Journal Article Ahead of print
PubMed: 41714896 DOI: 10.5534/wjmh.250266
Effects of Low-Intensity Shock Wave Therapy on Erectile Function and Penile Vascular Parameters in Men with Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.
World J Mens Health
Authors: Selahittin Cayan, Germar Michael Pinggera, Hiva Alipour, Rupin Shah, Bahadır Şahin, Baris Altay, Taymour Mostafa, Fotios Dimitriadis, Fereshteh Dardmeh, Naveen Kumar, Diana Carolina Angel Alarcon, Noor Fathalla, Nadia Sheibak, Sk Mizanur Rahman, Adel Gouri, Jose Moreno-Sepulveda, Salima Daoud, Christina Anagnostopoulou, Aleksei Ryzhkov, Tuncay Toprak, Mohamed Arafa, Erman Ceyhan, Ayman Rashed, Ayad Palani, Edoardo Pescatori, Manaf Al Hashimi, Kareim Khalafalla, Rossella Cannarella, Marco Falcone, Eric Chung, Ashok Agarwal
Affiliations
- Department of Urology, University of Mersin School of Medicine, Mersin, Türkiye.
- Global Andrology Forum, Global Andrology Foundation, Moreland Hills, OH, USA.
- Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.
- Department of Urology, Marmara University School of Medicine, İstanbul, Türkiye.
- Department of Urology, Ege University, Izmir, Türkiye.
- Department of Andrology, Sexology and STIs, Cairo University, Cairo, Egypt.
- Department of Urology, Aristotle University, Thessaloniki, Greece.
- Department of Urology, All India Institute of Medical Sciences, Patna, India.
- Department of Research and Development, Medinova, Reggio Emilia, Italy.
- Department of Anatomical Sciences, Zahedan University of Medical Sciences, Zahedan, Iran.
- Deparment of Embryology, BACC Women's and Children Hospital Pvt. Ltd. Dhaka, Bangladesh.
- Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Dhaka, Bangladesh.
- Department of Pharmacy, Faculty of Medicine, University of Badji Mokhtar, Annaba, Algeria.
- Department of Medical Biochemistry, Ibn Rochd University Hospital, Annaba, Algeria.
- Reproductive Medicine Unit, Clinica de la Mujer, Vina del Mar, Chile.
- Department of Gynecology, Universitat Autonoma de Barcelona, Barcelona, Chile.
- Department of Reproductive Biology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
- Unit of Reproductive Medicine, Embryo ART, Leto Maternity Hospital, Athens, Greece.
- Department of Urology and Nephrology, Yaroslavl State Medical University, Yaroslavl, Russia.
- Department of Urology, FSM Health Practice and Research Center, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul, Türkiye.
- Department of Urology, Hamad Medical Corporation, Doha, Qatar.
- Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar.
- Department of Urology, Baskent University Faculty of Medicine, Ankara, Türkiye.
- Department of Urology and Andrology, October 6 University, Giza, Egypt.
- Department of Basic Sciences, College of Medicine, University of Garmian, Kalar, Iraq.
- Department of Clinical Biochemistry, Zanko Clinical Laboratory, Kalar, Iraq.
- Andrology and Reproductive Medicine Unit, Next Fertility GynePro, Bologna, Italy.
- Department of Urology, Burjeel Hospital, Abu Dhabi, UAE.
- Department of Urology, College of Medicine, Qatar University, Doha, Qatar.
- Departiment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
- Department of Urology, University of Torino, Torino, Italy.
- Department of Urology, Biruni University, Istanbul, Türkiye.
- Department of Urology, University of Queensland/Princess Alexandra Hospital, Brisbane, Australia.
- Department of AndroUrology, AndroUrology Centre, Brisbane, Australia.
- Cleveland Clinic Foundation, Cleveland, OH, USA.
Abstract
PURPOSE
This systematic review and meta-analysis of randomized controlled trials evaluated the effects of low-intensity shock wave therapy (LiSWT) on erectile function (EF) and penile vascular parameters in men with erectile dysfunction (ED), compared with controls receiving sham or no treatment.
MATERIALS AND METHODS
A systematic search of Scopus, PubMed, and Cochrane databases identified studies assessing LiSWT in men with ED. Primary outcomes were changes in the International Index of Erectile Function (IIEF)-5 and the IIEF-EF domain scores. Secondary outcomes included erection hardness score (EHS), sexual encounter profile (SEP) diary Q2 and Q3, global assessment question (GAQ) scores, and penile Doppler ultrasound parameters-peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI). Changes from baseline to the end of follow-up were compared between LiSWT and control groups.
RESULTS
Of 527 retrieved articles, 12 met inclusion criteria. Pooled analysis demonstrated significantly greater improvements in the LiSWT group for IIEF-5 (standardized mean difference [SMD], 1.19; 95% confidence interval [CI], 0.47-1.91; p=0.001) and IIEF-EF (SMD, 1.24; 95% CI, 1.02-1.45; p<0.001) scores compared with controls. No significant differences were found for EHS (p=0.698), SEP-Q2 (p=0.934), SEP-Q3 (p=0.985), GAQ (p=0.993), and penile Doppler ultrasound parameters, including PSV (p=0.855), EDV (p=0.995), or RI (p=0.818).
CONCLUSIONS
LiSWT provides modest improvements in IIEF scores but fails to produce significant changes in other functional or vascular parameters. These findings suggest that while LiSWT may offer some benefit, the clinical relevance is limited for most patients. Current evidence does not support its routine inclusion in ED treatment algorithms. Future research should focus on identifying patient subgroups most likely to experience significant and sustained improvements from this therapy.
MeSH
Erectile Dysfunction, Extracorporeal Shockwave Therapy, Therapeutics