AB032. A systematic review (meta-analysis): low energy shock wave improves erectile function

Background: As a novel therapeutic method for erectile dysfunction (ED), the Low Energy Shock Wave (LESW) has been applied in the clinical setting recently. We feel that a summary of the current literature and a systematic review to evaluate the therapeutic efficacy of LESW for ED would be helpful for physicians who are interested in using this modality to treat patients.

Methods: A comprehensive search of the PubMed and EMBASE databases to November 2015 was performed. Studies reporting on patients with ED treated by LESW were included. The international index of erectile function (IIEF) score and Erection Hardness Score (EHS) were the most commonly used tools to evaluate the therapeutic efficacy of LESW.

Results: There were 14 studies including 806 patients from 2005 to 2015. Seven of the 14 studies were randomized controlled trials (RCTs). In these studies, the setup parameters of LESW and the protocols of treatment were in variation. The meta-analysis revealed that LESW could improve IIEF score (MD =2.00; 95% CI, 0.99–3.00; P<0.0001) and EHS score (RD =0.16; 95% CI, 0.03–0.28; P=0.01) significantly. The therapeutic efficacy could last at least three months. The patients with mild-moderate ED or without comorbidities had better therapeutic efficacy after treatment than patients with more severe ED or comorbidities. The energy density of LESW treatment was closely related to its clinical outcome, especially on IIEF improvement. More frequent treatment or longer treatment course did not improve IIEF score.

Conclusions: Studies of LESW for ED patients increased sharply in recent years. Most of these studies presented encouraging results, regardless of variation in LESW setup parameters or treatment protocols. These studies suggest that LESW could significantly improve the IIEF and EHS score of ED patients. The publication of robust evidence from additional randomized controlled trials and longer-term follow-up would provide us more confidence regarding utilization of LESW treatment for ED patients.

Keywords: Low energy shock wave; erectile function; randomized controlled trials (RCTs)