Impact of aging and comorbidity on the efficacy of low-intensity shock wave therapy for erectile dysfunction.
OBJECTIVE
To evaluate the efficacy of low-intensity shock wave therapy and to identify the predictive factors of its efficacy in Japanese patients with erectile dysfunction.


METHODS
The present study included 57 patients with erectile dysfunction who satisfied all the following conditions: more than 6-months history of erectile dysfunction, sexual health inventory for men score of ≤ 12 without phosphodiesterase type-5 inhibitor, erection hardness score grade 1 or 2, mean penile circumferential change by erectometer assessing sleep related erection of < 25 mm and non-neurological pathology. Patients were treated by a low-energy shock waves generator (ED1000; Medispec, Gaithersburg, MD, USA). A total of 12 shock wave treatments were applied. Sexual health inventory for men score, erection hardness score with or without phosphodiesterase type-5 inhibitor, and mean penile circumferential change were assessed at baseline, 1, 3 and 6 months after the termination of low-intensity shock wave therapy.


RESULTS
Of 57 patients who were assigned for the low-intensity shock wave therapy trial, 56 patients were analyzed. Patients had a median age of 64 years. The sexual health inventory for men and erection hardness score (with and without phosphodiesterase type-5 inhibitor) were significantly increased (P < 0.001) at each time-point. The mean penile circumferential change was also increased from 13.1 to 20.2 mm after low-intensity shock wave therapy (P < 0.001). In the multivariate analysis, age and the number of concomitant comorbidities were statistically significant predictors for the efficacy.


CONCLUSIONS
Low-intensity shock wave therapy seems to be an effective physical therapy for erectile dysfunction. Age and comorbidities are negative predictive factors of therapeutic response.
Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Shin-ichi
S
Hisasue
Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Toshiyuki
T
China
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Akira
A
Horiuchi
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Masaki
M
Kimura
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Keisuke
K
Saito
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Shuji
S
Isotani
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Hisamitsu
H
Ide
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Satoru
S
Muto
Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Raizo
R
Yamaguchi
Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan.|Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
Shigeo
S
Horie
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D048909:Diabetes Complications / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D007172:Erectile Dysfunction / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D010410:Penile Erection / Q000502:physiology*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014464:Ultrasonic Therapy
D058986:Phosphodiesterase 5 Inhibitors
erectile dysfunction; low intensity shock wave treatment; low-intensity shock wave therapy; predictive factor