Comparative effectiveness of focused shockwave therapy and radial wave therapy for erectile dysfunction: a two center prospective cohort study

Efectividad comparativa de la terapia de ondas de choque focalizadas y la terapia de ondas radiales en la disfunción eréctil: estudio de cohorte prospectivo multicéntrico

Background: Focused shockwave therapy (fSWT) has now taken its place in the algorithm for the treatment of vascular erectile dysfunction (ED) in current guidelines. Radial wave therapy (rWT) has started to be applied with the same indication in recent years and positive results have been reported. We aimed to compare the long-term effectiveness of fSWT and rWT in ED. Methods: A two-center study enrolled 200 patients aged 40 to 70 years with ED complaints. Patients were non-randomly allocated to either fSWT or rWT groups based on the clinic they visited. Results: After 3 months, the mean International Index of Erectile Function (IIEF) score for patients in the fSWT group was significantly higher compared with the baseline (13 ± 2.9 vs. 20.4 ± 4.7, p < 0.001), and the same trend was observed at 1 year (13 ± 2.9 vs. 18.1 ± 4.9, p < 0.001). Similarly, in the rWT group, the mean IIEF score was significantly higher at 3 months (13.1 ± 3 vs. 22.8 ± 4.6, p < 0.001) and 1 year (13.1 ± 3 vs. 19.4 ± 4.9, p < 0.001) compared with the baseline. However, there was no significant difference in the mean IIEF score changes between the two groups at both 3 months and 1 year. The proportion of patients giving a positive response to the Sexual Encounter Profile-2 (SEP-2) question was 81% at 3 months and 63.2% at 1 year in the fSWT group, and 88.9% at 3 months and 71.6% at 1 year in the rWT group, with no significant difference between the groups. Conclusions: Both fSWT and rWT are effective treatments for vascular-related ED, showing comparable efficacy in improving IIEF scores. Clinical Trial Registration: The study was retrospectively registered with https://www.isrctn.com/ as: ISRCTN14000407.

Resumen

Antecedentes: Nuestro objetivo fue comparar la efectividad a largo plazo de la terapia con ondas de choque focalizadas (fSWT) y la terapia con ondas radiales (rWT) en la disfunción eréctil. Métodos: En este estudio bicéntrico se incluyeron 200 pacientes de entre 40 y 70 años con quejas de disfunción eréctil. Los pacientes fueron asignados de forma no aleatoria a los grupos fSWT o rWT según el centro al que acudieron. Resultados: A los 3 meses, la puntuación media del Índice Internacional de Función Eréctil (IIEF) en el grupo fSWT fue significativamente superior a la basal (13 ± 2.9 vs. 20.4 ± 4.7; p < 0.001), manteniéndose esta mejoría al año (13 ± 2.9 vs. 18.1 ± 4.9; p < 0.001). De forma similar, en el grupo rWT la puntuación media del IIEF fue significativamente mayor a los 3 meses (13.1 ± 3 vs. 22.8 ± 4.6; p < 0.001) y al año (13.1 ± 3 vs. 19.4 ± 4.9; p < 0.001) en comparación con el valor basal. No se observaron diferencias significativas en los cambios medios del IIEF entre ambos grupos ni a los 3 meses ni al año. La proporción de pacientes con respuesta positiva a la pregunta el Perfil de Encuentro Sexual-2 (SEP-2) fue del 81% a los 3 meses y del 63.2% al año en el grupo fSWT, y del 88.9% a los 3 meses y del 71.6% al año en el grupo rWT, sin diferencias significativas entre los grupos. Conclusiones: Tanto la fSWT como la rWT son tratamientos eficaces para la disfunción eréctil de origen vascular, con una eficacia comparable en la mejoría de las puntuaciones del IIEF. Registro del Ensayo Clínico: Este estudio fue registrado retrospectivamente en https://www.isrctn.com/ con el identificador: ISRCTN14000407.

Erectile dysfunction; Focused shock wave; Non-focused; Radial wave

Palabras Clave

Disfunción eréctil; Terapia con ondas de choque focalizadas; Terapia con ondas radiales; Ondas de choque no focalizadas

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