Effects of Low-Intensity Shock Wave Therapy on Erectile Function and Penile Vascular Parameters in Men with Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

PURPOSE: This systematic review and meta-analysis of randomized controlled trials evaluated the effects of low-intensity shock wave therapy (LiSWT) on erectile function (EF) and penile vascular parameters in men with erectile dysfunction (ED), compared with controls receiving sham or no treatment. MATERIALS AND METHODS: A systematic search of Scopus, PubMed, and Cochrane databases identified studies assessing LiSWT in men with ED. Primary outcomes were changes in the International Index of Erectile Function (IIEF)-5 and the IIEF-EF domain scores. Secondary outcomes included erection hardness score (EHS), sexual encounter profile (SEP) diary Q2 and Q3, global assessment question (GAQ) scores, and penile Doppler ultrasound parameters-peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI). Changes from baseline to the end of follow-up were compared between LiSWT and control groups. RESULTS: Of 527 retrieved articles, 12 met inclusion criteria. Pooled analysis demonstrated significantly greater improvements in the LiSWT group for IIEF-5 (standardized mean difference [SMD], 1.19; 95% confidence interval [CI], 0.47-1.91; p=0.001) and IIEF-EF (SMD, 1.24; 95% CI, 1.02-1.45; p