Low-intensity extracorporeal shockwave therapy improves erectile dysfunction in kidney transplant recipients. Results of a prospective, randomized, double blinded, sham controlled study.
Presentation Authors: Kleiton Yamaçake, Felipe Carneiro, Rodolfo Lourenço, Affonso Celso Piovesan*, Miguel Srougi, William Carlos Nahas, Ioannis Michel Antonopoulos, Sao Paulo, Brazil
Erectile dysfunction (ED) in kidney transplant patients is not uncommon. The ideal treatment modality should not interfere with the graft function. Low-intensity Shock Wave Therapy Extracorporeal (Li-ESWT) has been of interest due to its angiogenic properties and has shown interesting results when used to treat patients with cardiovascular disease and non-transplanted men with ED. Our objective is to study the efficacy and safety of Li- ESWT for the treatment of ED in kidney transplanted men of probable vascular etiology.
Twenty men (mean age = 53.7 years, range 46 to 61 years ) that have been submitted to kidney transplant for at least 6 months and have been suffering from ED for at least 6 months were selected for the treatment. This was a double-blinded, single-center, prospective, randomized, sham-controlled trial. The ESWT protocol was based on 2 treatment sessions per week for 3 weeks. The sham treatment was performed using the same device replacing the effective probe for one that emits zero energy but delivers a sound and pulse sensation during treatment. Follow-up assessment was performed with the International Index of Erectile Function Questionnaire (IIEF) score and Erection Hardness Score (EHS) after 1, 4 and 12 months.
A total of 20 patients were recruited into the study. 10 patients were randomized into the sham therapy arm and 10 patients into the Li-ESWT arm. Groups were similar regarding the baseline IIEF score and EHS. IIEF score improvement was higher than 5 in 70% (ranged from 0-10) and in 10% (ranged from 1-14) in Li-ESWT and Sham groups, respectively. IIEF and EHS improvement were statistically significant in the Li-ESWT group, p < 0,0001. The mean change in IIEF score after 12 months was the 4.8in Li-ESWT group. Data are illustrated in Graphic 1.
Li-ESWT is a non-pharmacological treatment with clinical efficacy. Besides its rehabilitative potential, this treatment is feasible, tolerable and effective. Further studies are needed to determine optimal treatment protocols.