Do Antiplatelet Drugs Use Contribute to Clinical Outcomes in Patients Receiving Penile Low-Intensity Shock Wave Therapy (Li-SWT) for Erectile Dysfunction?
Year 2023,
, 194 - 198, 31.08.2023
Serdar Geyik
,
Mutlu Deger
,
Nebil Akdogan
,
Nâzım Abdülkadir Kankılıç
,
İsmail Önder Yılmaz
,
İbrahim Atilla Arıdoğan
Abstract
Introduction: Low-intensity extracorporeal shock wave therapy (Li-SWT) is one of the recommended treatment options in patients with erectile dysfunction (ED). Li-SWT is safe in patients using antiplatelet drugs (APs), however, there are no specific studies on the contribution of APs use to clinical improvement in erectile function. We aimed to evaluate the early clinical results of Li-SWT administration and whether the use of APs had an additional positive contribution to clinical improvement and safe in ED patients.
Materials and Methods: Patients with ED for more than 6 months despite using (5 mg/day) PDE5i were included in our study. Patients treated with Li-SWT and using PDE5i were classified as Group 1, patients treated with Li-SWT and using APs and using PDE5i were considered Group 2. The evaluation results of the International Index of Erectile Function-Erectile Function Area(IIEF-EF) in all patients baseline and after treatment were examined.
Results: There are 25 patients in each group. Analysis of IIEF-EF scores showed significant increases in both groups after treatment [group 1 (p=0.001); group 2 (p=0.001)]. When the IIEF-EF scores of the groups before and after the treatment were compared with each other; it was shown that baseline scores were similar(p=0.746) and that APs use had no statistically significant effect on post-treatment scores (p=0.613) No side effects were seen in APs.
Conclusion: This study showed that penile Li-SWT significantly increases the IIEF-EF scores and response of (5 mg/day) PDE5i in ED patients and safe, also in AP users. However, Using AP in Li-SWT does not contribute positively to clinical results.
References
- 1. Miner M, Kim ED. Cardiovascular disease and male sexual dysfunction. Asian J Androl 2015; 17: 3-4.
https://doi.org/10.4103/1008-682X.143753
- 2. Campbell JD, Trock BJ, Oppenheim AR, et al. Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction. Ther Adv Urol 2019; 11: 1756287219838364.
https://doi.org/10.1177/1756287219838364
- 3. Dorsey P, Keel C, Klavens M, et al. Phosphodiesterase type 5 (PDE5) inhibitors for the treatment of erectile dysfunction. Expert Opin Pharmacother 2010; 11: 1109-1122.
https://doi.org/10.1517/14656561003698131
- 4. Shamloul R, Ghanem H. Erectile dysfunction. Lancet 2013; 381: 153-165.
https://doi.org/10.1016/S0140-6736(12)60520-0
- 5. Campbell JD, Milenkovic U, Usta MF, et al. The good, bad, and the ugly of regenerative therapies for erectile dysfunction. Transl Androl Urol 2020; 9: S252-S261.
https://doi.org/10.21037/tau.2019.10.06
- 6. Sokolakis I, Dimitriadis F, Teo P, et al. The Basic Science Behind Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Scoping Review of Pre-Clinical Studies. J Sex Med 2019; 16: 168-194.
https://doi.org/10.1016/j.jsxm.2018.12.016
- 7. Liu T, Shindel AW, Lin G, et al. Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy. Int J Impot Res 2019; 31: 170-176.
https://doi.org/10.1038/s41443-019-0113-3
- 8. Schoofs E, Fode M, Capogrosso P, et al. Current guideline recommendations and analysis of evidence quality on low-intensity shockwave therapy for erectile dysfunction. Int J Impot Res 2019; 31: 209-217.
https://doi.org/10.1038/s41443-019-0132-0
- 9. Ziegler M, Wang X, Peter K. Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target. Cardiovasc Res 2019; 115: 1178-1188.
https://doi.org/10.1093/cvr/cvz070
- 10. Putilina MV. [Endothelium as a target for new therapeutic strategies in cerebral vascular diseases]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117: 122-130.
https://doi.org/10.17116/jnevro2017117101122-130
- 11. Kalyvianakis D, Memmos D, Mykoniatis I, et al. Low-Intensity Shockwave Therapy (LiST) for Erectile Dysfunction: Is It Safe for Patients on Anticoagulant Medication? J Sex Med 2019; 16: 1478- 1480.
https://doi.org/10.1016/j.jsxm.2019.05.008
- 12. Reisman Y, Hind A, Varaneckas A, et al. Initial experience with linear focused shockwave treatment for erectile dysfunction: a 6-month follow-up pilot study. Int J Impot Res 2015; 27: 108-112.
https://doi.org/10.1038/ijir.2014.41
- 13. Cappelleri JC, Rosen RC, Smith MD, et al. Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology 1999; 54: 346-351.
https://doi.org/10.1016/S0090-4295(99)00099-0
- 14. Wu SS, Ericson KJ, Shoskes DA. Retrospective comparison of focused shockwave therapy and radial wave therapy for men with erectile dysfunction. Transl Androl Urol 2020; 9: 2122-2128.
