title: Effects of Low-Intensity Extracorporeal Shockwave Therapy on Erectile Dysfunction: A Systematic Review and Meta-Analysis.
abstract: Low-intensity extracorporeal shock wave therapy (Li-ESWT) has been proposed as an effective non-invasive treatment option for erectile dysfunction (ED).
  
  
  
  To use systematic review and meta-analysis to assess the efficacy of Li-ESWT by comparing change in erectile function as assessed by the erectile function domain of the International Index of Erectile Function (IIEF-EF) in men undergoing Li-ESWT vs sham therapy for the treatment of ED.
  
  
  
  Systematic search was conducted of MEDLINE, EMBASE, and ClinicalTrials.gov for randomized controlled trials that were published in peer-reviewed journals or presented in abstract form of Li-ESWT used for the treatment of ED from January 2010 through March 2016. Randomized controlled trials were eligible for inclusion if they were published in the peer-reviewed literature and assessed erectile function outcomes using the IIEF-EF score. Estimates were pooled using random-effects meta-analysis.
  
  
  
  Change in IIEF-EF score after treatment with Li-ESWT in patients treated with active treatment vs sham Li-ESWT probes.
  
  
  
  Data were extracted from seven trials involving 602 participants. The average age was 60.7 years and the average follow-up was 19.8 weeks. There was a statistically significant improvement in pooled change in IIEF-EF score from baseline to follow-up in men undergoing Li-ESWT vs those undergoing sham therapy (6.40 points; 95% CI = 1.78-11.02; I2= 98.7%; P < .0001 vs 1.65 points; 95% CI = 0.92-2.39; I2= 64.6%; P < .0001; between-group difference, P = .047). Significant between-group differences were found for total treatment shocks received by patients (P < .0001).
  
  
  
  In this meta-analysis of seven randomized controlled trials, treatment of ED with Li-ESWT resulted in a significant increase in IIEF-EF scores.
authors.affiliation: Department of Urology, University of California, Los Angeles, CA, USA.
authors.forename: Raul I
authors.initials: RI
authors.lastname: Clavijo
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Taylor P
authors.initials: TP
authors.lastname: Kohn
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Jaden R
authors.initials: JR
authors.lastname: Kohn
authors.affiliation: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: ramasamy@miami.edu.
authors.forename: Ranjith
authors.initials: R
authors.lastname: Ramasamy
mesh_terms: D007172:Erectile Dysfunction / Q000628:therapy*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Erectile Dysfunction; Meta-Analysis; Randomized Controlled Trial; Shock Waves