Erectile Function Recovery Using Shockwave and Platelet-Rich Plasma: A Single-Centre Prospective Comparative Study.

Area of Science:

• Urology
• Regenerative Medicine
• Vascular Biology

Background:

• Arteriogenic erectile dysfunction (ED) necessitates effective treatment strategies.
• Low-intensity extracorporeal shockwave therapy (Li-ESWT) and platelet-rich plasma (PRP) are potential therapeutic options.
• Comparative analysis of Li-ESWT, PRP, and their combination is crucial for optimizing ED treatment.

Purpose of the Study:

• To compare the efficacy of Li-ESWT, PRP, and combination therapy for arteriogenic ED.
• To evaluate the impact of these treatments on erectile function and penile haemodynamics.
• To determine the most effective and sustained treatment approach for ED.

Main Methods:

• Prospective observational study involving 400 men aged 35-65 with arteriogenic ED.
• Participants were randomized into four groups: Li-ESWT, PRP, Li-ESWT + PRP, and Control.
• Outcomes assessed using the International Index of Erectile Function (IIEF-5) and penile Doppler ultrasonography (peak systolic velocity [PSV], end-diastolic velocity [EDV]) at baseline and 1, 3, and 6 months post-treatment.

Main Results:

• Li-ESWT significantly improved IIEF-5 scores at 3 months (p=0.001), with sustained effects at 6 months.
• PRP monotherapy showed transient mild improvement at 1 month (p=0.028) but no significant long-term effect (p=0.119).
• Combination therapy (Li-ESWT + PRP) yielded the most pronounced and sustained improvements in IIEF-5 scores and PSV (p=0.001), with negligible EDV changes.

Conclusions:

• Combination therapy of Li-ESWT and PRP is superior for treating arteriogenic ED, offering substantial and lasting improvements.
• Li-ESWT alone demonstrates notable efficacy, while PRP monotherapy provides limited, short-lived benefits.
• The combined approach significantly enhances both erectile function and arterial haemodynamics in patients with ED.