Low-intensity shockwave therapy for erectile dysfunction due to diabetes mellitus or coronary artery disease: An individual participant data meta-analysis from a single center.

Background: Low-intensity shockwave therapy (LiST) is a first-line treatment for vasculogenic erectile dysfunction (ED). However, its efficacy in challenging cases, such as ED solely due to type 2 diabetes mellitus (DM) or coronary artery disease (CAD), has not been adequately assessed. Materials and Methods This study presents an individual participant data meta-analysis of five double-blind randomized controlled trials involving 208 patients treated in a single academic center using a standardized LiST protocol (ARIES 2 generator, 5000 impulses/session). Results For outcomes, including International Index of Erectile Function-Erectile Function Domain scores, sexual encounter profile question 3 responses, resistance index, and minimal clinically important differences, LiST was equally effective in patients with ED due to DM or CAD compared to other causes. Subgroup analyses showed equivalent efficacy for 6 versus 12 LiST sessions. No adverse events were reported. Conclusions These findings confirm LiST's safety and effectiveness across different causes of vasculogenic ED, supporting its broader application in clinical practice.