For a study, researchers sought to examine the effectiveness and viability of linear low-intensity extracorporeal shockwave therapy (LI-LiESWT) as a penile rehabilitation technique for erectile dysfunction (ED) following bilateral nerve-sparing (NS) radical prostatectomy (RP).
Inclusion criteria for a study comprised patients who had had bilateral NS RP (either radical retropubic prostatectomy or robot-assisted laparoscopic RP) 3 or more months before the trial, had no ED preoperatively, and had mild to severe postoperative ED. Using the linear shockwave tissue coverage (LSTC-ED®) approach and the PiezoWave2 device with a linear shockwave applicator, 4 treatments were administered over the course of 4 weeks. If 2 months after initiating LI-LiESWT, the improvement in erectile function was still deemed unsatisfactory (less than an IIEF-5 score of 22–25), pharmaceutical penile rehabilitation was added. After a year, the treatment’s full impact was assessed. The primary outcome measure was the 5-item International Index of Erectile Function (IIEF-5) score changes.
A total of 40 patients were included in the trial between September 2019 and September 2020, and they were randomly split into 2 groups: the treatment group and the sham group. About 8 individuals were not investigated because they had other medical issues that required treatment, and they were thus omitted from the research (COVID-19 disease, postoperative incontinence, urethral stricture, and ischemic stroke). The final analysis comprised 32 patients: 16 from the control group and 16 from the therapeutic group. Patients in the treatment and sham groups both reached physiological IIEF-5 values 6 months after the conclusion of therapy, and the positive impact remained for 12 months after the end of treatment.
Because of the vasculogenic impact of LI-LiESWT as well as its neuroprotective and/or regenerative effects, the LSTC-ED® approach was an appropriate and secure treatment for penile rehabilitation in patients with ED following bilateral NS RP.