Terapia de ondas de choque lineales en el tratamiento de la disfunción eréctil

Pelayo-Nieto, M.; Linden-Castro, E.; Alías-Melgar, Alejandro; Grovas, D. Espinosa-Pérez; Rosa, F. Carreño-de la; Bertrand-Noriega, F.; Cortez-Betancourt, R.

doi:10.1016/j.acuro.2014.09.010

Cited by 24 publications

(10 citation statements)

References 9 publications

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“…Finally, 15 original articles ( 9 - 11 , 17 - 28 ) were included in the systematic review after full-text evaluation. Table-1 shows the characteristics of the eligible studies with 6 RCTs ( 10 , 17 , 18 , 21 , 25 , 28 ) and 9 prospective, single-arm trials ( 9 , 11 , 19 , 20 , 22 - 24 , 26 , 27 ). There was a study ( 27 ) about ED secondary to nerve-sparing prostatectomy, while the other studies focused on organic ED that was mainly considered to be vasculogenic.…”

Section: Resultsmentioning

confidence: 99%

Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis

et al. 2017

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Aim:The role of low-intensity extracorporeal shock wave therapy (LI-ESWT) in erectile dysfunction (ED) is not clearly determined. The purpose of this study is to investigate the short-term efficacy and safety of LI-ESWT for ED patients.Materials and Methods:Relevant studies were searched in Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WANFANG and VIP databases. Effective rate in terms of International Index of Erectile Function-Erectile Function Domain (IIEF-EF) and Erectile Hardness Score (EHS) at about 1XSmonth after LI-ESWT was extracted from eligible studies for meta-analysis to calculate risk ratio (RR) of effective treatment in ED patients treated by LI-ESWT compared to those receiving sham-treatment.Results:Overall fifteen studies were included in the review, of which four randomized controlled trials (RCTs) were for meta-analysis. Effective treatment was 8.31 [95°/o confidence interval (CI): 3.88-17.78] times more effective in the LI-ESWT group (n=176) than in the sham-treatment group (n= 101) at about 1 month after the intervention in terms of EHS, while it was 2.50 (95% CI: 0.74–8.45) times more in the treatment group (n= 121) than in the control group (n=89) in terms of IIEF-EF. Nine-week protocol with energy density of 0.09mJ/mm2 and 1500 pluses seemed to have better therapeutic effect than five-week protocol. No significant adverse event was reported.Conclusion:LI-ESWT, as a noninvasive treatment, has potential short-term therapeutic effect on patients with organic ED irrespective of sensitivity to PDE5is. Owing to the limited number and quality of the studies, more large-scale, well-designed and longterm follow-up time studies are needed to confirm our analysis.

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Section: Resultsmentioning

confidence: 99%

Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis

et al. 2017

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“…The literature generally confirms that LI-ESWT is safe and cohort studies investigating the clinical effects have generally been encouraging 2, 3, 9, 10, 11. In contrast, randomized trials have been less convincing.…”

Section: Discussionmentioning

confidence: 90%

Low-Intensity Extracorporeal Shockwave Therapy in Sexual Medicine: A Questionnaire-Based Assessment of Knowledge, Clinical Practice Patterns, and Attitudes in Sexual Medicine Practitioners

