Overview of the current study situation of urological shockwave therapies
© 2020 Elsevier Inc.
Prognostic Indicators for Successful Low-intensity Extracorporeal Shock Wave Therapy Treatment of Erectile Dysfunction
Conclusions: Li-ESWT is safe and effective treatment of ED with 30 months success in 76.3% of patients treated. Li-ESWT should be offered to patients with mild-to-moderate ED and not to those with severe ED.
© 2019 S. Karger AG, Basel
Erectile Dysfunction Treatment Using Focused Linear Low-Intensity Extracorporeal Shockwaves: Single-Blind, Sham-Controlled, Randomized Clinical Trial
Conclusion: The randomized single-blind study confirms that Li-ESWT significantly improves erectile function.
© 2018 Published by Elsevier Inc.
Long-term results of patient satisfaction after low-intensity shockwave treatment of erectile dysfunction and Peyronie’s disease in an urological private practice
Conclusion: Despite the many limitations of thissmall survey (e.g. unselected andsmall group of patients, variations ofstandard protocol and follow-upintervals due to patients will) it issafe to say, Li ESWT leads to highpatientsatisfactionandimprovement of complaints in EDand PD, not only in clinical studiesbut also in a private practice.While ED patients subjectivesatisfaction seem to match the clinical results of objective studies (1) in our small group PD patients didsurprisingly well. New clinicalstudies with modified protocolsshould be reconsidered. Li ESWT seems highly beneficial inPDE-5-I non responder patients,giving them back the ability toperform sexual intercourse (3).Also patient satisfaction is stillhigh, when the treatment is notcovered by their health insurancebut the costs seem to be affordablefor the patient.Still: it seems mandatory to findbetter criteria for future patientselection to increase the number ofsatisfied patients.
© 2017 Published by Elsevier Inc.
LISWT Might Improve the Genitoperineal Sensation and Erectile Dysfunction in Neurogenic and Diabetic Patients
Conclusion: LISWT might improve the male genitoperineal sensation and ED in diabetic and neurogenic patient. Randomized studies based on objective sensation tests are needed to further evaluate the effect of LISWT for such indication.
© Current Science Inc.
A Critical Assessment of Extracorporeal Shockwave Therapy for Peyronie’s Disease
Conclusion: Although recent studies suggest the clinical efficacy and safety of ESWT in the treatment of Peyronie’s disease, its real application in clinical practice remains under debate because there is a lack of clearly visible evidence-based findings. The mechanisms by which ESWT exerts its clinical effects remain unknown, and many variables, such as timing and modality of application, seem to play critical roles in the treatment of this condition. Although ESWT has been shown to be well tolerated by patients, the absence of controlled data and the short duration of the available follow-up do not allow the exclusion of potential risks and long-term side effects. Additional studies are needed to assess how ESWT is able to interfere with the natural history of Peyronie’s disease, the pathologic and biochemical mechanisms of which are not yet completely understood.
© 2020 Lurz et al.
Low-Intensity Shockwave Therapy in the Treatment of Erectile Dysfunction
Conclusion: LISWT may be a safe and potentially efficacious clinical modality for treatment of patients with mild to moderate vasculogenic ED demonstrating increases in cavernosal artery PSV and improvements in IIEF and EDITS scores in short-term follow-up. Longitudinal studies with increased power are needed to better evaluate the long-term efficacy and cost-efficiency of this therapy.
© Babak Vahdatpour et al
Efficacy of Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome: A Randomized, Controlled Trial
Conclusion: In conclusion, our findings confirmed ESWT to be a safe and effective therapy for CPPS in the short term. Nevertheless, more comprehensive surveys so as to describe a standard protocol for ESWT, with long-term followups, are essential.
