Low-energy shock wave therapy ameliorates erectile dysfunction in a pelvic neurovascular injuries rat model

Behr‐Roussel, Delphine; Giuliano, François

doi:10.21037/tau.2016.11.07

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…A shock wave applicator was placed on the ultrasonic gel covered penis. According to previous studies (12,24) each penis was treated with 300 impulses of ESWT at an energy flux density of 0.1 mJ/mm 2 with a frequency of 120/min. With a break for one day, ESWT was treated three times per week, and repeated for four weeks.…”

Section: Eswt and Sdf-1 Emsc Treatmentmentioning

confidence: 99%

“…Therapeutic ultrasound can induce VEGF expression, thereby stimulating angiogenesis (10). Since the first report of treatment of ED with Li-ESWT by Vardi et al (11), numerous studies have reported effects of ESWT on DM ED (12)(13)(14). It has been suggested that ESWT can promote regeneration and tissue repair by stimulating angiogenesis and restoring blood flow to injured areas (15).…”

Section: Introductionmentioning

confidence: 99%

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Extracorporeal shock wave therapy combined with engineered mesenchymal stem cells expressing stromal cell-derived factor-1 can improve erectile dysfunction in streptozotocin-induced diabetic rats

Shin¹,

Jeon²,

Tian³

et al. 2021

Transl Androl Urol

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Background: For erectile dysfunction (ED) in diabetes mellitus (DM) patients who have poor response to drugs, extracorporeal shock wave therapy (ESWT) and engineered mesenchymal stem cell (MSC) therapy have been studied as alternative treatment options. The objective of this study is to investigate whether ESWT in combination with stromal cell-derived factor-1 expressing engineered mesenchymal stem cell (SDF-1 eMSC) therapy can have synergistic effects on ED in streptozotocin-induced diabetic rats. Methods: Fifty 8-week-old male Sprague-Dawley rats were randomly divided into five groups (N=10 per group): (I) Normal group, (II) DM ED, (III) DM ED + ESWT group, (IV) DM ED + SDF-1 eMSC group, and (V) DM ED + ESWT + SDF-1 eMSC group. Each groups were treated with bilateral injections of SDF-1 eMSC or ESWT following the experiment protocol for eight weeks. Results:The ratio of ICP/MAP was distinctly higher in the DM ED + ESWT + SDF-1 eMSC group than that in the DM ED group. Concentration of α-smooth muscle actin (α-SMA) was elevated the highest in the DM ED + ESWT + SDF-1 eMSC group. Additionally, ESWT increased the intensity of SDF-1 expression in the corpus cavernosum. ESWT + SDF-1 eMSC treatment also induced neuronal nitric oxide synthase (nNOS) and NO/cGMP expression in the corpus cavernosum. Furthermore, numbers of penile progenitor cells were increased in DM ED rats.Conclusions: Combined treatment of ESWT with SDF-1 eMSC treatment is more effective than by a single therapy. It could be used as a potential and effective synergistic treatment for DM ED.

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Section: Eswt and Sdf-1 Emsc Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extracorporeal shock wave therapy combined with engineered mesenchymal stem cells expressing stromal cell-derived factor-1 can improve erectile dysfunction in streptozotocin-induced diabetic rats

Shin¹,

Jeon²,

Tian³

et al. 2021

Transl Androl Urol

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“… 6 In addition, Li-ESWT showed potential in promoting angiogenesis in a pelvic neurovascular injury rat model. 7 …”

Section: Introductionmentioning

confidence: 99%

Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction—12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study

