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. 2020 Oct;9(5):2122-2128.
doi: 10.21037/tau-20-911.

Retrospective comparison of focused shockwave therapy and radial wave therapy for men with erectile dysfunction

Shannon S Wu  1 , Kyle J Ericson  2 , Daniel A Shoskes  2
Affiliations

Retrospective comparison of focused shockwave therapy and radial wave therapy for men with erectile dysfunction

Shannon S Wu et al. Transl Androl Urol. 2020 Oct.

Abstract

Background: Low-intensity shockwave therapy (SWT) is an emerging treatment for erectile dysfunction (ED). Devices used for SWT include focused shockwave therapy (fSWT) or radial wave therapy (rWT), which differ in how the waves are generated, their tissue penetration, and the shape of their pressure waves. Most studies of SWT for ED to date have utilized fSWT. Although widely used, the efficacy of rWT for ED is unknown. Our objective is to compare the efficacy of rWT and fSWT for ED at our institution.

Methods: A retrospective chart review was performed to identify all men with ED treated by fSWT or rWT. Men with history suggesting non-vasculogenic ED were excluded. All men received 6 consecutive weekly treatments. The fSWT group received 3,000 shocks per treatment at 0.09 mJ/mm2. The rWT group received 10,000 shocks per treatment at 90 mJ and 15 Hz. Pre-treatment and 6-week post-treatment Sexual Health Inventory in Men (SHIM) scores were measured. Treatment response was categorized on a scale of 1-3 (1 if no improvement, 2 if erections sufficient for intercourse with phosphodiesterase 5 inhibitors (PDE5i), or 3 if sufficient erections without PDE5i). Primary endpoint was self-reported improvement score of 2 or greater.

Results: A total of 48 men were included: 24 treated by fSWT and 24 by rWT. There were no significant differences in age, duration of ED, pre-treatment PDE5i use, or pre-treatment SHIM scores between the groups. Following treatment with rWT, the mean SHIM score improved from 9.3 to 16.1 (P<0.001). The mean SHIM following fSWT improved from 9.3 to 15.5 (P<0.001). The mean improvement in SHIM score did not differ between rWT (6.8) and fSWT (6.2) (P=0.42). 54% of men treated by fSWT experienced a significant clinical improvement (≥ grade 2 response) compared to 75% in the rWT group (P=0.42). There were no reported side effects with either device.

Conclusions: In our patient population, both fSWT and rWT were moderately effective treatments for arteriogenic ED with no observable difference in efficacy between the two modalities.

Keywords: Low-intensity shockwave therapy (low-intensity SWT); erectile dysfunction (ED); focused shockwave therapy (fSWT); radial shockwave therapy.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-911). DAS serves as an unpaid editorial board member of Translational Andrology and Urology from Dec 2017 to Jul 2022. DAS reports investment from Triurol, paid consultant from UroGen, outside the submitted work. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Box and whisker plots of pre- and post-treatment Sexual Health Inventory in Men (SHIM) scores for men treated by (A) focused shockwave therapy and (B) radial wave therapy (rWT). X-marks within the box plot denote the mean SHIM score.
Figure 2
Figure 2
Mean change in Sexual Health Inventory in Men (SHIM) score from pre- to post-treatment with focused shockwave therapy (fSWT) and radial wave therapy (rWT).
See this image and copyright information in PMC

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