Shock Wave Therapy inVasculogenic Erectile Dysfunction
Objective: The aim of this study is to evaluate the response to shock wave therapy in a group of patients with vasculogenic erectile dysfunction after underwent deep dorsal vein embolization. Methods: A clinical record of 30 patients from 26 to 45 years with a clinical diagnosis of vasculogenic ED of more than six months and without venous leakage from legs of the penis, and cancer pathology has not been identified. Patient diagnostics consisted of questionnaire (IIEF-5), Penile Pharmacological Doppler Ultrasonography and CT Cavernosography. After confirming the diagnosis of vasculogenic ED, they all underwent deep dorsal vein embolization. Then the second stage all patients received a treatment by the shockwave device - “BTL-6000 SWT TOPLINE” (BTL Corporate). The effectiveness of therapy was evaluated by two criteria: the IIEF-5 score and evaluation of penile blood flow. Results: The average IIEF-5 score has greatly increased from 16.7 at baseline to 22.2 post treatment. Out of 30 patients, 26 (81%) subjectively noted a persistent improvement in erectile function. An increase in the penile blood flow in the right cavernosum artery from 17.7 mm Hg at baseline to 34 mm Hg post treatment, in the left cavernosum artery from 13.2 mm Hg to 28.3 mm Hg, in the right dorsal artery from 18 mm Hg to 32 mm Hg and in the left dorsal artery from 16 mm Hg to 33 mm Hg. As well as, increase in the diameter of the cavernous bodies was noted. Conclusion: The results of this study indicate erectile dysfunction treatment should have a personalized approach. Shock wave therapy in combination with the reduction of venous outflow may be an alternative to revascularization of the penis.