Lei Hongen, Liu Jing, Li Huixi, Wang Lin, Xu Yongde, Tian Wenjie, Lin Guiting, Xin Zhongcheng
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Department of Urology, China-Japan Union Hospital of Jilin University, Jilin, China.
World J Mens Health. 2013 Dec;31(3):208-14. doi: 10.5534/wjmh.2013.31.3.208. Epub 2013 Dec 24.
Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.
尽管5型磷酸二酯酶抑制剂（PDE5Is）是勃起功能障碍（ED）治疗领域的一项革命性成果，自1998年上市以来，但它们无法恢复阴茎的病理变化。低能量冲击波疗法（LESWT）已被开发用于治疗ED，临床研究表明，LESWT有可能影响对PDE5I无反应的ED患者，且不良反应较少。动物研究表明，LESWT可显著改善阴茎血流动力学，并恢复糖尿病性ED动物模型阴茎的病理变化。尽管其机制仍有待研究，但最近的研究报告称，LESWT可部分恢复海绵体纤维肌肉病理变化、内皮功能障碍和周围神经病变。在不久的将来，LESWT可能成为治疗ED的一种新方法，尤其是对患有器质性ED的PDE5I无反应者。然而，还需要进一步广泛的循证基础和临床研究。本综述旨在总结LESWT对ED疗效的科学背景。
