Low-intensity shock wave therapy and its application to erectile dysfunction.
Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Hongen
H
Lei
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Jing
J
Liu
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Huixi
H
Li
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Lin
L
Wang
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Yongde
Y
Xu
Department of Urology, China-Japan Union Hospital of Jilin University, Jilin, China.
Wenjie
W
Tian
Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA.
Guiting
G
Lin
Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
Zhongcheng
Z
Xin
ESWL; Erectile dysfunction; Extracorporeal shockwave lithotripsy; Phosphodiesterase 5 inhibitors