Low-intensity shockwave therapy plus tadalafil improves erectile function in men with ED

Combination treatment with 12 sessions of low-intensity shockwave therapy (LiST) three times weekly and daily tadalafil for 4 weeks results in a 2-point difference in the International Index of Erectile Function–Erectile Function domain (IIEF-EF) compared with sham therapy plus tadalafil in patients with severe vasculogenic erectile dysfunction (ED) after 1 and 3 months of treatment completion.

The absolute scores in the IIEF-EF after treatment were higher in men receiving LiST plus tadalafil than in those receiving sham therapy plus tadalafil both at the 1-month (12.1 vs 10.2; p=0.002) and 3-month (12.9 vs 10.8; p<0.001) assessment.

Of note, the proportion of “yes” responses to question 3 of the Sexual Encounter Profile (SEP) diary between the two groups did not reach statistical significance, while the number of patients achieving a minimally clinically important difference in the IIEF-EF was statistically significant only at the 3-month evaluation period. Adverse events were not reported.

“Application of LiST in patients with severe vasculogenic ED receiving daily dose tadalafil may further improve erectile function compared with tadalafil as a stand-alone treatment on the short term,” the investigators said.

This study included 48 sexually active men who were randomized to receive either 12 sessions of LiST three times weekly and tadalafil 5 mg once daily (n=34) or sham therapy plus tadalafil (n=17) for 4 weeks. The investigators examined patients at 1 and 3 months after treatment completion. They assessed erectile function improvement using the IIEF-EF or 6-item IIEF and the SEP diary.

“Although we provided the first study in the field, severe vasculogenic ED was defined based on medical history and clinical examination and not based on penile ultrasound measures,” the investigators noted.