News — July 12, 2022 – For men with moderate erectile dysfunction (ED), a noninvasive technique called low-intensity shockwave therapy (LiST) leads to significant improvement in sexual function, a clinical trial concludes The Journal of Urology®, an official journal of the American Urological Association (AUA). The journal is published in the Lippincott Portfolio by Wolters Kluwer.

“Our results suggest that LiST is highly effective and safe in patients with moderate vasculogenic erectile dysfunction,” write Nikolaos Pyrgidis, MD, of the Aristotle University of Thessaloniki, Greece, and colleagues. In the study, more than two-thirds of patients on 6-week LiST treatment showed clinically significant improvement on a standard rating scale of sexual function and satisfaction.

LiST may provide new option for “regenerative treatment” of moderate erectile dysfunction

Low-intensity shock wave therapy has emerged as a promising non-surgical, non-drug treatment for erectile dysfunction. In the LiST procedure, the urologist uses a special probe to deliver low-intensity shock waves along the penis. The aim is to stimulate the formation of new blood vessels (angiogenesis), leading to better blood circulation.

The new study included 70 men with blood flow-related (vasculogenic) erectile dysfunction. All patients had moderate erectile dysfunction, according to a standard questionnaire, the International Index of Erectile Function (IIEF). All men had at least a partial response to ED medications (phosphodiesterase type 5 inhibitors), which they stopped taking 1 month before and during the study.

A group of patients was randomly assigned to active treatment with LiST, 12 sessions given twice a week for 6 weeks. The other group received an inactive sham treatment. Response to LiST was assessed after 1 and 3 months, based on erectile function score on the IIEF.

Men receiving active LiST had a significant improvement in erectile function score: from 14 points (out of 30 possible) before treatment, to 19 points at 1 month, to 20 points at 3 months. In contrast, men assigned to the fake LiST had little or no improvement. At 3 months, 79% of men in the active LiST group had at least a 5-point improvement in erectile function score – defined as the “minimum clinically significant difference” – compared to none in the sham LiST group.

Active LiST was also associated with a significant increase in the number of patients reporting successful intercourse. For this and for the increase in erectile function score, the improvement remained significant after adjusting for baseline responses.

While LiST is emerging as a new treatment alternative for erectile dysfunction, there is still little evidence about its effectiveness and which patients are most likely to benefit from it. European guidelines recommend LiST as first-line treatment for patients with blood flow-related erectile dysfunction. The most recent AAU guidelines identify LiST as an investigational treatment; it is not yet approved for the treatment of erectile dysfunction by the United States Food and Drug Administration.

The new study helps fill gaps in LiST research by demonstrating its effectiveness in the large group of men with moderate erectile dysfunction. Patients with moderate erectile dysfunction “may be an ideal population for the application of regenerative treatment modalities with the goal of delaying the progression of erectile dysfunction,” write Dr. Pyrgidis and colleagues. However, they point to the need for larger randomized trials, including longer-term follow-up.

Click here to read “The Effect of Low-Intensity Shockwave Therapy on Moderate Erectile Dysfunction: A Double-Blind, Randomized, Simulation-Controlled Clinical Trial”

DOI: 10.1097/JU.0000000000002684


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An official journal of the American Urological Association (AUA), Urology practice focuses on clinical trends, challenges and practical applications in the four areas of business, health policy, specialty and patient care. Information that can be used in daily practice will be provided to the urological community via peer-reviewed clinical practice articles (including best practices, reviews, clinical guidelines, selected clinical trials, editorials and books white papers), “research letters” (short original studies with an important clinical message), the affairs of urology practice, health policy issues in urology, education and training in urology, as well as content for members of the urology care team.

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