DOES LOW-INTENSITY EXTRACORPOREAL SHOCK WAVE THERAPY HAVE A PHYSIOLOGIC EFFECT ON ERECTILE FUNCTION? SHORT-TERM RESULTS OF A RANDOMIZED, DOUBLE-BLIND, SHAM-CONTROLLED STUDY

FEBS Lett. 2002 Jun 5;520(1-3):153-5.

Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock wavestreatment.

Gotte GAmelio ERusso SMarlinghaus EMusci GSuzuki H.

Source

Dipartimento di Scienze Neurologiche e della Visione, Sezione di Chimica Biologica, Università di Verona, Verona, Italy.

Abstract

The evidence that nitric oxide (NO) production is possible by a non-enzymatic pathway has already been shown under restrictive experimental conditions. Here we show that NO can non-enzymatically be formed with short-time kinetics (min), by ‘bombing’ with shock waves a solution containing 1 mM hydrogen peroxide and 10 mM L-arginine. This procedure is widening its medical application with surprisingly positive effects in tissue regeneration and our finding could be one of the first steps for the understanding of the biochemical responsible for these therapeutical effects.
PMID:12044888 PubMed – indexed for MEDLINE]

 

The Journal of Urology Volume 187, Issue 4, Supplement , Page e606, April 2012
DOES LOW-INTENSITY EXTRACORPOREAL SHOCK WAVE THERAPY HAVE A PHYSIOLOGIC EFFECT ON ERECTILE FUNCTION? SHORT-TERM RESULTS OF A RANDOMIZED, DOUBLE-BLIND, SHAM-CONTROLLED STUDY
Vardi, Appel, Kilchevsky, Gruenwald
 

Affiliations

  • ·Haifa, Israel
INTRODUCTION AND OBJECTIVES
Low-intensity extracorporeal shockwave therapy (LI-ESWT) is currently under investigation regarding its ability to promote neovascularization in different organs. Our aim is to study the clinical and physiologic effect of LI-ESWT on the erectile function of men with erectile dysfunction (ED) and cardiovascular risk factors who are phosphodiesterase-5 inhibitor (PDE5i) responders.
METHODS
After a 1-month PDE5i washout period, 67 men were randomized in a 2:1 ratio to receive either 12 sessions of LI-ESWT (treated) or sham therapy (sham-treated). Erectile function and penile hemodynamics were assessed prior to the first treatment (V1) and one month after the final treatment (FU1) using validated sexual function questionnaires and veno-occlusive strain gauge plethysmography.
RESULTS
Clinically, we found a significantly greater increase in the International Index of Erectile Function-ED (IIEF-ED) domain score from V1 to FU1 in the treated group versus the sham-treated group (6.7±0.9 vs. 3.0±1.4 [mean ± SEM], P=0.0322). Nineteen men in the treated group who were unable to achieve erections hard enough for penetration initially (Erection Hardness Score (EHS) ≤ 2) were subsequently able to achieve erections firm enough for penetration (EHS ≥ 3) following treatment, compared to none in the sham-treated group. Physiologically, penile blood flow significantly improved in the treated group versus the sham-treated group (maximal post-ischemic penile blood flow: 8.2 ml/min/dL vs 0.1 ml/min/dl, p<0.0001). None of the men experienced discomfort or reported any adverse effects due to the treatment.
CONCLUSIONS
This is the first randomized, double-blind, sham-controlled study showing that LI-ESWT has a positive short-term clinical and physiologic effect on the erectile function of men who respond to oral PDE5i therapy. The feasibility and tolerability of this treatment, coupled with its potential rehabilitative characteristics, make it an attractive new therapeutic option for men with ED.
Source of Funding: Medispec Ltd, Israel provided a partial unrestricted grant that included the use of the focused shockwave probe, Omnispec ED1000.
PII: S0022-5347(12)02381-6
Inflamm Allergy Drug Targets. 2012 Feb;11(1):48-57.