Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature
Context: Erectile dysfunction (ED) following radical prostatectomy is a concern for patients and their partners. Low-intensity extracorporeal shockwave therapy (LI-ESWT) can potentially enhance tissue repair and regeneration. The aim of the current study was to systematically review the literature t...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-09-01
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| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168322007352 |
| _version_ | 1828356774138216448 |
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| author | Maria Chiara Sighinolfi Ahmed Eissa Carlo Bellorofonte Alessandro Mofferdin Mosaab Eldeeb Simone Assumma Enrico Panio Tommaso Calcagnile Daniele Stroppa Giorgio Bozzini Giorgia Gaia Stefano Terzoni Mattia Sangalli Salvatore Micali Bernardo Rocco |
| author_facet | Maria Chiara Sighinolfi Ahmed Eissa Carlo Bellorofonte Alessandro Mofferdin Mosaab Eldeeb Simone Assumma Enrico Panio Tommaso Calcagnile Daniele Stroppa Giorgio Bozzini Giorgia Gaia Stefano Terzoni Mattia Sangalli Salvatore Micali Bernardo Rocco |
| author_sort | Maria Chiara Sighinolfi |
| collection | DOAJ |
| description | Context: Erectile dysfunction (ED) following radical prostatectomy is a concern for patients and their partners. Low-intensity extracorporeal shockwave therapy (LI-ESWT) can potentially enhance tissue repair and regeneration. The aim of the current study was to systematically review the literature to assess the role of LI-ESWT in the management of patients with postprostatectomy ED. Evidence acquisition: Two authors independently performed a systematic search of the PubMed and Web of Science databases to identify all relevant articles. Non-English reports, case reports, reviews, letters, and editorials were excluded. Risk of bias was assessed according to the GRADE guidelines. Evidence synthesis: Nine articles met the inclusion criteria and were included in the qualitative analysis. All the studies included were published between 2015 and 2022 and the majority of them compared phosphodiesterase type 5 inhibitors (PDE5Is) alone versus a combination of LI-ESWT and PDE5Is. Only three studies were randomized controlled trials (RCTs). In general, there is no standardized protocol for LI-ESWT for postprostatectomy ED. In comparisons of LI-ESWT + PDE5Is versus PDE5Is alone, some authors found a statistically significant improvement in erectile function with LI-ESWT + PDE5Is. The starting time for LI-ESWT differed among the studies, ranging from 3 d to 6 mo after surgery. The main limitations of the review are the scarcity of studies, small sample sizes, high risk of bias, and high heterogeneity among studies. Conclusions: There is currently limited evidence on the use of LI-ESWT either alone or in combination with PDE5Is in penile rehabilitation protocols after prostatectomy. However, small clinical trials with short follow-up show that LI-ESWT could potentially play a role in the management of postprostatectomy ED in the future. Further RCTs with larger sample sizes are needed. Patient summary: Despite limited reports in the literature, low-intensity shockwave therapy after removal of the prostate is a promising noninvasive treatment for dealing with erectile dysfunction after surgery. |
| first_indexed | 2024-04-14T03:04:20Z |
| format | Article |
| id | doaj.art-e5a2e92367e742dab64c43694c9f04a4 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-14T03:04:20Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-e5a2e92367e742dab64c43694c9f04a42022-12-22T02:15:48ZengElsevierEuropean Urology Open Science2666-16832022-09-01434553Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the LiteratureMaria Chiara Sighinolfi0Ahmed Eissa1Carlo Bellorofonte2Alessandro Mofferdin3Mosaab Eldeeb4Simone Assumma5Enrico Panio6Tommaso Calcagnile7Daniele Stroppa8Giorgio Bozzini9Giorgia Gaia10Stefano Terzoni11Mattia Sangalli12Salvatore Micali13Bernardo Rocco14Urology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, ItalyUrology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Corresponding author. Department of Urology, Tanta University Hospitals, Al-Giesh Street, El-Gharbia 31527, Tanta, Egypt. Tel. +2 11 10304666.Urology Unit, Columbus Clinic Center, Milan, ItalyUrology Department, University of Modena & Reggio Emilia, Modena, ItalyUrology Department, Faculty of