© Springer Nature Limited 2019
Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials
Abstract: The efficacy of low intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED) has received hard criticism and recently published meta-analyses were not able to provide further insights, nor specific recommendations. The aim of this systematic review and meta-analysis is to evaluate the efficacy of LI-ESWT for ED, identify the ideal treatment population and treatment protocol, and provide recommendations for future research in the field. A systematic research for relevant clinical studies published from January 2010 to September 2018 was performed, using the following databases: Medline, Embase, The Cochrane Library, Scopus, and Web of Science. Only clinical studies that investigated the efficacy of LI-ESWT for ED only, and reported primary outcomes using IIEF-EF scores/questionnaires were included. Both, randomised controlled trials (RCTs) and cohort studies were included, but the meta-analysis was performed only for sham-controlled RCTs. Ten RCTs including 873 patients were selected for the meta-analysis. Pooling data of these studies showed that LI-ESWT could significantly improve erectile function in men with ED regarding both patient-subjective outcomes (IIEF-EF: +3.97; 95% CI [2.09–5.84]; p < 0.0001, EHS ≥ 3: OR: 4.35; 95% CI [1.82–10.37]; p = 0.0009) and patient-objective outcomes (peak systolic velocity: +4.12; 95% CI [2.30–5.94]; p < 0.00001). In conclusion, the present meta-analysis provided results showing that LI-ESWT significantly improves erectile function in patients with vasculogenic ED.
© 2018 The Authors
Low-intensity shock wave therapy for erectile dysfunction and the influence of disease duration
Conclusions: LiSWT is a safe, harmless and repeatable treatment tool for ED with good outcomes reported. Our results suggest that length of disease duration doesn´t negatively influences treatment results.
© 2016 by authors and Scientific Research Publishing Inc.
Application of Low Intensity Shockwaves Using Novel Linear Shockwave Tissue Coveragetechnique. A Prospective, Multicentric, Placebo-controlled Study.
Conclusions: The results of this study indicate that Piezowave² and the LSTC-ED® technique are very effective to treat mild to severe ED using low-intensity shockwaves. Given that the reported success rate after treating patients with other comorbidities and an initial IIEF-5 score of 6-8 points is only around 20%, selecting eligible patients with vasculogenic ED suitable for treatment is crucial. We are currently working on the first unique algorithm which will allow us to customize treatment to each patient. The overall number of shocks applied will take factors into account that could influence the outcome of treatment (e.g., degree of erectile dysfunction, blood sugar and lipid levels, smoking, etc.). We believe that this “tailored” treatment will not only reduce costs but also increase the efficacy of treatment. The study is still ongoing, with more patients included and further follow-ups planned to evaluate the duration of treatment efficacy. We expect the IIEF- 5 score to have increased by 3-6 months post treatment as has been reported in similar studies. More studies are required to confirm the safety and efficacy of this approach, and to
© 2019 Published by Elsevier Inc.
Linear Shockwave Tissue Coverage (LTSC) in the Treatment of Erectile Dysfunction (ED)
Conclusion: LiSWT appears to result in clinically and subjectively significant improvement in patients with mild to moderate ED. Longitudinal studies with increased power should continue to evaluate the efficacy and durability of this therapy.
By Motíl I., Šramková T.
Treatment of Erectile Dysfunction (ED) Using Low-intensity Shockwave Treatment – Comparison of Available Devices and Therapeutic Techniques in 150 Patients
Summary: Our aim was to compare currently available devices and techniques, which use low-intensity shockwaves to treat ED and objectively assess the efficacy of these treatments. The PIEZOWAVE² unit appears to us to be currently the most suitable device to treat ED using low-intensity shockwaves, for the following reasons: The linear probe together with the Linear Shockwave Tissue Coverage (LSTC-ED™) method developed in our institution ensures coverage of the entire organ requiring treatment. Because it uses frequencies of up to 8 Hz, the treatment time with this device is the shortest but it still delivers sufficient amounts of applied energy in the required treatment time. The device is the most compact of all the devices tested and is easy to use. The costs of purchase and operation (extremely long guaranteed lifespan of the probe) are lowest for the PIEZOWAVE² unit. Despite the relatively low initial IIEF-5 score in our group of 35 patients compared to other published studies, we were able to demonstrate the high efficacy of the LiSW method using the PIEZOWAVE² unit to treat moderate to light vascular ED. It is clear that the method is more effective in patients with higher initial IIEF-5 scores and less severe cases of ED. Patients with initial IIEF-5 scores of 12 or below will benefit less from this treatment method. It is also important to correct the unrealistic expectations of some patients who were not entirely satisfied with the treatment outcome despite a significant improvement in their IIEF-5 score.
