Department of Urology, University of Cagliari, Santissima Trinità Hospital, Cagliari, Italy.
Department of Urology, University of Florence, Careggi Hospital, Florence, Italy.
Investig Clin Urol. 2023 Mar;64(2):118-125. doi: 10.4111/icu.20220327.
To review the evidence of clinical efficacy of low-intensity extracorporeal shock wave therapy (Li-ESWT) for the treatment of erectile dysfunction (ED). A search on PubMed using Medical Subject Headings terms [((low intensity extracorporeal shockwave therapy) OR (Li-ESWT)) AND (erectile dysfunction)] was conducted in August 2022, to obtain studies on the use of Li-ESWT for the treatment of ED. Its success rate in terms of International Index of Erectile Function-5 (IIEF-5) score and Erection Hardness Score (EHS) improvement was recorded and analysed. A total of 139 articles were reviewed. Overall, 52 studies were included in the final review. 17 studies were on vasculogenic ED, 5 on post pelvic surgery ED, 4 specifically on ED in diabetic patients, 24 on non-specified origin ED and 2 on mixed pathophysiological origin ED. The mean age of patients was 55.87±7.91 (standard deviation) years and the duration of ED was 4.36±2.08 years. The mean IIEF-5 score went from 12.04±2.67 at baseline to 16.12±5.72, 16.30±3.26 and 16.85±1.63 respectively at 3, 6 and 12 months. The mean EHS went from 2.00±0.46 at baseline to 2.58±0.60, 2.75±0.46 and 2.87±0.16 respectively at 3, 6 and 12 months. Li-ESWT may be a safe and efficacy option for the treatment and cure of ED. Further studies are needed to assess which patients are more suitable for this procedure and which Li-ESWT protocol can lead to the best outcomes.
回顾低强度体外冲击波治疗（Li-ESWT）治疗勃起功能障碍（ED）的临床疗效证据。2022 年 8 月，使用医学主题词（[（低强度体外冲击波治疗）或（Li-ESWT）]）在 PubMed 上进行了搜索，以获取关于 Li-ESWT 治疗 ED 的研究。记录并分析了其在国际勃起功能指数-5（IIEF-5）评分和勃起硬度评分（EHS）改善方面的成功率。共审查了 139 篇文章。总的来说，最终综述共纳入 52 项研究。17 项研究为血管性 ED，5 项为骨盆手术后 ED，4 项为糖尿病患者 ED，24 项为非特定病因 ED，2 项为混合病理生理病因 ED。患者的平均年龄为 55.87±7.91 岁（标准差），ED 持续时间为 4.36±2.08 年。平均 IIEF-5 评分从基线时的 12.04±2.67 分别提高到 3、6 和 12 个月时的 16.12±5.72、16.30±3.26 和 16.85±1.63。平均 EHS 从基线时的 2.00±0.46 分别提高到 3、6 和 12 个月时的 2.58±0.60、2.75±0.46 和 2.87±0.16。Li-ESWT 可能是治疗和治愈 ED 的一种安全有效的选择。需要进一步的研究来评估哪些患者更适合这种治疗方法，以及哪种 Li-ESWT 方案可以带来最佳效果。
