Extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP) have shown potential in treating erectile dysfunction (ED). Combining these two therapies could potentially amplify their effects and provide a more effective treatment option for ED. The study focused on the ability of ESWT and the combination of PRP with ESWT to correct ED.

164 men with ED were assigned to 2 groups. Group 1 (n=82) received ESWT per penile (Dornier Aries) twice weekly for 6 weeks. The average age was 40.1 years (20-69), and the duration of ED was 4.1 years (0.5-19). Group 2 (n=82) received 2 therapy sessions per week for 6 weeks; the average age was 45.6 years (19-71), and the duration of ED was 3.7 years (0.5-16). Session 1 included ESWT per penile and PRP injections into the penile; finally, PRP was activated with ESWT. Session 2 included ESWT per penile. All men were evaluated at days 0 and 60 of the study using IIEF-5, EHS, SEP, GAQ, D-PDU (median (IQR%). The study was approved by the Ethics Committee of the RUDN Medical Institute.

At the beginning, data for the first group will be presented. IIEF-5 improved from 13.1 (9.3-19.1) to 20.2 (15.9-22.6) (p<0.001). SEP changed from 2.4 (1-3) to 3 (2-4) (p<0.001). EHS improved from 1.2 (1-2) to 3 (2.4-3) (p<0.001). Baseline PSV was 15.5 cm/s (11.6-24.5); at 60 days post-ESWT, PSV was 25.8 cm/s (20.2-28.9) (p<0.001), RI changed from 0.69 (0.7-0.9) to 0.91 (0.81-1) (p<0.05) according to D-PDU. Total testosterone level increased from 13.0 nmol/l (9.0-18.6) to 15.72 nmol/l (11.3-19.7) (p>0.05). 55 patients (67%) noted positive dynamics by the GAQ at the last examination. After that, data on the second group will be presented. IIEF-5 was 12.6 (10-16) at 0 days, 19.6 (17-23) at 60 days (p<0.001). SEP improved from 2 (1.5-3) to 3.8 (3-4) post combined treatment (p<0.001). EHS changed from 2 (1-2) to 3 (3-4) (p<0.001) at the last examination. D-PDU results demonstrated an increase in median PSV from 16.5 cm/s (12.7-23.1) to 28 cm/s (23.3-34.9) (p<0.001) and median RI from 0.76 (0.65-1) to 1 (0.88-1) (p<0.05). Total testosterone level elevated from 14.01 nmol/l (9.6-23.7) to 16.9 (12.8-22.5) (p>0.05). 68 men declared positive effects according to GAQ (82.9%). Intergroup comparison demonstrates that combination therapies (group 2) significantly increase erectile function according to SEP, EHS, PDDU (p<0.05). The IIEF-5 scores did not differ significantly between the groups.

These suggested treatments were well-tolerated by all patients. Extracorporeal shock wave therapy and the combination of platelet-rich plasma plus are effectiveness methods for correcting erectile dysfunction. PRP plus ESWT is a more attractive therapy due to its greater effectiveness.

The proposed treatment is a promising method of treatment of men in this population. The study continues on a larger sample of patients.

Continence 12S (2024) 101544
DOI: 10.1016/j.cont.2024.101544