2017

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IntroductionLow-intensity extracorporeal shockwave therapy (LI-ESWT) has emerged as a treatment option for male sexual dysfunction. However, results have been contradictory.AimTo investigate the knowledge, practice patterns, and attitudes regarding LI-ESWT among experts in sexual medicine.MethodsA study-specific questionnaire was handed out at the 18th Congress for the European Society for Sexual Medicine. Participants were queried on their knowledge about LI-ESWT and about their use of the equipment.Main Outcome MeasuresDescriptive data on the knowledge of LI-ESWT and perception of treatment effects.ResultsOne hundred ninety-two questionnaires were available for analysis. Most respondents were physicians (79.7%) and most of these specialized in urology (58.9%). Overall, 144 of 192 (75%) reported that they were familiar with LI-ESWT in sexual medicine. Twenty-seven (14.1%) had performed the treatment. Of the 117 non-users who were familiar with LI-ESWT, 37 sometimes referred patients for the treatment. Nevertheless, 103 of 144 (71.5%) stated that they considered LI-ESWT an effective treatment for erectile dysfunction (ED) and 10 of 144 (6.9%) considered it an effective treatment for Peyronie disease. Of participants who regarded LI-ESWT an effective ED treatment, 91.2% would consider the treatment specifically for vasculogenic ED and 81.6% would combine it with phosphodiesterase type 5 inhibitors. Most participants (83.7%) regarded LI-ESWT as safe. A urology background (odds ratio = 2.4; 95% CI = 1.3–4.8; P = .0093) and working in a private setting (odds ratio = 2.8; 95% CI = 1.5–5.3; P = .0084) were significant predictors of familiarity with LI-ESWT in sexual medicine and of being an LI-ESWT user. Likewise, urologists were significantly more likely than non-urologists to consider the treatment effective (odds ratio = 2.8; 95% CI = 1.1–7.1; P = .033).ConclusionLI-ESWT is well known among experts in sexual medicine and the treatment is perceived as safe and effective against vasculogenic ED when combined with phosphodiesterase type 5 inhibitors. The treatment is mainly offered by urologists.Fode M, Lowenstein L, Reisman Y. Low-Intensity Extracorporeal Shockwave Therapy in Sexual Medicine: A Questionnaire-Based Assessment of Knowledge, Clinical Practice Patterns, and Attitudes in Sexual Medicine Practitioners. Sex Med 2017;5:e94–e98.

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“…In a comparison of patients with at least one vascular co-morbidity (cardiovascular disease, hypertension, high cholesterol), to those with none, Reisman et al identified lower success rates in those with co-morbidities (76.2% vs 93.7%, respectively) [ 20 ]. Smoking status was seen to negatively impact the success of LISWT in one study, with patients possessing a smoking index of less than 20 having a statistically significant chance of improving erectile function (91% vs. 50%) [ 19 ]. Finally, the presence of diabetes demonstrated mixed results.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, the presence of diabetes demonstrated mixed results. Whilst one study demonstrated success rates which were 25% lower in diabetic patients, with shorter duration of treatment effects [ 20 ], Pelayo-Nieto et al contrastingly identified that diabetic patients demonstrated an improved clinical response to LISWT (62% vs 47%) [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the long-term efficacy of low-intensity shockwave therapy for vasculogenic erectile dysfunction

et al. 2019

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Purpose To look at the evidence base for LISWT as a treatment modality for vasculogenic erectile dysfunction, focusing on the long-term outcomes at over 6 months following treatment. Methods A systematic literature search was conducted utilising MEDLINE and Scopus databases from 2010 to September 2018 by two independent reviewers. Outcome measures extracted for long-term efficacy included International Index of Erectile Function scores and Erection Hardness Scores. Subgroup analysis for LISWT effectiveness included age, PDE5i responsiveness, presence of vascular co-morbidities and smoking status. Results The search identified eleven studies, representing a total of 799 patients. Nine studies found a significant improvement in erectile function after LISWT at 6-month follow-up (median IIEF-EF improvement in 5.3 at 6 months). However, of five studies assessing erectile function at 12 months; two identified a plateauing of results, with three a deterioration (IIEF-EF score changes of − 2 to 0.1 from 6 months). Erectile function did, however, remain above baseline results in all of these studies. Subgroup analysis revealed increasing age to reduce the response to LISWT treatment. Whilst ED severity, PDE5i responsiveness and co-morbidities potentially influence effectiveness, results are still inconsistent. Conclusions LISWT may be a safe and acceptable potential ED treatment with demonstrated benefits at 6 months. There is some question regarding efficacy deterioration beyond this, but there is still a demonstrated benefit seen even at 12 months post treatment. However, quality of evidence remains low with larger multiinstitutional studies required, standardising confounders such as shockwave administration and oral medication use. Electronic supplementary material The online version of this article (10.1007/s11255-019-02127-z) contains supplementary material, which is available to authorized users.

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Terapia de ondas de choque lineales en el tratamiento de la disfunción eréctil

Cited by 24 publications

References 9 publications

Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis

Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis

Low-Intensity Extracorporeal Shockwave Therapy in Sexual Medicine: A Questionnaire-Based Assessment of Knowledge, Clinical Practice Patterns, and Attitudes in Sexual Medicine Practitioners

A systematic review of the long-term efficacy of low-intensity shockwave therapy for vasculogenic erectile dysfunction

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