Детайли

Създадена на Понеделник, 20 Ноември 2017 10:54

Автор на статията доц. д-р Пенчо Генов д.м. - Уролог

Stoykov B.A. 1 , Kolev N.H. 1 , Genov P. 1 , Dunev V.R. 1 , Vanov A. 1 , Atanasov J.A. 1 , Koleva M.I. 2

1Medical University Hospital, Dept. of Urology, Pleven, Bulgaria, 2Clinic Physiomed, Dept. of Physiotherapy, Pleven, Bulgaria

Introduction & Objectives: The experience gained in recent years with low-intensity extracorporeal shock wave therapy (LI-ESWT) demonstrates its safety, efficacy and good tolerance in the treatment of erectile dysfunction (ED). The aim of our study was to compare LI-ESWT with phosphodiesterase type-5 inhibitors (PDE5I) in terms of their efficacy and safety in patients with bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP).

 Materials & Methods: For the period from May 2015 to January 2017, 53 BNSRRP were committed. The patients were divided into 2 groups and in both groups treatment started immediately after the catheter was removed and lasted for 9 weeks. In group 1, 27 patients were included with 2 sessions LI-ESWT per week for 3 weeks. They were followed by 3 weeks without therapy, then repeated 2 sessions LI-ESWT per week for another three weeks. Group 2 included 26 patients, all of them received 25 mg of sildenafil citrate every evening. Patients were evaluated before surgery and at third and sixth month after the treatment. The effect of therapy was reported with the international index of erectile function (IIEF)-erectile function (EF) domain and the erection hardness score (EHS).

Results: 81.35% of the participants were between age of 60 and 67 years old. The mean age was 64 years old. In group 1, the mean IIEF-EF domain prior to surgery was 27 points and group 2 - 26 points. At third months post-treatment in group 1 - 16 (59%) of patients had normal EF (IIEF-EF domain ≥26 and EHS ≥3), 7 (26%) had improvement in IIEF score but still have mild to moderate ED (IIEF-EF domain 11-25 and EHS ≤ 2), and 4 (15%) had no response to treatment. In group 2 at the third month, 17 (65%) of patients had normal EF, 6 (23%) had improvement in IIEF and 3 (12%) had no response to treatment (p < 0.05). Six months after the therapy in group 1-19 (70%) of patients were with normal EF, 5 (19%) had improvement in IIEF score but still have mild to moderate ED, and 3 (11%) had no response to treatment. In group 2 at the sixth month, 19 (73%) of patients had normal EF, 4 (15%) had improvement in IIEF and 3 (12%) had no response to treatment (p < 0.05).

Conclusions: There was no statistically significant difference between the two groups of patients at the third and sixth months after initiation of treatment, both in the percentage of patients restoring their EF and in patients who experienced improvement or lack of treatment effect. These initial results indicate that LI-ESWT is as effective and safe as PDE5I after BNSRRP.

Eur Urol Suppl 2017; 16(11);e2919