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Urology. 2018 Sep;119:97-103. doi: 10.1016/j.urology.2017.09.011. Epub 2017 Sep 27.

Low-intensity Extracorporeal Shock Wave Therapy for Erectile Dysfunction: A Systematic Review and Meta-analysis.

Author information

1
Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
2
Department of Urology, Beijing Jishuitan Hospital, Beijing, China. Electronic address: lee_gz99@soh.com.

Abstract

OBJECTIVE:

To assess the efficacy of low-energy extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED), a systematic review and meta-analysis was undertaken.

METHODS:

A comprehensive search of the PubMed, Cochrane Register, and Embase databases to March 2017 was performed for randomized controlled trials reporting on patients with ED treated with LI-ESWT. The International Index of Erectile Function (IIEF) and the Erection Hardness Score (EHS) were the most commonly used tools to evaluate the therapeutic efficacy of LI-ESWT.

RESULTS:

There were 9 studies including 637 patients from 2005 to 2017. The meta-analysis revealed that LI-ESWT could significantly improve IIEF (mean difference [MD]: 2.54; 95% confidence interval [CI], 0.83-4.25; P = .004) and EHS (risk difference [RD]: 0.16; 95% CI, 0.03-0.28; P = .01). Therapeutic efficacy could last at least 3 months (MD: 4.15; 95% CI, 1.40-6.90; P = .003). Lower energy density (0.09 mJ/mm2, MD: 4.14; 95% CI, 0.87-7.42; P = .01) increased the number of pulses (3000 pulses per treatment, MD: 5.11; 95% CI, 3.18-7.05, P < .0001) and shorter total treatment courses (<6 weeks, MD: 3.73; 95% CI, 0.54-6.93; P = .02) resulted in better therapeutic efficacy.

CONCLUSION:

These studies suggest that LI-ESWT could significantly improve the IIEF and EHS of patients with ED. The publication of robust evidence from additional randomized controlled trials and longer-term follow-up would provide more confidence regarding the use of LI-ESWT for patients with ED.

PMID:
28962876
DOI:
10.1016/j.urology.2017.09.011
[Indexed for MEDLINE]

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