Medicine, Tanta University, Tanta, EgyptUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy; Urology Department, University of Modena & Reggio Emilia, Modena, ItalyUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy; Urology Department, University of Modena & Reggio Emilia, Modena, ItalyUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy; Urology Department, University of Modena & Reggio Emilia, Modena, ItalyUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, ItalyUrology Department, ASST Lariana, Como, ItalyGynecology Department, ASST Santi Paolo e Carlo, Milan, ItalyUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, ItalyUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, ItalyUrology Department, University of Modena & Reggio Emilia, Modena, ItalyUrology Department, ASST Santi Paolo e Carlo, University of Milan, Milan, ItalyContext: Erectile dysfunction (ED) following radical prostatectomy is a concern for patients and their partners. Low-intensity extracorporeal shockwave therapy (LI-ESWT) can potentially enhance tissue repair and regeneration. The aim of the current study was to systematically review the literature to assess the role of LI-ESWT in the management of patients with postprostatectomy ED. Evidence acquisition: Two authors independently performed a systematic search of the PubMed and Web of Science databases to identify all relevant articles. Non-English reports, case reports, reviews, letters, and editorials were excluded. Risk of bias was assessed according to the GRADE guidelines. Evidence synthesis: Nine articles met the inclusion criteria and were included in the qualitative analysis. All the studies included were published between 2015 and 2022 and the majority of them compared phosphodiesterase type 5 inhibitors (PDE5Is) alone versus a combination of LI-ESWT and PDE5Is. Only three studies were randomized controlled trials (RCTs). In general, there is no standardized protocol for LI-ESWT for postprostatectomy ED. In comparisons of LI-ESWT + PDE5Is versus PDE5Is alone, some authors found a statistically significant improvement in erectile function with LI-ESWT + PDE5Is. The starting time for LI-ESWT differed among the studies, ranging from 3 d to 6 mo after surgery. The main limitations of the review are the scarcity of studies, small sample sizes, high risk of bias, and high heterogeneity among studies. Conclusions: There is currently limited evidence on the use of LI-ESWT either alone or in combination with PDE5Is in penile rehabilitation protocols after prostatectomy. However, small clinical trials with short follow-up show that LI-ESWT could potentially play a role in the management of postprostatectomy ED in the future. Further RCTs with larger sample sizes are needed. Patient summary: Despite limited reports in the literature, low-intensity shockwave therapy after removal of the prostate is a promising noninvasive treatment for dealing with erectile dysfunction after surgery.http://www.sciencedirect.com/science/article/pii/S2666168322007352Low-intensity extracorporeal shockwave therapyErectile dysfunctionRadical prostatectomy |
| spellingShingle | Maria Chiara Sighinolfi Ahmed Eissa Carlo Bellorofonte Alessandro Mofferdin Mosaab Eldeeb Simone Assumma Enrico Panio Tommaso Calcagnile Daniele Stroppa Giorgio Bozzini Giorgia Gaia Stefano Terzoni Mattia Sangalli Salvatore Micali Bernardo Rocco Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature European Urology Open Science Low-intensity extracorporeal shockwave therapy Erectile dysfunction Radical prostatectomy |
| title | Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature |
| title_full | Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature |
| title_fullStr | Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature |
| title_full_unstemmed | Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature |
| title_short | Low-intensity Extracorporeal Shockwave Therapy for the Management of Postprostatectomy Erectile Dysfunction: A Systematic Review of the Literature |
| title_sort | low intensity extracorporeal shockwave therapy for the management of postprostatectomy erectile dysfunction a systematic review of the literature |
| topic | Low-intensity extracorporeal shockwave therapy Erectile dysfunction Radical prostatectomy |
| url | http://www.sciencedirect.com/science/article/pii/S2666168322007352 |
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