LOW INTENSITY EMSW TREATMENT IN ERECTILE DISFUNCTION (PRELIMINARI EXPERIENCE ON 158 PTS)
The purpose of this study is to define the feasybility and efficacy of LI-SWT in the treatment of erectile disfunction in 158 pts with ED.
Materials and Methods
We enrolled , between 2015 april and 2016 december, 158 pts suffering of erectile disfunction.
110 pts (Group A) had vasculogenic impotence (82 arteriogenic and 28 with venous leak). 48 pts (Group B) had ED subsequent to NSRP (both robotic and laparoscopic). 110 pts with pure vasculogenic ED were treated with 4 weeks course of LISWT for a total amount of 16000 SW in 4 different sites(cavernosal bodies and crura) with a frequency of 180 shock waves / min and an energy flow density of 0.09 mj/cm2. 48 pts with ED after NSRP had a 6 weeks course of LI-ESWT for a total amount of 18000 SW with same frequency and energy in 2 different sites (only corpora cavernosa). All patients were treated at the same time with PDE5 inhibitors and Tribulus Terrestris Plus Arginine for 2 mnths. The positive response means sexual performance improvement (PDE5 responder can suspend the medication & PDE5 not responder became responder) based on IIEF5 test and EHS.
The A Group presented a positive response in 77 pts (70 %). The IIEF5 score improved in mean 5 points; EHS score passed from 2 to 4. The B Group had a positive response in 20 pts (48%). In this case IIEF5 had a mean improvement of 9 points;EHS score passed from 1 to 3.
LI-SWT showed in many sudies the capacity to create a new angiogenesis of the corporal bodies through the increase of local VEGF, that stimulates local stem cells to create new vessels.
The PDE5 medication don't treat the cause of ED. The LI-ESWT directly works on the corporal vascular system, stimulating the new angiogenesis, that improve the blood flow to restart the erection.
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