First Department of Urology, G. Gennimatas Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Institute for the Study of Urological Diseases, Thessaloniki, Greece.
J Urol. 2022 Aug;208(2):388-395. doi: 10.1097/JU.0000000000002684. Epub 2022 May 6.
We conducted the first double-blind, randomized, sham-controlled trial evaluating the efficacy and safety of low-intensity shock wave therapy (LiST) exclusively in patients with moderate erectile dysfunction.
Seventy patients were randomized to 12 sessions of LiST (35) or sham therapy (35) twice weekly. Patients were evaluated at 1 and 3 months after completion of treatment. The proportion of participants attaining minimal clinically important difference (MCID) in the International Index of Erectile Function-Erectile Function (IIEF-EF) and the effect of LiST on erectile function, as well as on safety, were the study outcomes.
At 3 months, MCID was attained by 27 (79%) patients in the LiST group compared to 0 patients in the sham group. The risk difference between the 2 groups was 79% (95% confidence interval [CI]: 66-93, p <0.001) and the baseline-adjusted mean between-group-difference in the IIEF-EF was 4.4 points (95% CI: 3.4-5.4, p <0.001). At 1 month, MCID was attained by 20 (59%) patients in the LiST group compared to 1 (2.9%) patient in the sham group. The risk difference between the 2 groups was 56% (95% CI: 38-73, p <0.001) and the baseline-adjusted mean between-group-difference in the IIEF-EF was 3.9 points (95% CI: 2.7-5.2, p <0.001).
Twelve sessions of LiST twice weekly for 6 weeks with a treatment protocol of 5,000 impulses, 0.096 mJ/mm energy flux density and 5 Hz frequency are highly effective in patients with moderate erectile dysfunction. Still, further long-term randomized studies are warranted to corroborate our findings.
我们进行了首次双盲、随机、假对照试验,专门评估低强度冲击波治疗(LiST)在中度勃起功能障碍患者中的疗效和安全性。
70 名患者被随机分为 LiST 组(35 名)和假治疗组(35 名),每组接受 12 次治疗,每周 2 次。治疗结束后 1 个月和 3 个月对患者进行评估。研究结果为国际勃起功能指数-勃起功能(IIEF-EF)中最小临床重要差异(MCID)的参与者比例,以及 LiST 对勃起功能的影响,以及安全性。
3 个月时,LiST 组 27 名(79%)患者达到 MCID,而假治疗组 0 名患者达到 MCID。两组之间的风险差异为 79%(95%可信区间[CI]:66-93,p<0.001),IIEF-EF 的组间平均差异为 4.4 分(95%CI:3.4-5.4,p<0.001)。1 个月时,LiST 组 20 名(59%)患者达到 MCID,而假治疗组 1 名(2.9%)患者达到 MCID。两组之间的风险差异为 56%(95%可信区间[CI]:38-73,p<0.001),IIEF-EF 的组间平均差异为 3.9 分(95%CI:2.7-5.2,p<0.001)。
每周两次,共 12 次,每次 5000 次脉冲,能量通量密度 0.096 mJ/mm,频率 5 Hz 的 LiST 治疗方案对中度勃起功能障碍患者非常有效。然而,仍需要进一步的长期随机研究来证实我们的发现。