Effects of Low-intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-analysis.

This present systemic review and meta-analysis was conducted to assess the effectiveness of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) based on the relevant randomised controlled trials (RCTs). A comprehensive search of databases, including Medline and Embase databases, from 1st January 2012 to 31st July 2020, that investigated the efficacy of Li-ESWT for ED, was searched. All the trials were divided into two groups: the experimental group received a different shockwave treatment, and the control group received the same treatment as the corresponding experimental group vibration, sound, etc) but no energy transmission. The primary endpoint was the International Index of Erectile Function-Erectile Function domain (IIEF-EF) score/questionnaire or erectile hardness score (EHS). The average IIEF-EF score was increased with statistical significance in the Li-ESWT group relative to the control group (p<0.001). Besides, the Li-ESWT group had evidently elevated changes in IIEF-EF score (p<0.001). Altogether seven articles reported the remarkably elevated EHS score with different total pulses (p<0.001). The favourable outcomes in terms of the average IIEF scores were observed in the cases developing mild or moderate ED (p<0.001). Compared with placebo treatment, Li-ESWT alleviates ED symptoms in patients, particularly those who have mild or moderate ED. Taken together, these results suggest that the Li-ESWT may hold promise for patients with ED. Key Words: Erectile dysfunction, Low-intensity extracorporeal shockwave therapy, Meta-analysis, Randomised controlled trials.