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Chapter 3. TREATMENT OF ERECTILE DYSFUNCTION Section 3.5.3. Shockwave therapy (page no. 555)

Chapter 3. TREATMENT OF ERECTILE DYSFUNCTION Section 3.5.3. Shockwave therapy (page no. 555).

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Chapter 3. TREATMENT OF ERECTILE DYSFUNCTION Section 3.5.3. Shockwave therapy (page no. 555)

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  1. Chapter 3. TREATMENT OF ERECTILE DYSFUNCTIONSection 3.5.3. Shockwave therapy (page no. 555) Recently, the use of low-intensity extracorporeal shock wave therapy was proposed as a novel treatment for ED (93). In the first randomised, double-blind, sham-controlled study, it was demonstrated that low-intensity extracorporeal shock wave therapy had a positive short-term clinical and physiological effect on the erectile function of men who respond to oral PDE5Is (94). Moreover, there are preliminary data showing improvement in penile hemodynamics and endothelial function, as well as IIEF-EF domain score in severe ED patients who are poor responders to PDE5Is (95).The feasibility and tolerability of this treatment, coupled with its potential rehabilitative characteristics, make it an attractive new therapeutic option for men with ED. However, current data are limited and clear recommendations cannot be given. Data regarding the mechanism of action of this procedure are still lacking. In a diabetic rat model, low-intensity extracorporeal shock wave therapy ameliorated diabetes mellitus associated ED by promoting regeneration of nNOS-positive nerves, endothelium, and smooth muscle in the penis. These beneficial effects appear to be mediated by recruitment of endogenous mesechymal stem cells (MSCs) (96).

  2. References 93. Vardi Y, Appel B, Jacob G, et al.Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol. 2010 Aug;58(2):243-8. http://www.ncbi.nlm.nih.gov/pubmed/20451317 94. Vardi Y, Appel B, Kilchevsky A, Gruenwald I. Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol. 2012 May;187(5):1769-75. http://www.ncbi.nlm.nih.gov/pubmed/22425129 95. Gruenwald I, Appel B, Vardi Y. Low-intensity extracorporeal shock wave therapy--a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy. J Sex Med. 2012 Jan;9(1):259-64. http://www.ncbi.nlm.nih.gov/pubmed/22008059 96. Qiu X, Lin G, Xin Z, et al. Effects of Low-Energy Shockwave Therapy on the Erectile Function and Tissue of a Diabetic Rat Model. J Sex Med. 2012 Dec 17. doi: 10.1111/jsm.12024. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/23253086

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