Low-energy shock waves in treatment of erectile dysfunction. Clinical experience with the first one hundred patients in Venezuela
Bastidas, G1; Escovar, P1; Ballesteros, C1; Rubiano, S1
Introduction: It is described that low-energy shock waves stress the tissue where are they are applied and produce micro-trauma, with the subsequent activation of biological reactions, that result in angiogenesis and neovascularization. Nowadays their use is recommended in treatment of vascular caused erectile dysfunction.
Aim: To determine the low-energy shock waves effectiveness in Venezuelan patients with erectile dysfunction from vascular cause.
Materials and Methods: This was a prospective study, the sample was constituted by 100 men aged 39-78 years with vascular caused erectile dysfunction diagnosis, from whom 20 (20%) were PDE5-i non-responders, to which was applied International Index of Erectile Function 5-item (IIEF-5) before and after the treatment (Valencia protocol), that consisted in twelve sessions of 1.500 shock waves of 0,09mJ/mm2 each one, spread over five regions (300 in each one), three in penis (radix and corpora cavernosa right and left) and two in the crura of the penis (right and left), making a total of 18.000 shock waves.
Results: The IIEF-5 increased significantly going from 14,5 (before treatment) to 23,8 (after treatment) P<0.001. 80% of PDE5-i non-responders became responders. There weren`t adverse or side effects, without use of anesthetics and analgesics.
Conclusion: In our clinical experience can be consider the use of shock waves in patients with vascular caused erectile dysfunction, PDE5-i responders or not, obtaining significant improvements in the IIEF-5. However double-blind, randomized and long term monitoring studies are still required.
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