PARIS—Low-intensity extracorporeal shockwave therapy (LI-ESWT) is an effective treatment option for men with vasculogenic erectile dysfunction (ED), according to findings presented at the 27th Annual Congress of the European Association of Urology.

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In a double-blind, placebo-controlled study, Yoram Vardi, MD, and collaborators at Rambam Medical Center in Haifa, Israel, showed that the treatment significantly improved various measures of erectile function, including penile hardness, hemodynamics, and endothelial function.

LI-ESWT is the first therapy shown to reverse the pathology in the penis of men with vasculogenic ED, Dr. Vardi said. “It is really a breakthrough in the sense that it is the first treatment that can probably cure or at least improve the erectile mechanism.”

Dr. Vardi and his team studied 60 men who were randomly assigned to receive LI-ESWT or sham treatment. LI-ESWT was applied to the penile shaft and crura at five different sites. The researchers assessed erectile function prior to the first treatment and at one month after the final treatment session using the International Index of Erectile Function (IIEF) and the Erection Hardness Scale (EHS). They also assessed penile hemodynamics and endothelial function using the flow mediated dilatation technique (FMD). The main outcome measure of treatment success was a change in IIEF-ED Domain score of more than five points.

The LI-ESWT group showed a greater increase in total IIEF and IIEF-ED score compared with the sham group and significantly greater improvement in FMD. Combining the objective and subjective parameters, the researchers found that 22 patients in the LI-ESWT group (56%) showed significant improvement in both IIEF and FMD compared with only one (5%) in the sham group. In addition, 13 patients in the LI-ESWT group had an EHS of 3 or greater before treatment compared with 31 after treatment. In the sham group, there was no significant difference in the number of patients with an EHS of 3 or greater (eight before sham treatment, seven after).

The LI-ESWT group experienced a significantly greater increase in the IIEF Total Satisfaction category than the sham group.