Objective
To assess the efficacy of low-energy extracorporeal shock wave therapy (LI-ESWT) for
erectile dysfunction (ED), a systematic review and meta-analysis was undertaken.
Methods
A comprehensive search of the PubMed, Cochrane Register, and Embase databases to March
2017 was performed for randomized controlled trials reporting on patients with ED
treated with LI-ESWT. The International Index of Erectile Function (IIEF) and the
Erection Hardness Score (EHS) were the most commonly used tools to evaluate the therapeutic
efficacy of LI-ESWT.
Results
There were 9 studies including 637 patients from 2005 to 2017. The meta-analysis revealed
that LI-ESWT could significantly improve IIEF (mean difference [MD]: 2.54; 95% confidence
interval [CI], 0.83-4.25; P = .004) and EHS (risk difference [RD]: 0.16; 95% CI, 0.03-0.28; P = .01). Therapeutic efficacy could last at least 3 months (MD: 4.15; 95% CI, 1.40-6.90;
P = .003). Lower energy density (0.09 mJ/mm2, MD: 4.14; 95% CI, 0.87-7.42; P = .01) increased the number of pulses (3000 pulses per treatment, MD: 5.11; 95% CI,
3.18-7.05, P < .0001) and shorter total treatment courses (<6 weeks, MD: 3.73; 95% CI, 0.54-6.93;
P = .02) resulted in better therapeutic efficacy.
Conclusion
These studies suggest that LI-ESWT could significantly improve the IIEF and EHS of
patients with ED. The publication of robust evidence from additional randomized controlled
trials and longer-term follow-up would provide more confidence regarding the use of
LI-ESWT for patients with ED.
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Article info
Publication history
Published online: September 26, 2017
Accepted:
September 16,
2017
Received:
April 9,
2017
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: This work was supported by Beijing Municipal Science & Technology Commission No.Z171100001017133.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
