1- Bu konuda 2017 yılında yaptığımız çalışmada ESWT’nin şeker hastalığı olan hayvanlarda yeni damar oluşumunu sağlayan faktörlerin erken salınımını sağladığı gösterildi.
Turk J Urol. 2017 Jun;43(2):130-134. doi: 10.5152/tud.2017.35002. Epub 2017 May 3.
Effect of low-energy shockwave therapy on angiogenic factors in the penile tissue of diabetic rats
Ateş Kadıoğlu ve ark.
Abstract
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.
Andrology.2021 Mar 29. doi: 10.1111/andr.13007.
The Impact of Extracorporeal Shock Wave Therapy (ESWT) for the Treatment of Young Patients with Vasculogenic Mild-Erectile Dysfunction (ED): A Prospective Randomized Single-Blind, Sham Controlled Study
Ateş Kadıoğlu ve ark.
Abstract
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.