https://doi.org/10.21037/tau-20-911
- 15. Vardi Y, Appel B, Jacob G, et al. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol 2010; 58: 243-248.
https://doi.org/10.1016/j.eururo.2010.04.004
- 16. Vardi Y, Appel B, Kilchevsky A, et al. Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol 2012; 187: 1769-1775.
https://doi.org/10.1016/j.juro.2011.12.117
- 17. Verze P, Capece M, Creta M, et al. Efficacy and safety of low-intensity shockwave therapy plus tadalafil 5 mg once daily in men with type 2 diabetes mellitus and erectile dysfunction: a matched-pair comparison study. Asian J Androl 2020; 22: 379-382.
https://doi.org/10.4103/aja.aja_121_19
- 18. Gruenwald I, Appel B, Kitrey ND, et al. Shockwave treatment of erectile dysfunction. Ther Adv Urol 2013; 5: 95-99.
https://doi.org/10.1177/1756287212470696
- 19. Sokolakis I, Dimitriadis F, Psalla D, et al. Effects of low-intensity shock wave therapy (LiST) on the erectile tissue of naturally aged rats. Int J Impot Res 2019; 31: 162-169.
https://doi.org/10.1038/s41443-018-0064-0
- 20. Srini VS, Reddy RK, Shultz T, et al. Low intensity extracorporeal shockwave therapy for erectile dysfunction: a study in an Indian population. Can J Urol 2015; 22: 7614-7622.
- 21. Lu Z, Lin G, Reed-Maldonado A, et al. Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis. Eur Urol 2017; 71: 223-233.
https://doi.org/10.1016/j.eururo.2016.05.050
- 22. Adeldaeim HM, Abouyoussif T, Gebaly OE, et al. Prognostic Indicators for Successful Low- intensity Extracorporeal Shock Wave Therapy Treatment of Erectile Dysfunction. Urology 2021; 149: 133-139.
https://doi.org/10.1016/j.urology.2020.12.019
- 23. Olsen AB, Persiani M, Boie S, et al. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol 2015; 49: 329-333.
https://doi.org/10.3109/21681805.2014.984326
- 24. Summary of revisions for the 2009 Clinical Practice Recommendations. Diabetes Care 2009; 32 Suppl 1: S3-5.
https://doi.org/10.2337/dc09-S003
- 25. Chrysant SG. Antihypertensive therapy causes erectile dysfunction. Curr Opin Cardiol 2015; 30: 383-390.
https://doi.org/10.1097/HCO.0000000000000189
Do Antiplatelet Drugs Use Contribute to Clinical Outcomes in Patients Receiving Penile Low- Intensity Shock Wave Therapy (Li-SWT) for Erectile Dysfunction?
Year 2023,
, 194 - 198, 31.08.2023
Serdar Geyik
,
Mutlu Deger
,
Nebil Akdogan
,
Nâzım Abdülkadir Kankılıç
,
İsmail Önder Yılmaz
,
İbrahim Atilla Arıdoğan
Abstract
Aim: Low-intensity extracorporeal shock wave therapy (Li-SWT) is one of the recommended treatment options in patients with erectile dysfunction (ED). Li-SWT is safe in patients using antiplatelet drugs (APs), however, there are no specific studies on the contribution of APs use to clinical improvement in erectile function. We aimed to evaluate the early clinical results of Li-SWT administration and whether the use of APs had an additional positive contribution to clinical improvement and safe in ED patients.
Methods: Patients with ED for more than 6 months despite using (5 mg/day) PDE5i were included in our study. Patients treated with Li-SWT and using PDE5i were classified as Group 1, patients treated with Li-SWT and using APs and using PDE5i were considered Group 2. The evaluation results of the International Index of Erectile Function-Erectile Function Area(IIEF-EF) in all patients baseline and after treatment were examined.
Results: There are 25 patients in each group. Analysis of IIEF-EF scores showed significant increases in both groups after treatment [group 1 (p=0.001); group 2 (p=0.001)]. When the IIEF-EF scores of the groups before and after the treatment were compared with each other; it was shown that baseline scores were similar(p=0.746) and that APs use had no statistically significant effect on post-treatment scores (p=0.613) No side effects were seen in APs.
Conclusions: This study showed that penile Li-SWT significantly increases the IIEF-EF scores and response of (5 mg/day) PDE5i in ED patients and safe, also in AP users. However, Using AP in Li- SWT does not contribute positively to clinical results.