2017

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IntroductionShort-term data on the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) have been inconsistent. The suggested mechanisms of action of Li-ESWT on ED include stimulation of cell proliferation, tissue regeneration, and angiogenesis, which can be processes with a long generation time. Therefore, long-term data on the effect of Li-ESWT on ED are strongly warranted.AimTo assess the outcome at 6 and 12 months of linear Li-ESWT on ED from a previously published randomized, double-blinded, sham-controlled trial.MethodsSubjects with ED (N = 126) who scored lower than 25 points in the erectile function domain of the International Index of Erectile Function (IIEF-EF) were eligible for the study. They were allocated to 1 of 2 groups: 5 weekly sessions of sham treatment (group A) or linear Li-ESWT (group B). After a 4-week break, the 2 groups received active treatment once a week for 5 weeks. At baseline and 6 and 12 months, subjects were evaluated by the IIEF-EF, the Erectile Hardness Scale (EHS), and the Sexual Quality of Life in Men.Main Outcome MeasuresThe primary outcome measure was an increase of at least 5 points in the IIEF-EF (ΔIIEF-EF score). The secondary outcome measure was an increase in the EHS score to at least 3 in men with a score no higher than 2 at baseline. Data were analyzed by linear and logistic regressions.ResultsLinear regression of the ΔIIEF-EF score from baseline to 12 months included 95 patients (dropout rate = 25%). Adjusted for the IIEF-EF score at baseline, the difference between groups B and A was −1.30 (95% CI = −4.37 to 1.77, P = .4). The success rate based on the main outcome parameter (ΔIIEF-EF score ≥ 5) was 54% in group A vs 47% in group B (odds ratio = 0.67, P = .28). Improvement based on changes in the EHS score in groups A and B was 34% and 24%, respectively (odds ratio = 0.47, P = .82).ConclusionExposure to 2 cycles of linear Li-ESWT for ED is not superior to 1 cycle at 6- and 12-month follow-ups.Fojecki GL, Tiessen S, Osther PJS. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction—12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study. Sex Med 2018;6:1–7.

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“…A review of the association between dose regimen and medication compliance found that the daily prescribed dosage number is inversely correlated with compliance ; the lower the dosing frequency, the better compliance. Amongst the clinical applications of ESWT, most protocols use frequencies of two or three times per week, which is not only time‐ and cost‐consuming for patients, but also reduces compliance . A few studies have performed Li‐ESWT once weekly and have reported promising outcomes .…”

Section: Discussionmentioning

confidence: 99%

Low‐intensity extracorporeal shockwave therapy ameliorates diabetic underactive bladder in streptozotocin‐induced diabetic rats

Wang

et al. 2018

BJU International

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Objectives To evaluate the therapeutic effect of once-per-week low-intensity extracorporeal shock wave therapy (Li-ESWT) on underactive bladder (UAB) in the streptozotocin-induced diabetic rat model. Materials and Methods Thirty-six female Sprague-Dawley rats were assigned into 3 groups: normal control (NC), diabetes control (DMC), and diabetes underwent Li-ESWT (DM Li-ESWT). The two DM groups received intraperitoneal 60 mg/kg streptozotocin injection to induce diabetes mellitus. The Li-ESWT was applied toward the pelvis of the rats started 4 weeks after the streptozotocin administration and lasted for 4 weeks. The shock wave therapy was given once-per-week with energy flux density of 0.02 mJ/mm2 at 3 Hz for 400 pulses. All rats were subjected to conscious cystometry, leak point pressure, ex-vivo organ bath study, histology, immunofluorescence, and western blot analysis. Results Conscious cystometry revealed voiding dysfunction in DMC group, whereas DM Li-ESWT group showed significantly improved voiding function in reduced post-void residual urine and increased leak point pressure compared to DMC group. Ex-vivo organ bath study showed that Li-ESWT enhances muscle contractile activity (MCA) of bladder and urethra in electrical field stimulation (EFS) and drug stimulation. Histologically, Li-ESWT significantly restored bladder morphology in reducing intravesical lumen area and increasing muscle proportion of the bladder wall. Western blot analysis showed higher smooth muscle actin (SMA) expression of bladder wall in DM Li-ESWT compared to DMC group. Immunofluorescence showed decreased nerve-ending distribution, and destroyed and shortened nerve fibers in DMC group and recovery of neuronal integrity and innervation in DM Li-ESWT group. Conclusions In conclusion, Li-ESWT ameliorated underactive bladder and urinary incontinence in the diabetic UAB rat model. The improvement seems to be the results of restoration of bladder and urethra structure and function by Li-ESWT. Li-ESWT is non-invasive and may become a better alternative therapy for UAB. Further investigations are warranted.

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Low-energy shock wave therapy ameliorates erectile dysfunction in a pelvic neurovascular injuries rat model

Cited by 15 publications

References 26 publications

Extracorporeal shock wave therapy combined with engineered mesenchymal stem cells expressing stromal cell-derived factor-1 can improve erectile dysfunction in streptozotocin-induced diabetic rats

Extracorporeal shock wave therapy combined with engineered mesenchymal stem cells expressing stromal cell-derived factor-1 can improve erectile dysfunction in streptozotocin-induced diabetic rats

Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction—12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study

Low‐intensity extracorporeal shockwave therapy ameliorates diabetic underactive bladder in streptozotocin‐induced diabetic rats

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