madman
Super Moderator
Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials
Abstract
The efficacy of low intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED) has received hard criticism and recently published meta-analyses were not able to provide further insights, nor specific recommendations. The aim of this systematic review and meta-analysis is to evaluate the efficacy of LI-ESWT for ED, identify the ideal treatment population and treatment protocol, and provide recommendations for future research in the field. A systematic research for relevant clinical studies published from January 2010 to September 2018 was performed, using the following databases: Medline, Embase, The Cochrane Library, Scopus, and Web of Science. Only clinical studies that investigated the efficacy of LI-ESWT for ED only, and reported primary outcomes using IIEF-EF scores/questionnaires were included. Both, randomised controlled trials (RCTs) and cohort studies were included, but the meta-analysis was performed only for sham controlled RCTs. Ten RCTs including 873 patients were selected for the meta-analysis. Pooling data of these studies showed that LI-ESWT could significantly improve erectile function in men with ED regarding both patient-subjective outcomes (IIEF-EF: +3.97; 95% CI [2.09–5.84]; p<0.0001, EHS≥3: OR: 4.35; 95% CI [1.82–10.37]; p=0.0009) and patient objective outcomes (peak systolic velocity: +4.12; 95% CI [2.30–5.94]; p<0.00001). In conclusion, the present meta analysis provided results showing that LI-ESWT significantly improves erectile function in patients with vasculogenic ED.
In conclusion, the present meta-analysis showed that LIESWT significantly improves erectile function in patients with vasculogenic ED. Larger multicentric RCTs with longer than 1-year follow-up are needed, before considering this new treatment as the new standard for the treatment of ED. However, LI-ESWT could be offered to patients with vasculogenic ED (especially to PDE5i-responders) as an alternative first-line treatment, especially in younger patients searching for a non-pharmacological treatment.
Abstract
The efficacy of low intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED) has received hard criticism and recently published meta-analyses were not able to provide further insights, nor specific recommendations. The aim of this systematic review and meta-analysis is to evaluate the efficacy of LI-ESWT for ED, identify the ideal treatment population and treatment protocol, and provide recommendations for future research in the field. A systematic research for relevant clinical studies published from January 2010 to September 2018 was performed, using the following databases: Medline, Embase, The Cochrane Library, Scopus, and Web of Science. Only clinical studies that investigated the efficacy of LI-ESWT for ED only, and reported primary outcomes using IIEF-EF scores/questionnaires were included. Both, randomised controlled trials (RCTs) and cohort studies were included, but the meta-analysis was performed only for sham controlled RCTs. Ten RCTs including 873 patients were selected for the meta-analysis. Pooling data of these studies showed that LI-ESWT could significantly improve erectile function in men with ED regarding both patient-subjective outcomes (IIEF-EF: +3.97; 95% CI [2.09–5.84]; p<0.0001, EHS≥3: OR: 4.35; 95% CI [1.82–10.37]; p=0.0009) and patient objective outcomes (peak systolic velocity: +4.12; 95% CI [2.30–5.94]; p<0.00001). In conclusion, the present meta analysis provided results showing that LI-ESWT significantly improves erectile function in patients with vasculogenic ED.
In conclusion, the present meta-analysis showed that LIESWT significantly improves erectile function in patients with vasculogenic ED. Larger multicentric RCTs with longer than 1-year follow-up are needed, before considering this new treatment as the new standard for the treatment of ED. However, LI-ESWT could be offered to patients with vasculogenic ED (especially to PDE5i-responders) as an alternative first-line treatment, especially in younger patients searching for a non-pharmacological treatment.