© 2018 Published by Elsevier Inc.
Low intensity shock wave tissue coverage for management of Erectile Dysfunction patients: preliminary comparative study
Conclusion: LSTC-ED is completely safe, associated with excellent results in non-severe ED & less comorbidities, while poor results appeared in severe ED & multiple comorbidities. Aging, dyslipidemia & diabetes are important predictors of poor results. The durabilty of this line of management is still questionable.
© 2015 BJU International
Evaluation of clinical efficacy, safety and patient satisfaction rate after LiESWT for the treatment of male erectile dysfunction
Conclusion: LiESWT appears to improve erectile function, is safe and potential plays an important role in penile rehabilitation in men whom failed medical therapy.
© 2011 MedReviews®, LLC
Peyronie’s Disease: Nonsurgical Therapy Options
Conclusions: There is still a great need for further investigation of the pathology of PD to make clear recommendations for patients suffering from penile narrowing, deviation, and painful erections due to PD. Various conservative treatment modalities have been examined, some showed promising data whereas others were not useful at all. There is no gold standard available for the nonsurgical therapeutic approach. The best approach from our point of view is multimodal therapy. Patients who suffer from severe penile deviation, narrowing, or indentation, who report disease stability for at least 3 months, and who specify to have a curvature that impedes sexual intercourse should be advised to undergo surgical correction of PD.
Overview of the current study situation of urological shockwave therapies
© 2020 Elsevier Inc.
Prognostic Indicators for Successful Low-intensity Extracorporeal Shock Wave Therapy Treatment of Erectile Dysfunction
Conclusions: Li-ESWT is safe and effective treatment of ED with 30 months success in 76.3% of patients treated. Li-ESWT should be offered to patients with mild-to-moderate ED and not to those with severe ED.
© 2019 S. Karger AG, Basel
Erectile Dysfunction Treatment Using Focused Linear Low-Intensity Extracorporeal Shockwaves: Single-Blind, Sham-Controlled, Randomized Clinical Trial
Conclusion: The randomized single-blind study confirms that Li-ESWT significantly improves erectile function.
© 2018 Published by Elsevier Inc.
Long-term results of patient satisfaction after low-intensity shockwave treatment of erectile dysfunction and Peyronie’s disease in an urological private practice
Conclusion: Despite the many limitations of thissmall survey (e.g. unselected andsmall group of patients, variations ofstandard protocol and follow-upintervals due to patients will) it issafe to say, Li ESWT leads to highpatientsatisfactionandimprovement of complaints in EDand PD, not only in clinical studiesbut also in a private practice.While ED patients subjectivesatisfaction seem to match the clinical results of objective studies (1) in our small group PD patients didsurprisingly well. New clinicalstudies with modified protocolsshould be reconsidered. Li ESWT seems highly beneficial inPDE-5-I non responder patients,giving them back the ability toperform sexual intercourse (3).Also patient satisfaction is stillhigh, when the treatment is notcovered by their health insurancebut the costs seem to be affordablefor the patient.Still: it seems mandatory to findbetter criteria for future patientselection to increase the number ofsatisfied patients.
© 2017 Published by Elsevier Inc.