References
- 1. Miner M, Kim ED. Cardiovascular disease and male sexual dysfunction. Asian J Androl 2015; 17: 3-4.
https://doi.org/10.4103/1008-682X.143753
- 2. Campbell JD, Trock BJ, Oppenheim AR, et al. Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction. Ther Adv Urol 2019; 11: 1756287219838364.
https://doi.org/10.1177/1756287219838364
- 3. Dorsey P, Keel C, Klavens M, et al. Phosphodiesterase type 5 (PDE5) inhibitors for the treatment of erectile dysfunction. Expert Opin Pharmacother 2010; 11: 1109-1122.
https://doi.org/10.1517/14656561003698131
- 4. Shamloul R, Ghanem H. Erectile dysfunction. Lancet 2013; 381: 153-165.
https://doi.org/10.1016/S0140-6736(12)60520-0
- 5. Campbell JD, Milenkovic U, Usta MF, et al. The good, bad, and the ugly of regenerative therapies for erectile dysfunction. Transl Androl Urol 2020; 9: S252-S261.
https://doi.org/10.21037/tau.2019.10.06
- 6. Sokolakis I, Dimitriadis F, Teo P, et al. The Basic Science Behind Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Scoping Review of Pre-Clinical Studies. J Sex Med 2019; 16: 168-194.
https://doi.org/10.1016/j.jsxm.2018.12.016
- 7. Liu T, Shindel AW, Lin G, et al. Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy. Int J Impot Res 2019; 31: 170-176.
https://doi.org/10.1038/s41443-019-0113-3
- 8. Schoofs E, Fode M, Capogrosso P, et al. Current guideline recommendations and analysis of evidence quality on low-intensity shockwave therapy for erectile dysfunction. Int J Impot Res 2019; 31: 209-217.
https://doi.org/10.1038/s41443-019-0132-0
- 9. Ziegler M, Wang X, Peter K. Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target. Cardiovasc Res 2019; 115: 1178-1188.
https://doi.org/10.1093/cvr/cvz070
- 10. Putilina MV. [Endothelium as a target for new therapeutic strategies in cerebral vascular diseases]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117: 122-130.
https://doi.org/10.17116/jnevro2017117101122-130
- 11. Kalyvianakis D, Memmos D, Mykoniatis I, et al. Low-Intensity Shockwave Therapy (LiST) for Erectile Dysfunction: Is It Safe for Patients on Anticoagulant Medication? J Sex Med 2019; 16: 1478- 1480.
https://doi.org/10.1016/j.jsxm.2019.05.008
- 12. Reisman Y, Hind A, Varaneckas A, et al. Initial experience with linear focused shockwave treatment for erectile dysfunction: a 6-month follow-up pilot study. Int J Impot Res 2015; 27: 108-112.
https://doi.org/10.1038/ijir.2014.41
- 13. Cappelleri JC, Rosen RC, Smith MD, et al. Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology 1999; 54: 346-351.
https://doi.org/10.1016/S0090-4295(99)00099-0
- 14. Wu SS, Ericson KJ, Shoskes DA. Retrospective comparison of focused shockwave therapy and radial wave therapy for men with erectile dysfunction. Transl Androl Urol 2020; 9: 2122-2128.
https://doi.org/10.21037/tau-20-911
- 15. Vardi Y, Appel B, Jacob G, et al. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol 2010; 58: 243-248.
https://doi.org/10.1016/j.eururo.2010.04.004
- 16. Vardi Y, Appel B, Kilchevsky A, et al. Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol 2012; 187: 1769-1775.
https://doi.org/10.1016/j.juro.2011.12.117
- 17. Verze P, Capece M, Creta M, et al. Efficacy and safety of low-intensity shockwave therapy plus tadalafil 5 mg once daily in men with type 2 diabetes mellitus and erectile dysfunction: a matched-pair comparison study. Asian J Androl 2020; 22: 379-382.
https://doi.org/10.4103/aja.aja_121_19
- 18. Gruenwald I, Appel B, Kitrey ND, et al. Shockwave treatment of erectile dysfunction. Ther Adv Urol 2013; 5: 95-99.
https://doi.org/10.1177/1756287212470696
- 19. Sokolakis I, Dimitriadis F, Psalla D, et al. Effects of low-intensity shock wave therapy (LiST) on the erectile tissue of naturally aged rats. Int J Impot Res 2019; 31: 162-169.
https://doi.org/10.1038/s41443-018-0064-0
- 20. Srini VS, Reddy RK, Shultz T, et al. Low intensity extracorporeal shockwave therapy for erectile dysfunction: a study in an Indian population. Can J Urol 2015; 22: 7614-7622.
- 21. Lu Z, Lin G, Reed-Maldonado A, et al. Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis. Eur Urol 2017; 71: 223-233.
https://doi.org/10.1016/j.eururo.2016.05.050
- 22. Adeldaeim HM, Abouyoussif T, Gebaly OE, et al. Prognostic Indicators for Successful Low- intensity Extracorporeal Shock Wave Therapy Treatment of Erectile Dysfunction. Urology 2021; 149: 133-139.
https://doi.org/10.1016/j.urology.2020.12.019
- 23. Olsen AB, Persiani M, Boie S, et al. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol 2015; 49: 329-333.
https://doi.org/10.3109/21681805.2014.984326
- 24. Summary of revisions for the 2009 Clinical Practice Recommendations. Diabetes Care 2009; 32 Suppl 1: S3-5.
https://doi.org/10.2337/dc09-S003
- 25. Chrysant SG. Antihypertensive therapy causes erectile dysfunction. Curr Opin Cardiol 2015; 30: 383-390.
https://doi.org/10.1097/HCO.0000000000000189