Indirect assessment of low-intensity shockwave therapy's energy density and pulse frequency for erectile dysfunction: a systematic review, bayesian network meta-analysis and meta-regression.

Hinojosa-Gonzalez, David E; Talamas Mendoza, Alejandro; Torres-Martinez, Mauricio; Diaz-Garza, Karla; Hernandez, Beatriz S; Muñoz Hibert, Monica Isabel; Ramirez-Mulhern, Isabela; Morales Palomino, Kimberly Lizet; Gonzalez-Oyervides, Roberto

Hinojosa-Gonzalez, David E; Talamas Mendoza, Alejandro; Torres-Martinez, Mauricio; Diaz-Garza, Karla; Hernandez, Beatriz S; Muñoz Hibert, Monica Isabel; Ramirez-Mulhern, Isabela; Morales Palomino, Kimberly Lizet; Gonzalez-Oyervides, Roberto.

Afiliación

Hinojosa-Gonzalez DE; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico. David.Hinojosa-Gonzalez@bcm.edu.
Talamas Mendoza A; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. David.Hinojosa-Gonzalez@bcm.edu.
Torres-Martinez M; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.
Diaz-Garza K; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.
Hernandez BS; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.
Muñoz Hibert MI; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.
Ramirez-Mulhern I; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.
Morales Palomino KL; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.
Gonzalez-Oyervides R; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, Monterrey, NL, 64000, Mexico.

Int J Impot Res ; 2024 May 23.

Article en En | MEDLINE | ID: mdl-38778153

ABSTRACT

ABSTRACT

Shockwaves are thought to activate regenerative and angiogenic pathways, providing a possible therapeutic benefit for patients with erectile dysfunction. This study aimed to analyze the effectiveness of low-intensity extracorporeal shockwave therapy energy density and pulse frequency. In May 2022, a systematic search of online databases was performed to identify randomized clinical trials related to low-intensity extracorporeal shockwave therapy in erectile dysfunction. Eligible articles compared low-intensity extracorporeal shockwave therapy to controls or sham procedures. A Bayesian framework with 200,000 Markov chains was performed. We included a total of 1272 patients from 18 studies. The energy flux density measured in joules included 0.09 mJ/mm2 (mean difference 3.2 IIEF [95% CrI 2.8, 3.6]), 0.15 mJ/mm2 (mean difference 4.9 IIEF [95% CrI 2.8, 7.2]) and 0.20 mJ/mm2 (mean difference 1.2 IIEF [95% CrI 0.11, 2.3]). Of these, 0.15 mJ/mm2 had the greatest ranking (SUCRA = 0.983) compared with placebo. When analyzed by pulse frequency, significant increases were found in 500 pulses/session (mean difference 2.5 IIEF [CrI 1.9, 3.2]), 1500 pulses/session (mean difference 4.6 IIEF [95% CrI 3.9, 5.4]) and > 3000 pulses/session (mean difference 3.1 IIEF [95% CrI 2.1, 4.2]). Of these, 1500 pulses/session had the highest SUCRA, at 0.996. Our network meta-analysis suggests that low-intensity extracorporeal shockwave therapy is an effective intervention for erectile dysfunction, as measured by increases in the IIEF-EF. Sessions featuring 1500 pulses and an energy flux density of 0.15 mJ/mm2 appear to be the most effective.

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Impot Res Asunto de la revista: MEDICINA REPRODUTIVA / UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: México Pais de publicación: Reino Unido

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