LISWT Might Improve the Genitoperineal Sensation and Erectile Dysfunction in Neurogenic and Diabetic Patients
Conclusion: LISWT might improve the male genitoperineal sensation and ED in diabetic and neurogenic patient. Randomized studies based on objective sensation tests are needed to further evaluate the effect of LISWT for such indication.
© Current Science Inc.
A Critical Assessment of Extracorporeal Shockwave Therapy for Peyronie’s Disease
Conclusion: Although recent studies suggest the clinical efficacy and safety of ESWT in the treatment of Peyronie’s disease, its real application in clinical practice remains under debate because there is a lack of clearly visible evidence-based findings. The mechanisms by which ESWT exerts its clinical effects remain unknown, and many variables, such as timing and modality of application, seem to play critical roles in the treatment of this condition. Although ESWT has been shown to be well tolerated by patients, the absence of controlled data and the short duration of the available follow-up do not allow the exclusion of potential risks and long-term side effects. Additional studies are needed to assess how ESWT is able to interfere with the natural history of Peyronie’s disease, the pathologic and biochemical mechanisms of which are not yet completely understood.
© 2020 Lurz et al.
Low-Intensity Shockwave Therapy in the Treatment of Erectile Dysfunction
Conclusion: LISWT may be a safe and potentially efficacious clinical modality for treatment of patients with mild to moderate vasculogenic ED demonstrating increases in cavernosal artery PSV and improvements in IIEF and EDITS scores in short-term follow-up. Longitudinal studies with increased power are needed to better evaluate the long-term efficacy and cost-efficiency of this therapy.
© Babak Vahdatpour et al
Efficacy of Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome: A Randomized, Controlled Trial
Conclusion: In conclusion, our findings confirmed ESWT to be a safe and effective therapy for CPPS in the short term. Nevertheless, more comprehensive surveys so as to describe a standard protocol for ESWT, with long-term followups, are essential.
© Springer Nature Limited 2019
Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials
Abstract: The efficacy of low intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED) has received hard criticism and recently published meta-analyses were not able to provide further insights, nor specific recommendations. The aim of this systematic review and meta-analysis is to evaluate the efficacy of LI-ESWT for ED, identify the ideal treatment population and treatment protocol, and provide recommendations for future research in the field. A systematic research for relevant clinical studies published from January 2010 to September 2018 was performed, using the following databases: Medline, Embase, The Cochrane Library, Scopus, and Web of Science. Only clinical studies that investigated the efficacy of LI-ESWT for ED only, and reported primary outcomes using IIEF-EF scores/questionnaires were included. Both, randomised controlled trials (RCTs) and cohort studies were included, but the meta-analysis was performed only for sham-controlled RCTs. Ten RCTs including 873 patients were selected for the meta-analysis. Pooling data of these studies showed that LI-ESWT could significantly improve erectile function in men with ED regarding both patient-subjective outcomes (IIEF-EF: +3.97; 95% CI [2.09–5.84]; p < 0.0001, EHS ≥ 3: OR: 4.35; 95% CI [1.82–10.37]; p = 0.0009) and patient-objective outcomes (peak systolic velocity: +4.12; 95% CI [2.30–5.94]; p < 0.00001). In conclusion, the present meta-analysis provided results showing that LI-ESWT significantly improves erectile function in patients with vasculogenic ED.
© 2018 The Authors
Low-intensity shock wave therapy for erectile dysfunction and the influence of disease duration
Conclusions: LiSWT is a safe, harmless and repeatable treatment tool for ED with good outcomes reported. Our results suggest that length of disease duration doesn´t negatively influences treatment results.
© 2016 by authors and Scientific Research Publishing Inc.
Application of Low Intensity Shockwaves Using Novel Linear Shockwave Tissue Coveragetechnique. A Prospective, Multicentric, Placebo-controlled Study.
