(PM-29) Efficacy of low-intensity shock waves in patients with erectile dysfunction after robot-assisted radical prostatectomy

Abstract Introduction Erectile Dysfunction (ED) is a frequent complication after radical prostatectomy, even when performed by robotic approach. Injury to neurovascular bands during the procedure can compromise the recovery of erectile function, even with nerve sparing procedures. Low-Intensity Shockwave (LiSWT) has emergerd as a potencial therapeutic alternative in this context. Objective To evaluate the efficacy of LiSWT in patients with severe ED following robot-assisted radical prostatectomy (RARP), who were previously potent. Material In this retropective observational study, 32 patients who underwent RAPR between 2022 and 2025 were evaluated. All patients were previousy potents and developed severe ED postoperatively. It was define by an IIEE-5 score < 11. All had used Tadalafil 10 mg daily for at least 3 months after surgery. All patients underwent a LiWST session for 6 weeks. Treatment parameters included: 3000 radial pulses per session, frequency of 120/min, energy of 0.09 mj/mm2. Tadalafil 10 mg daily was maintained throughout the treatment period of 6 months. Results After LiSWT, 21 out of 32 patients (65%) showed an improvement of at least 5 points in IIEF-5 score, after 6 months. All of these patients reported achieving erections sufficient for penetration, in more than half of the attempts, without manual assistance. The remaining 11 patients (35%) did not respond to the treatment. No adverse effects were reported. Conclusion LiSWT proved to be effective in a significant proportion of patients with severe ED after RARP, who were unresponsive to oral Tadalafil. LiSWT may represent a safe and promising alternative for this subset of treatment refractory patients. Financing No conflict.