Efficacy of Penile Low-Intensity Shockwave Therapy and Determinants of Treatment Response in Taiwanese Patients with Erectile Dysfunction
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Patients
2.2. Inclusion and Exclusion Criteria
2.3. Li-ESWT Protocol
2.4. Assessment of Li-ESWT Efficacy Using Erectile Function (EF) Indices
2.5. Li-ESWT Outcome Measurement
2.6. Statistical Analysis
3. Results
3.1. Taiwanese Patients with ED Are Mostly Older Than 45 Years and Present with Advanced Disease Severity
3.2. Li-ESWT Significantly Improves the Erectile Function of Taiwanese Patients Compared with Baseline
3.3. Taiwanese Patients with Advanced ED Severity Benefit More from the Therapeutic Effect of Li-ESWT, Compared with the Less Severe Cases
3.4. Li-ESWT Is Therapeutically Efficacious in Taiwanese Patients Regardless of Their PDE5i Response Status, Albeit Slightly More So among PDE5i Responders
3.5. Age > 45 Years and Uncontrolled Hyperlipidemia Are Independent Negative Predictors of Li-ESWT Response or Success in Taiwanese Patients with ED
4. Discussion
4.1. Limitations
4.2. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Ethics Approval and Consent to Participate
References
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Characteristic | |
---|---|
Age (years, median (Q1–Q3)) | 55 (45–66) |
Body mass index (kg/m2, median (SD)) | 24.6 (3.89) |
Baseline erectile function, median (SD) | |
EHS | 2.0 (0.80) |
IIEF-5 | 10 (5.54) |
ED Severity, n (%) | |
Mild (IIEF-5 score: 17–21) | 6 (8.6%) |
Mild-to-Moderate (IIEF-5 score: 12–16) | 16 (23.2%) |
Moderate (IIEF-5 score: 8–11) | 20 (29%) |
Severe (IIEF-5 score: 5–7) | 24 (34.8%) |
Duration of ED (months, median (Q1–Q3)) | 12 (6–36) |
PDE5i non-responders, n (%) | 52 (75.4%) |
Testosterone level (ng/dL, mean (SD)) | 3.92 (1.45) |
Co-morbidity, n (%) | |
Diabetes mellitus | 29 (42%) |
Hypertension | 16 (23.2%) |
Hyperlipidemia | 33 (47.8%) |
Chronic kidney disease | 9 (13%) |
Hypogonadism | 21 (30.4%) |
Tobacco smoking, n (%) | 7 (10.1%) |
Erectile Function Index | Change from Baseline | |
---|---|---|
Mean (95% CI) | p-Value | |
1 month follow-up | ||
IIEF-5 | 6.65 (5.30–7.99) | <0.001 |
EHS | 0.88 (0.67–1.09) | <0.001 |
QoL | −0.45 (−0.74–−0.16) | 0.003 |
Success * n (%) | 39 (56.5%) | |
3 months follow-up | ||
IIEF-5 | 6.37 (5.08–7.67) | <0.001 |
EHS | 0.89 (0.69–1.10) | <0.001 |
QoL | −0.57 (−0.83–−0.30) | <0.001 |
Success * n (%) | 37 (53.6%) | |
6 months follow-up | ||
IIEF-5 | 5.79 (4.46–7.12) | <0.001 |
EHS | 0.86 (0.64–1.09) | <0.001 |
QoL | −0.56(−0.83–−0.29) | <0.001 |
Success * n (%) | 38 (55.1%) | |
12 months follow-up | ||
IIEF-5 | 5.10 (3.65–6.55) | <0.001 |
EHS | 0.80 (0.58–1.03) | <0.001 |
QoL | −0.59 (−0.86–−0.32) | <0.001 |
Success * n (%) | 32 (46.4%) |
Univariate | Multivariate | |||
---|---|---|---|---|
Odds Ratio | p-Value | Odds Ratio | p-Value | |
Age (>45 years) | 0.27 | 0.04 * | 0.24 | 0.04 * |
BMI (kg/m2) | 0.90 | 0.25 | ||
Tobacco smoking | 1.30 | 0.28 | ||
Hypogonadism | 0.63 | 0.40 | ||
Hypertension | 0.71 | 0.54 | ||
Diabetes mellitus | 0.43 | 0.09 | ||
Diabetes mellitus (uncontrolled) | 0.17 | 0.04 * | 0.21 | 0.08 |
Hyperlipidemia | 0.53 | 0.19 | ||
Hyperlipidemia (uncontrolled) | 0.25 | 0.01 ** | 0.27 | 0.03 * |
Severe and moderate ED | 0.56 | 0.27 | ||
Duration of ED (>2 year) | 0.54 | 0.38 | ||
EHS < 3 | 0.62 | 0.37 | ||
PDE5i non-responders | 0.88 | 0.83 |
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Tzou, K.-Y.; Hu, S.-W.; Bamodu, O.A.; Wang, Y.-H.; Wu, W.-L.; Wu, C.-C. Efficacy of Penile Low-Intensity Shockwave Therapy and Determinants of Treatment Response in Taiwanese Patients with Erectile Dysfunction. Biomedicines 2021, 9, 1670. https://doi.org/10.3390/biomedicines9111670
Tzou K-Y, Hu S-W, Bamodu OA, Wang Y-H, Wu W-L, Wu C-C. Efficacy of Penile Low-Intensity Shockwave Therapy and Determinants of Treatment Response in Taiwanese Patients with Erectile Dysfunction. Biomedicines. 2021; 9(11):1670. https://doi.org/10.3390/biomedicines9111670
Chicago/Turabian StyleTzou, Kai-Yi, Su-Wei Hu, Oluwaseun Adebayo Bamodu, Yuan-Hung Wang, Wen-Ling Wu, and Chia-Chang Wu. 2021. "Efficacy of Penile Low-Intensity Shockwave Therapy and Determinants of Treatment Response in Taiwanese Patients with Erectile Dysfunction" Biomedicines 9, no. 11: 1670. https://doi.org/10.3390/biomedicines9111670