LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY (LI-ESWT) IN PATIENTS WITH TYPICAL DIABETES MELLITUS ERECTILE DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
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Abstract
Introduction: Erectile dysfunction and diabetes mellitus present a challenging condition to treat due to the involvement of vasculogenic, endocrinogenic, and neurogenic factors. Although PDE5I is usually the treatment of choice, not all patients are suitable or respond to it. Currently, Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT), known as a vasculogenic erectile dysfunction treatment, tends to be safe, non-invasive, and effective. Objective: This study aims to determine the efficacy of Li-ESWT on patients with erectile dysfunction and diabetes mellitus. Material & Methods: RCT data were collected from PubMed, Science Direct, and Cochrane databases. Patients with erectile dysfunction and diabetes who underwent Li-ESWT assessed through the International Index of Erectile Function (IIEF) were included. In this study, we used RevMan 5.4, Cochrane Risk of Bias 2.0, and the PRISMA checklist. Out of 603 records identified, four RCTs were identified for qualitative synthesis. Three of these studies met the criteria for inclusion in the meta-analysis. Results: All four studies reported a statistically significant increase in the Li-ESWT group compared to the control group, with the average pre-therapy IIEF score increasing from 11.68 to 17.50 after treatment (p < 0.05). Moreover, Li-ESWT combined with other therapy was found more superior than monotherapy. Meta-analysis showed that Li-ESWT was effective to improve erectile function in diabetic patients (SMD 1.24; 95% CI: 0.85-1.63; p < 0.00001; I2 = 0%). Conclusion: Li-ESWT was effective for mild to moderate erectile dysfunction patients with Diabetes Mellitus. Keywords: Shockwave therapy, diabetes mellitus, erectile dysfunction.
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Shockwave Therapy, Diabetes Mellitus, Erectile Dysfunction
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