Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli,", Naples, Italy.
Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II,", Naples, Italy.
Andrology. 2022 Oct;10(7):1368-1375. doi: 10.1111/andr.13240. Epub 2022 Aug 17.
Extracorporeal shock wave therapy is an established treatment for erectile dysfunction and Peyronie's disease. Concerns regarding the safety of extracorporeal shock wave therapy for andrological purposes on testicular function were raised by animal studies.
To evaluate the impact of extracorporeal shock wave therapy for erectile dysfunction or Peyronie's disease on reproductive and hormonal testicular function.
We designed a prospective controlled study in which consecutive patients were enrolled. Males aged between 18 and 40 years with mild vasculogenic erectile dysfunction or acute inflammatory Peyronie's disease and normozoospermia were included. All enrolled patients were offered extracorporeal shock wave therapy, and subjects who refused extracorporeal shock wave therapy for any reason were considered as the Control group. All patients in the Intervention group were treated with DUOLITH SD1 T-TOP by a single expert urologist. Semen analysis and serum total testosterone dosage were performed before the start (T0) and 3 months after the end of extracorporeal shock wave therapy (T1) in Intervention group. The same parameters were evaluated after the extracorporeal shock wave therapy refusal (T0) and at the end of the following 3 months (T1) in Control group. Normozoospermia was chosen as the primary outcome, serum total testosterone concentration was selected as the secondary outcome.
A total of 94 patients were enrolled in the study (48 Group A, 46 Group B). At T0, all patients were normozoospermic in both groups (p = 0.563), and no significant difference in mean ± SD total testosterone levels was recorded between the groups (582.5 ± 107.2 vs. 634.6 ± 108.4 ng/dl; p = 0.221). At T1, no significant deterioration (p > 0.05) in semen parameters was recorded in both groups. Only a statistically significant reduction in seminal pH was found after extracorporeal shock wave therapy compared to baseline (7.9 ± 0.3 vs. 7.5 ± 0.2; p < 0.001) and untreated patients (7.8 ± 0.2 vs. 7.5 ± 0.2; p < 0.001). No significant difference in total testosterone levels was recorded in Intervention group after extracorporeal shock wave therapy compared to baseline (p = 0.584).
Extracorporeal shock wave therapy in erectile dysfunction and Peyronie's disease patients does not seem to affect reproductive and hormonal testicular function.
体外冲击波疗法是治疗勃起功能障碍和 Peyronie 病的一种既定方法。动物研究对男科领域体外冲击波疗法对睾丸功能的安全性提出了担忧。
评估体外冲击波疗法治疗勃起功能障碍或 Peyronie 病对生殖和激素睾丸功能的影响。
我们设计了一项前瞻性对照研究，连续纳入患者。纳入年龄在 18 至 40 岁之间、患有轻度血管性勃起功能障碍或急性炎症性 Peyronie 病且精子正常的男性。所有纳入的患者均接受体外冲击波治疗，因任何原因拒绝体外冲击波治疗的患者被视为对照组。干预组中的所有患者均由一位专家泌尿科医生使用 DUOLITH SD1 T-TOP 进行治疗。干预组在开始前（T0）和体外冲击波治疗结束后 3 个月（T1）进行精液分析和血清总睾酮检测。对照组在拒绝体外冲击波治疗后（T0）和接下来的 3 个月结束时（T1）评估相同参数。选择正常精子计数作为主要结局，选择血清总睾酮浓度作为次要结局。
本研究共纳入 94 例患者（A 组 48 例，B 组 46 例）。在 T0 时，两组患者的精子均正常（p=0.563），且两组间的平均总睾酮水平无显著差异（582.5±107.2 与 634.6±108.4ng/dl；p=0.221）。在 T1 时，两组患者的精液参数均无显著恶化（p>0.05）。与基线相比（7.9±0.3 与 7.5±0.2；p<0.001）和未经治疗的患者相比（7.8±0.2 与 7.5±0.2；p<0.001），仅发现体外冲击波治疗后精液 pH 值有统计学显著降低。与基线相比（p=0.584），体外冲击波治疗后干预组的总睾酮水平无显著变化。
体外冲击波疗法治疗勃起功能障碍和 Peyronie 病患者似乎不会影响生殖和激素睾丸功能。
