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Volume 23, Issue 5 (September 2021) 23, 462–467; 10.4103/aja.aja_15_21

Efficacy of penile low-intensity shockwave treatment for erectile dysfunction: correlation with the severity of cavernous artery disease

Nicola Caretta1, Maurizio De Rocco Ponce1, Nadia Minicuci2, Ilaria De Santis3, Pierfrancesco Palego1, Andrea Garolla1, Carlo Foresta1

1 Department of Medicine, University of Padova, Padova 35128, Italy
2 CNR, Neuroscience Institute, Padova 35128, Italy
3 Foresta Foundation Onlus for Biomedical Research, Padova 35128, Italy

Correspondence: Dr. N Caretta (ncaretta@gmail.com)

Date of Submission 02-Jul-2020 Date of Acceptance 13-Jan-2021 Date of Web Publication 16-Mar-2021


We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction (ED) combined with cavernous artery disease (CAD). ED was evaluated by the International Index of Erectile Function, subdividing patients into mild and moderate/severe forms. CAD was assessed using penile color Doppler ultrasonography. Patients (n = 111) with a positive outcome after treatment, based upon the minimal clinically important difference of the International Index of ED, were followed up for 3 months and 6 months. We found a significant mean increase in the index of erectile function, with an overall improvement in hemodynamic parameters of the cavernous artery. In particular, 93.9% of the patients with mild ED without CAD responded to treatment and 72.7% resumed normal erectile function. Only 31.2% of the patients with moderate/severe ED and CAD responded to treatment, and none resumed normal erectile function. All patients with mild ED and no CAD maintained the effects of therapy after 3 months, while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months. Thus, patients with mild ED and no CAD have better and longer lasting responses to such treatment, with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.

Keywords: cavernous artery disease; erectile dysfunction; extracorporeal shockwave therapy; International Index of Erectile Dysfunction; penile color Doppler ultrasound

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