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Updated: Mar 6, 2026
Author Spotlight: Effectiveness of Extracorporeal Shockwave Therapy in Achilles Tendinopathy Treatment
Published on: August 2, 2024
Low-intensity extracorporeal shock wave therapy in vasculogenic erectile dysfunction refractory to PDE5 inhibitors: a
Giuseppe Saitta1, Giuseppe Di Paola1, Simone Di Salvatore2
1Istituto Clinico Città Studi, Milan.
Background:
Low-intensity extracorporeal shock wave therapy (Li-ESWT) has emerged as a promising treatment for vasculogenic erectile dysfunction (ED), particularly in men who do not respond to phosphodiesterase type-5 inhibitors (PDE5-Is).
Objective:
To evaluate the feasibility, safety, and clinical effectiveness of Li-ESWT in men with vasculogenic ED through a prospective 12- and 18-month follow-up.
Methods:
A prospective observational study was conducted on 188 patients with vasculogenic ED and inadequate response to PDE5-Is. Patients underwent 6 weekly sessions of Li-ESWT. Erectile function was assessed using the international index of erectile function (IIEF) and erection hardness score (EHS). Responders were defined as those achieving ≥ 3-point improvement on IIEF-EF and/or EHS ≥3.
Results:
Mean age was 66.6 years; mean ED duration was 24 months. IIEF-EF improved from 11 at baseline to 21 at 12 months and 18 at 18 months. At 12 months, 71% of patients showed improvement in EHS. Younger age (<45 years), shorter ED duration (<12 months), and moderate baseline severity predicted better response (p<0.05). Sustained improvement was observed in 65% of patients at 12 months and 54% at 18 months. No adverse events were reported.
Conclusions:
Li-ESWT is a safe and effective treatment for vasculogenic ED unresponsive to PDE5-Is, with maximum benefit observed within 12 months. Efficacy tends to decline at 18 months. Larger controlled studies are needed to define long-term outcomes.
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