Session: MP79: Sexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy II
MP79-19: Indirect Assessment of Low Intensity Shockwave Therapy’s Energy Density and Pulse Frequency for Erectile Dysfunction: A Bayesian Network Meta-Analysis and Meta-Regression
Introduction: Erectile dysfunction(ED) is the persistent inability to achieve and maintain penile rigidity necessary for sexual activity. Emerging alternative therapies such as Low – intensity shockwave therapy (LiST) are a possible therapeutic alternative, these are hypothesized to activate regenerative pathways, enhancing endothelial function, angiogenesis and neuroplasticity. This study aims to employ a network meta-analysis framework to compare LiSWT energy density and pulse frequency’s effectivenes. Methods: In May 2022 a systematic search of online databases PubMed, MEDLINE, Scopus, Web of Science and Google Scholar was performed. Search terms included keywords “Erectile dysfunction”, “Management of Erectile Dysfunction”, “Shock wave therapy for Erectile Dysfunction”. Abstracted RCTs were used to model data for IIEF networks analyzed through a Bayesian Network framework. Results: A total of 1,207 patients were included. Treatment stratification by energy delivery as measured by joules, which included 0.09, 0.15, and 0.20 as well as radial waves revealed LiST to be effective regardless of intensity while radial waves were found to have non-significant differences with placebo groups. Out of these interventions, 0.15 joules had the greatest increase in IIEF at a MD vs Placebo of 4.9[2.8,7.2] and the highest ranking at SUCRA=0.983. Treatment stratification by number of pulses per session, which included 500, 1500, and >3000 as well as radial waves revealed all of the aforementioned interventions except radial waves to have a significant increase in IIEF. Out of these, 1500 pulses/session had the highest ranking with a MD vs Placebo of 4.6[3.9,5.4] SUCRA = 0.996 Conclusions: Our network meta-analysis suggests LI-SWT to be an effective intervention for ED as measured by increases in IIEF compared to placebo. Sessions featuring 1,500 shocks and energy density of 0.15 joules appear to be the most effective while radial waves did not seem to be an effective intervention. Further high quality studies such as randomized controlled clinical trials are needed to validate these findings. SOURCE OF Funding: No funding was received.
