LYON, FRANCE—Israeli researchers have reported promising preliminary results using low-intensity shock wave therapy to treat vasculogenic erectile dysfunction (ED).
In fact, 15 of 20 patients with mild or moderate ED who have been treated thus far had a significant improvement in erectile function and in most cases were able to discontinue treatment with phosphodiesterase-5 (PDE-5) inhibitors. There were no reports of pain or other adverse effects.
Yoram Vardi, MD, chief of the neuro-urology unit at Rambam Medical Center in Haifa, presented the findings here at the annual meeting of the European Society for Sexual Medicine.
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Low-energy shock wave therapy is being increasingly used to induce regeneration of small coronary vessels in patients with angina who are not suitable for coronary surgery or angioplasty, Dr. Vardi explained.
His group had hypothesized that if the therapy can improve the vasculature of the heart, it might also be effective in the penis because 80% of ED cases are of vascular origin.
Participants in the trial had a score of 12 to 20 on the Erectile Function domain of the International Index of Erectile Function (IIEF-ED) and abnormal nocturnal penile tumescence (NPT). In all cases, ED had a vascular origin. The mean duration of ED was 35 months.
During each treatment session, low-energy shock wave therapy was applied on the penile shaft and crus for three minutes in each of five anatomical sites. The shock waves were are one-tenth the level of intensity as the shock waves used to pulverize kidney stones.
The men underwent a three-week course of two weekly treatment sessions and a second identical round of therapy starting three weeks later. Erectile function was assessed at the time of enrollment and four weeks after the end of treatment.
“The protocol used to enhance vasculogenesis of the ischemic heart is the same one we used to treat ED,” Dr. Vardi said.
Results showed that the IIEF-ED score improved by more than five points in 15 patients (75%). Seven of 20 patients (35%) had an improvement of more than 10 points.
Six-month follow-up data show that 12 of the 15 patients who improved significantly with treatment said they no longer needed to use PDE-5 inhibitors to treat their condition.
Scores on several other validated ED questionnaires including Quality of Erection Questionnaire, Self-Esteem and Relationship Questionnaire, and Erectile Dysfunction Inventory of Treatment Satisfaction also improved significantly.
The analysis additionally showed a significant improvement in baseline and maximal flow values on a penile endothelial function test.
“We are very excited by our findings but it’s important to emphasize that they are preliminary and that further evaluation is needed using sham control and long-term follow-up,” Dr. Vardi said. “And what has been especially gratifying is that patients have told us that they are very pleased with the results and they tell us that they are again having morning erections and that they can perform better.”
