Presentation Authors: Kleiton Yamaçake, Felipe Carneiro, Rodolfo Lourenço, Affonso Celso Piovesan*, Miguel Srougi, William Carlos Nahas, Ioannis Michel Antonopoulos, Sao Paulo, Brazil
Introduction: Erectile dysfunction (ED) in kidney transplant patients is not uncommon. The ideal treatment modality should not interfere with the graft function. Low-intensity Shock Wave Therapy Extracorporeal (Li-ESWT) has been of interest due to its angiogenic properties and has shown interesting results when used to treat patients with cardiovascular disease and non-transplanted men with ED. Our objective is to study the efficacy and safety of Li- ESWT for the treatment of ED in kidney transplanted men of probable vascular etiology.
Methods: Twenty men (mean age = 53.7 years, range 46 to 61 years ) that have been submitted to kidney transplant for at least 6 months and have been suffering from ED for at least 6 months were selected for the treatment. This was a double-blinded, single-center, prospective, randomized, sham-controlled trial. The ESWT protocol was based in a 2 treatment sessions per week for 3 weeks.The sham treatment was performed using the same device replacing the effective probe for one that emits zero energy, but delivers a sound and pulse sensation during treatment. Follow-up assessment was performed with International Index of Erectile Function Questionnaire (IIEF) score and Erection Hardness Score (EHS) after 1, 4 and 12 months.
Results: A total of 20 patients were recruited into the study. 10 patients were randomized into the sham therapy arm and 10 patients into the Li-ESWT arm. Groups were similar regarding the baseline IIEF score and EHS. IIEF score improvement was higher than 5 in 70% (ranged from 0-10) and in 10% (ranged from 1-14) in Li-ESWT and Sham groups, respectively. IIEF and EHS improvement were statistically significant in Li-ESWT group, p < 0,0001. The mean change in IIEF score after 12 months was 4.8in Li-ESWT group. Data is illustrated in Graphic 1.
Conclusions: Li-ESWT is a non pharmacological treatment with clinical efficacy. Besides its rehabilitative potential, this treatment is feasible, tolerable and effective. Further studies are needed to determine the optimal treatment protocols.