Low-intensity shockwave therapy in the management of erectile dysfunction in Singapore

Lau, W. Y.; Shum, Cheuk Fan; Lua, Hui Chung Alex; Teo, Chang Peng Colin

doi:10.47102/annals-acadmedsg.202151

Cited by 4 publications

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, clinical practice has gradually attempted to employ exogenous mechanical stimulation and microenergy to treat ED 9–11 . Low‐intensity pulsed ultrasound (LIPUS) has an extremely small thermal effect and is frequently employed in rehabilitation medicine 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Recently, clinical practice has gradually attempted to employ exogenous mechanical stimulation and microenergy to treat ED. 9 , 10 , 11 Low‐intensity pulsed ultrasound (LIPUS) has an extremely small thermal effect and is frequently employed in rehabilitation medicine. 12 In a multicenter clinical study, Cui et al demonstrated that LIPUS could safely and effectively treat patients with mild to moderate ED.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

LIPUS‐SCs‐Exo promotes peripheral nerve regeneration in cavernous nerve crush injury‐induced ED rats via PI3K/Akt/FoxO signaling pathway

Yin

et al. 2023

CNS Neurosci Ther

View full text Add to dashboard Cite

ObjectiveClinical treatment of erectile dysfunction (ED) caused by cavernous nerve (CN) injury during pelvic surgery is difficult. Low‐intensity pulsed ultrasound (LIPUS) can be a potential strategy for neurogenic ED (NED). However, whether Schwann cells (SCs) can respond to LIPUS stimulation signals is unclear. This study aims to elucidate the signal transmission between SCs paracrine exosome (Exo) and neurons stimulated by LIPUS, as well as to analyze the role and potential mechanisms of exosomes in CN repair after injury.MethodsThe major pelvic ganglion (MPG) neurons and MPG/CN explants were stimulated with LIPUS of different energy intensities to explore the appropriate LIPUS energy intensity. The exosomes were isolated and purified from LIPUS‐stimulated SCs (LIPUS‐SCs‐Exo) and non‐stimulated SCs (SCs‐Exo). The effects of LIPUS‐SCs‐Exo on neurite outgrowth, erectile function, and cavernous penis histology were identified in bilateral cavernous nerve crush injury (BCNI)‐induced ED rats.ResultsLIPUS‐SCs‐Exo group can enhance the axon elongation of MPG/CN and MPG neurons compared to SCs‐Exo group in vitro. Then, the LIPUS‐SCs‐Exo group showed a stronger ability to promote the injured CN regeneration and SCs proliferation compared to the SCs‐Exo group in vivo. Furthermore, the LIPUS‐SCs‐Exo group increased the Max intracavernous pressure (ICP)/mean arterial pressure (MAP), lumen to parenchyma and smooth muscle to collagen ratios compared to the SCs‐Exo group in vivo. Additionally, high‐throughput sequencing combined with bioinformatics analysis revealed the differential expression of 1689 miRNAs between the SCs‐Exo group and the LIPUS‐SCs‐Exo group. After LIPUS‐SCs‐Exo treatment, the phosphorylated levels of Phosphatidylinositol 3‐kinase (PI3K), protein kinase B (Akt) and forkhead box O (FoxO) in MPG neurons increased significantly compared to negative control (NC) and SCs‐Exo groups.ConclusionOur study revealed that LIPUS stimulation could regulate the gene of MPG neurons by changing miRNAs derived from SCs‐Exo, then activating the PI3K‐Akt‐FoxO signal pathway to enhance nerve regeneration and restore erectile function. This study had important theoretical and practical significance for improving the NED treatment.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

LIPUS‐SCs‐Exo promotes peripheral nerve regeneration in cavernous nerve crush injury‐induced ED rats via PI3K/Akt/FoxO signaling pathway

Yin

et al. 2023

CNS Neurosci Ther

View full text Add to dashboard Cite

show abstract

Conservative Non-surgical Options for Erectile Dysfunction

et al. 2022

View full text Add to dashboard Cite

Extracorporeal shock wave therapy for erectile dysfunction: rethinking study design, implementation, and analysis

Desai,

Huyghe,

Maffulli

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction: Extracorporeal shock wave therapy (ESWT) for erectile dysfunction (ED) presents a challenging paradox. While numerous clinical studies, systematic reviews, and meta-analyses have been published, indicating a substantial body of evidence supporting the efficacy and safety of ESWT, significant questions remain. Notably, the American Urological Association (AUA) continues to classify ESWT for ED as investigational (Evidence Level: Grade C), suggesting that the true therapeutic effect of ESWT may differ considerably from current estimates. This review aims to critically assess the evidence and propose strategies to address this unresolved discrepancy. Data sources: We systematically searched two electronic databases (PubMed and Ovid/Embase) and published systematic reviews on ESWT for ED and compiled a systematic literature review and meta-analysis based on 87 relevant studies. Areas of agreement: There is clear evidence that ESWT for ED is effective and can therefore be a valuable treatment modality in the management of ED. Areas of controversy: Current assessments of ESWT for ED as investigational by, e.g., the AUA may not stem from a lack of clinical studies, insufficient related basic science, or an inadequate number of systematic reviews and meta-analyses. Instead, the deficits lie in the area of the scientific quality of the clinical studies published to date. Growing points: We hypothesize that this unfortunate situation will only change if the following aspects will be rigorously considered in future clinical studies on ESWT for ED: adequate characterization and reporting of extracorporeal shock waves, appropriate handling of missing data and intercurrent events, and comprehensive classification of ESWT in the overall context of the available treatment options for ED. Areas for developing research: We are convinced that the consistent implementation of these aspects will significantly contribute to establishing ESWT as the first truly regenerative therapy in the management of ED. This overall aim justifies the corresponding efforts, for the benefit of our patients.

show abstract

Low-intensity shockwave therapy in the management of erectile dysfunction in Singapore

Cited by 4 publications

References 6 publications

LIPUS‐SCs‐Exo promotes peripheral nerve regeneration in cavernous nerve crush injury‐induced ED rats via PI3K/Akt/FoxO signaling pathway

LIPUS‐SCs‐Exo promotes peripheral nerve regeneration in cavernous nerve crush injury‐induced ED rats via PI3K/Akt/FoxO signaling pathway

Conservative Non-surgical Options for Erectile Dysfunction

Extracorporeal shock wave therapy for erectile dysfunction: rethinking study design, implementation, and analysis

Contact Info

Product

Resources

About