Conclusions: The results of this study indicate that Piezowave² and the LSTC-ED® technique are very effective to treat mild to severe ED using low-intensity shockwaves. Given that the reported success rate after treating patients with other comorbidities and an initial IIEF-5 score of 6-8 points is only around 20%, selecting eligible patients with vasculogenic ED suitable for treatment is crucial. We are currently working on the first unique algorithm which will allow us to customize treatment to each patient. The overall number of shocks applied will take factors into account that could influence the outcome of treatment (e.g., degree of erectile dysfunction, blood sugar and lipid levels, smoking, etc.). We believe that this “tailored” treatment will not only reduce costs but also increase the efficacy of treatment. The study is still ongoing, with more patients included and further follow-ups planned to evaluate the duration of treatment efficacy. We expect the IIEF- 5 score to have increased by 3-6 months post treatment as has been reported in similar studies. More studies are required to confirm the safety and efficacy of this approach, and to
© 2019 Published by Elsevier Inc.
Linear Shockwave Tissue Coverage (LTSC) in the Treatment of Erectile Dysfunction (ED)
Conclusion: LiSWT appears to result in clinically and subjectively significant improvement in patients with mild to moderate ED. Longitudinal studies with increased power should continue to evaluate the efficacy and durability of this therapy.
By Motíl I., Šramková T.
Treatment of Erectile Dysfunction (ED) Using Low-intensity Shockwave Treatment – Comparison of Available Devices and Therapeutic Techniques in 150 Patients
Summary: Our aim was to compare currently available devices and techniques, which use low-intensity shockwaves to treat ED and objectively assess the efficacy of these treatments. The PIEZOWAVE² unit appears to us to be currently the most suitable device to treat ED using low-intensity shockwaves, for the following reasons: The linear probe together with the Linear Shockwave Tissue Coverage (LSTC-ED™) method developed in our institution ensures coverage of the entire organ requiring treatment. Because it uses frequencies of up to 8 Hz, the treatment time with this device is the shortest but it still delivers sufficient amounts of applied energy in the required treatment time. The device is the most compact of all the devices tested and is easy to use. The costs of purchase and operation (extremely long guaranteed lifespan of the probe) are lowest for the PIEZOWAVE² unit. Despite the relatively low initial IIEF-5 score in our group of 35 patients compared to other published studies, we were able to demonstrate the high efficacy of the LiSW method using the PIEZOWAVE² unit to treat moderate to light vascular ED. It is clear that the method is more effective in patients with higher initial IIEF-5 scores and less severe cases of ED. Patients with initial IIEF-5 scores of 12 or below will benefit less from this treatment method. It is also important to correct the unrealistic expectations of some patients who were not entirely satisfied with the treatment outcome despite a significant improvement in their IIEF-5 score.
© 2018 Published by Elsevier Inc.
Low intensity shock wave tissue coverage for management of Erectile Dysfunction patients: preliminary comparative study
Conclusion: LSTC-ED is completely safe, associated with excellent results in non-severe ED & less comorbidities, while poor results appeared in severe ED & multiple comorbidities. Aging, dyslipidemia & diabetes are important predictors of poor results. The durabilty of this line of management is still questionable.
© 2015 BJU International
Evaluation of clinical efficacy, safety and patient satisfaction rate after LiESWT for the treatment of male erectile dysfunction
Conclusion: LiESWT appears to improve erectile function, is safe and potential plays an important role in penile rehabilitation in men whom failed medical therapy.
© 2011 MedReviews®, LLC
Peyronie’s Disease: Nonsurgical Therapy Options
Conclusions: There is still a great need for further investigation of the pathology of PD to make clear recommendations for patients suffering from penile narrowing, deviation, and painful erections due to PD. Various conservative treatment modalities have been examined, some showed promising data whereas others were not useful at all. There is no gold standard available for the nonsurgical therapeutic approach. The best approach from our point of view is multimodal therapy. Patients who suffer from severe penile deviation, narrowing, or indentation, who report disease stability for at least 3 months, and who specify to have a curvature that impedes sexual intercourse should be advised to undergo surgical correction of PD.
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