Long-Term Prospective Evaluation of Li-ESWT with or without PDE5 Inhibitors for Erectile Dysfunction Following Nerve-Sparing Radical Prostatectomy.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-05-11 DOI:10.1159/000546359

Rashad Sholan, Rufat Aliyev, Seymur Karimov, Malahat Sultan, Anar Almazkhanli

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引用次数: 0

Abstract

Background: Erectile dysfunction (ED) is a common complication following radical prostatectomy (RP). Although phosphodiesterase type 5 inhibitors (PDE5i) are used for penile rehabilitation, their efficacy post-RP is limited. Low-intensity extracorporeal shockwave therapy (Li-ESWT) has emerged as a potential non-invasive treatment, promoting tissue regeneration. This study evaluates the effectiveness of Li-ESWT, with or without PDE5i, for post-RP ED.

Methods: This prospective study included 104 patients who underwent nerve-sparing RP and received Li-ESWT. Patients were divided into two groups: Group 1 received daily 5 mg tadalafil along with Li-ESWT, while Group 2 received Li-ESWT alone. Erectile function was assessed using the International Index of Erectile Function (IIEF-5) at baseline, 6, 12, and 24 months postoperatively.

Results: The preoperative mean IIEF-5 score was 15.7±4.7, with 54.8% of patients scoring below 17. Postoperatively, significant improvements in IIEF-5 scores were observed at 12 and 24 months in both groups compared to the 6th month. In patients with preoperative IIEF-5 <17, Group 1 showed significantly greater improvement in IIEF-5 scores compared to Group 2 (p=0.008). No significant difference was observed between the groups in patients with preoperative IIEF-5 ≥17 (p=0.893).

Conclusion: Li-ESWT is an effective treatment for ED following nerve-sparing RP, with or without PDE5i. In patients with mild-to-moderate or greater preoperative ED, the combination of PDE5i and Li-ESWT may provide additional benefits, whereas Li-ESWT alone appears sufficient for those with milder cases.

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Li-ESWT加或不加PDE5抑制剂治疗保神经根治性前列腺切除术后勃起功能障碍的长期前瞻性评价

背景：勃起功能障碍是根治性前列腺切除术（RP）后常见的并发症。虽然磷酸二酯酶5型抑制剂（PDE5i）用于阴茎康复，但其rp后的疗效有限。低强度体外冲击波治疗（Li-ESWT）已成为一种潜在的非侵入性治疗方法，可促进组织再生。该研究评估了Li-ESWT治疗RP后ed的有效性，无论是否使用PDE5i。方法：这项前瞻性研究包括104例接受神经保留RP并接受Li-ESWT治疗的患者。患者分为两组：1组每日给予他达拉非5mg，同时给予Li-ESWT； 2组单独给予Li-ESWT。使用国际勃起功能指数（IIEF-5）在基线、术后6个月、12个月和24个月评估勃起功能。结果：术前IIEF-5平均评分为15.7±4.7分，54.8%的患者评分低于17分。术后，与第6个月相比，两组患者在12个月和24个月时的IIEF-5评分均有显著改善。结论：Li-ESWT是保留神经RP后ED的有效治疗方法，无论是否伴有PDE5i。在轻度至中度或更严重的术前ED患者中，PDE5i和Li-ESWT联合使用可能会提供额外的益处，而对于轻度ED患者，单独使用Li-ESWT似乎就足够了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.