1- Bu konuda 2017 yılında yaptığımız çalışmada ESWT’nin şeker hastalığı olan hayvanlarda yeni damar oluşumunu sağlayan faktörlerin erken salınımını sağladığı gösterildi.
Objective: The aim of this study is to investigate the effect of low-energy shock wave therapy (LESWT) on angiogenesis factors at penile tissue in a diabetic rat model.
Material and methods: A total of 30 male Sprague-Dawley rats which were allocated into three equal groups were included study. Group 1 (control group) included 10 male rats which did not receive any treatment were randomly chosen to serve as normal control. The remaining rats were injected intraperitoneally with 60 mg/kg of streptozotocin (STZ) to induce diabetes. Diabetic rats were divided into two equal group which constituted diabetic control, and LESWT treatment (DM+LESWT) group. Each rat in the DM+LESWT group received L-ESWT therapy. Endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) mRNA expression levels of penile tissue were evaluated.
Results: Following STZ dosing eNOS level dropped in the diabetic control group relative to the control group. Statistically significant increase in eNOS levels were seen in the LESWT+DM group. Similarly, in the diabetic control group STZ treatment decreased VEGF levels, while in the LESWT+DM group VEGF nearly approached to baseline levels. However variations in VEGF levels were not statistically significant.
Conclusion: Mechanism action of ESWT in the penile tissue seems to involve angiogenic factors.
2- Yeni yayınlanan çalışmamızda sertleşme sorunu olan genç erkeklerde ESWT’nin etkili olduğu bulunmuştur.
Çalışmaya hafif derecede sertleşme sorunu olan 66 hasta katıldı. 3 ay’ın sonunda ESWT grubunda hastaların % 74’ünde IIEF-EF skorunda anlamlı iyileşme görülürken, plasebo grubunda bu oran % 36 olarak bulunmuştur.
Bu bulguların ışığında, ESWT, vaskülojenik ED’de yararlı bir tedavi seçeneği olabilir.
Background: Low-intensity extracorporeal shock wave therapy (ESWT) for the treatment of vasculogenic erectile dysfunction (ED) has emerged as a promising method directly targeting the underlying pathophysiology of the disease.
Objectives: To compare outcomes in ED patients after ESWT and placebo treatment.
Materials and methods: Prospective randomized placebo-controlled single-blinded trial on 66 patients with mild ED. The study comprised a 4-week washout phase, a 4-week treatment phase, and a 48-week follow-up. Inclusion criteria included age between 18 and 75 years and diagnosis of mild ED (IIEF-EF score= 17-25) being made at least six months prior to study inclusion and being confirmed by Penile Doppler ultrasonography (US) at baseline examination. Efficacy endpoints were changes from baseline in patient-reported outcomes of erectile function(International Index of Erectile Function domain scores [IIEF-EF]), as well as erection hardness and duration (Sexual Encounter Profile diary [SEP] and Global Assessment Questions [GAQ]). Safety was assessed throughout the study.
Results: A total of 66 enrolled patients were allocated to ESWT (n=44) or placebo (n=22). Mean age of ESWT and placebo group were 42.32 ± 9.88 and 39.86 ± 11.64 (p=0.374) respectively. Mean baseline IIEF-EF scores of ESWT group and placebo were 20.32±2.32 and 19.68±1.55 respectively (p = 0.34). At 3-months follow-up, mean IIEF-EF scores were significantly higher in ESWT patients than in placebo patients (23.10 ± 2.82 vs. 20.95 ± 2.19, p = 0.003), and IIEF-EF scores of ESWT patients remained high during the 6- months (22.67 ± 3.35 vs. 19.82 ± 1.56) follow-up. The percentage of patients reporting both successful penetration (SEP2) and intercourse (SEP3) in more than 50% of attempts was significantly higher in ESWT-treated patients than in placebo patients (p = 0.001). A minimal clinically important difference between the IIEF=EF baseline and 3-months follow-up was found in 74 % of ESWT and 36 % of placebo. No serious adverse events were reported.
Discussion and Conclusion ESWT significantly improved the erectile function of relatively young patients with vasculogenic mild ED when compared to placebo, and the beneficial effect of this treatment up to 6 months. These findings suggest that ESWT could be a useful treatment option in vasculogenic ED.