Penile shear-wave elastography predicts the outcome of botulinum neurotoxin (Botox) in the management of non-responders to phosphodiesterase-5-inhibitors: A pilot study.

IF 1.2 Q3 UROLOGY & NEPHROLOGY

Arab Journal of Urology Pub Date : 2025-01-12 eCollection Date: 2025-01-01 DOI:10.1080/20905998.2025.2451488

Mohamed Wael Ragab, Khaled Ahmed Shawky, Ahmed Zein Eldin Fathy Bendary, Abo-Almagd Mohamed Albohy

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引用次数: 0

Abstract

Objective: Botulinum neurotoxin (BoNT) was introduced as a minimally invasive treatment option for erectile dysfunction (ED). However, there is no proven method that predicts improvement after BoNT injection. Shear wave elastography is an emerging imaging modality that evaluates tissue stiffness. This study aims to assess the reliability of SWE in predicting BoNT response in patients with ED and phosphodiesterase 5 inhibitors (PDE-5i) non-responders.

Methods: This study comprised 20 men presenting with ED and PDE-5i non-responders. Mean tissue stiffness values (TSVs) were measured by SWE, international index of erectile function (IIEF-5), erection hardness score (EHS), sexual encounter profile questions 2 and 3 (SEP-2 and SEP-3), and global assessment questionnaire (GAQ) were evaluated before and after 100 IU of BoNT injection by 6 and 12 weeks.

Results: In comparison with baseline, there was a significant improvement in IIEF-5 and EHS scores after BoNT injection at 6- and 12 weeks (p < 0.001). Similar improvements were observed in SEP-2&3 (p < 0001 & p = 0.001, respectively) and GAQ-1&2 (p = 0.008 & p = 0.006, respectively). We found that mean SWE in a penile flaccid state can predict failure of clinically significant improvement after BoNT injection using a cutoff point of 12.7 kPa (sensitivity = 100%, specificity = 54%, AUC = 0.86, p = 0.014).

Conclusion: This finding could be applied to avoid unnecessary BoNT injections in men with ED and PDE-5i non-responders.

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阴茎剪切波弹性成像预测肉毒杆菌神经毒素（Botox）对磷酸二酯酶-5抑制剂无反应的管理结果：一项初步研究。

目的：引入肉毒杆菌神经毒素（BoNT）作为勃起功能障碍（ED）的微创治疗选择。然而，目前还没有经过验证的方法可以预测BoNT注射后的改善。横波弹性成像是一种评估组织刚度的新兴成像方式。本研究旨在评估SWE预测ED和磷酸二酯酶5抑制剂（PDE-5i）无反应患者BoNT反应的可靠性。方法：本研究纳入了20名ED和PDE-5i无反应的男性。分别于注射100 IU BoNT前后6周和12周，采用SWE测量平均组织刚度值（tsv）、国际勃起功能指数（IIEF-5）、勃起硬度评分（EHS）、性接触剖面问题2和3 （SEP-2和SEP-3）以及总体评估问卷（GAQ）。结果：与基线相比，BoNT注射后第6周和12周IIEF-5和EHS评分（p p分别= 0.001）和GAQ-1&2评分（p = 0.008和p = 0.006）均有显著改善。我们发现阴茎松弛状态的平均SWE可以用12.7 kPa的截断点预测BoNT注射后临床显著改善的失败（敏感性= 100%，特异性= 54%,AUC = 0.86, p = 0.014）。结论：这一发现可用于避免ED和PDE-5i无反应男性不必要的BoNT注射。

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

Arab Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

2.80

自引率

0.00%

发文量

期刊介绍： The Arab Journal of Urology is a peer-reviewed journal that strives to provide a high standard of research and clinical material to the widest possible urological community worldwide. The journal encompasses all aspects of urology including: urological oncology, urological reconstructive surgery, urodynamics, female urology, pediatric urology, endourology, transplantation, erectile dysfunction, and urinary infections and inflammations. The journal provides reviews, original articles, editorials, surgical techniques, cases reports and correspondence. Urologists, oncologists, pathologists, radiologists and scientists are invited to submit their contributions to make the Arab Journal of Urology a viable international forum for the practical, timely and state-of-the-art clinical urology and basic urological research.