( 60 ). In this randomized, single blinded sham-controlled clinical trial, 32 patients were followed 3 months after nerve sparing RP: 16 in the treatment arm and 16 in the placebo arm (baseline IIEF-5 scores of 5.4±1.2 and 5.9±2.4, respectively).…”

Section: Restoration Of Erectile Function Following Therapy For Prost...mentioning

confidence: 99%

The use of low-intensity extracorporeal shockwave therapy in management of erectile dysfunction following prostate cancer treatment: a review of the current literature

Matthew¹,

Rogers²,

Grob³

et al. 2023

Transl Androl Urol

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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.

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Linear Low-Intensity Extracorporeal Shockwave Therapy as a Method for Penile Rehabilitation in Erectile Dysfunction Patients after Radical Prostatectomy: A Randomized, Single-Blinded, Sham-Controlled Clinical Trial

Cited by 4 publications

References 13 publications

Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers

Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers

Variations in Low Intensity Shockwave Treatment Protocols for Erectile Dysfunction: A Review of the Literature and Guide to Offering Treatment

The use of low-intensity extracorporeal shockwave therapy in management of erectile dysfunction following prostate cancer treatment: a review of the current literature

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