Evaluation of the effectiveness of shockwave therapy in drug-resistant impotence

Abstract

Erectile dysfunction (ED) is a common condition that mainly affects older and middle-aged men. Medication therapy using PDE5 inhibitors is currently considered the first choice of treatment for erectile dysfunction. However, individuals tend to respond differently to this therapeutic approach, with some patients showing a lack of efficacy. Shockwave therapy, an emerging treatment modality, was investigated in this study which had promising results in previous studies. The current study aims to investigate the impact of low-intensity shockwave therapy as a treatment option for patients who exhibit an unfavorable or inadequate response to conventional pharmacological interventions based on PDE5 inhibitor medications. Individuals with drug-resistant forms of erectile dysfunction that fail to achieve satisfactory symptom control with standard pharmaceutical treatments represent the target population under investigation. Method: This study uses a research design known as a single-arm clinical trial, A total of 48 patients diagnosed with drug-resistant erectile dysfunction, defined as a lack of therapeutic benefit from PDE5 inhibitor medications, were enrolled in the study. The therapeutic intervention consisted of low-intensity shockwave therapy administered over a 6-week period at a frequency of one treatment session per week. Patients were assessed with IIEF at baseline, 6 weeks and 3 months after shockwave therapy for sexual function. This criterion can be divided into 5 sexual parameters; orgasmic function, erectile function, sexual desire, sexual satisfaction and patients' overall satisfaction. Patients' background factors were also assessed. Patients' data were statistically analyzed using T-test and Linear regression models in SPSS 24 software and results with P-value less than 0.05 were reported as significant. Results: 48 participating patients were questioned with IIEF questionnaire at baseline, 6 weeks and 3 months after which a significant improvement was observed in all sexual parameters at both times. (P-value <0.000) Of the 48 patients in the study, 10 had been suffering from erectile dysfunction for over two years. The most common risk factor among participants was dyslipidemia, present in 25 patients. In contrast, the least prevalent risk factor was obesity, affecting 12 patients. These results suggest that certain patient characteristics, particularly the presence of diabetes, may limit the benefits of shockwave therapy for drug-resistant erectile dysfunction. Longer durations of erectile dysfunction prior to treatment and older patient age were also found to negatively influence outcomes related to sexual satisfaction and overall satisfaction following shockwave therapy.