The efficacy of low-intensity shock wave therapy based on the stratification of erectile dysfunction patients

Abstract Background Low-intensity extracorporeal shockwave therapy (LI-ESWT) has a considerable positive influence on erectile function (EF) among individuals diagnosed with vasculogenic erectile dysfunction (ED). Purpose Our objective was to study the impact of LI-ESWT on several subcategories of ED and to determine the duration of the enhancement in EF by a comprehensive long-term follow-up. Method This was a retrospective study. Individuals diagnosed with vasculogenic ED received 6–12 sessions of LI-ESWT with 5000 impulses at a dosage of 0.01 j/mm 2 . The therapy was administered employing the electromagnetic Dornier Aries® 1 machine. Each patient underwent no less than six sessions of LI-ESWT. Subsequently, the participants had clinical assessment utilizing the International Index of Erectile Function (IIEF-EF) and the Erection Hardness Scores (EHS) domain score at 3 months following LI-ESWT, followed by assessments every 6 months. In addition, the penile blood flow dynamics were assessed 3 months after LI-ESWT and throughout the final follow-up examination. Results Forty-two individuals had been included, with a mean age of 50 ± 12 years. The median duration of ED was 31 (15–49) months, and the median follow-up duration was 24 months and IQR of 27 months. The initial IIEF-EF score had been 16 ± 6 and increased to 22 ± 6 after 3-month period, and then decreased to 21 ± 6 at the final follow-up ( p < 0.01). A minimal clinically important difference (MCID) variation was observed in 69% of participants at 3 months and in 60% of the entire study population at the final follow-up. The factors of risk that were shown to be related with a greater likelihood of MCID at 3 months had been age ( p = 0.01), uncontrolled diabetes mellitus (DM) ratio ( p = 0.04), hypertension ( p = 0.24), cardiovascular disease ( p = 0.8), smoking ( p = 0.63), and ex smoking ( p = 0.3). Conclusion LI-ESWT shows promising long-term effectiveness in treating various degrees of ED, as demonstrated by the enhancement in penile blood flow observed during the final follow-up. This effect is particularly notable in individuals with well-managed DM and older age.