Abstract

Background. One of the most frequent causes of vasculogenic erectile dysfunction (VED) is penile arterial insufficiency. Recently, low-intensity extracorporeal shock wave therapy (Li-ESWT) was reported to improve VED by enhancing perfusion of the penis. The current study was performed to evaluate the effect of Li-ESWT in VED patients with penile arterial insufficiency. Methods. Single-arm study of sixty patients with a diagnosis of VED (penile arterial insufficiency) confirmed by penile duplex ultrasonography and failed to respond to phosphodiesterase type 5 inhibitors (PDE5is) and intracavernosal injection with five item version of the international index of erectile function (IIEF-5) scores from 5 to 21 and erection hardness score (EHS) of ≤ 3. Li-ESWT treatment consisted of 3,000 shockwaves twice weekly for 6 weeks. All patients continued their regular PDE5is use. The IIEF-5 and EHS were used to evaluate the change in erectile function before the first session, at the end of the last session, and follow up after 3 months. Results. The results showed that there was marked improvement in scores of IIEF-5 and EHS post treatment compared with that of pre treatment. But, there was no remarkable difference between post treatment and follow up. Conclusion. Adding Li-ESWT to PDE5is can improve the quality of erection in VED patients with penile arterial insufficiency and failed to respond to medical treatment only.

Key words:

vasculogenic erectile dysfunction, penile arterial insufficiency, low intensity extracorporeal shock wave therapy, international index of erectile function, erection hardness score