EFFICIENCY ASSESSMENT OF SHOCK WAVE THERAPY IN PATIENTS WITH PELVIC PAIN EMPLOYING HARMONIC ANALYSIS OF PENILE BIOIMPEDANCE
In searching for novel objective methods to diagnosticate pelvic pain and assess the efficiency of analgesic therapy, 37 male patients were examined prior to and after the course of extracorporeal shock wave therapy (5-10 sessions) with the waves directed to projections of prostate and/or shaft of the penis. The repetition rate of mechanical pulses was 3-5 Hz. The range of energy pulse density was 0.09-0.45 mJ/mm2 . The overall number of pulses ... in a session was 1500-3000 in any treated zone with total energy smaller than 60 J. The applicator was relocated every other series of 300-500 pulses. Effect of the shock wave therapy was assessed according to subjective symptomatic scales: International Prostate Symptom Score, International Index of Erectile Function, Quality of Life, and nociceptive Visual Analog Scale.
TADALAFIL ONCE DAILY AND EXTRACORPOREAL SHOCK WAVE THERAPY IN THE MANAGEMENT OF PATIENTS WITH PEYRONIE’S DISEASE AND ERECTILE DYSFUNCTION: RESULTS FROM A PROSPECTIVE RANDOMIZED TRIAL
Extracorporeal shock wave therapy improves erectile function in patients with Peyronie’s disease. However, erectile dysfunction still persists in many cases. We aimed to investigate the effects of extracorporeal shock wave therapy plus tadalafil 5 mg once daily in the management of patients with Peyronie’s disease and erectile dysfunction not previously treated. One hundred patients were enrolled in a prospective, randomized, controlled study.... Patients were randomly allocated to receive either extracorporeal shock wave therapy alone for 4 weeks (n = 50) or extracorporeal shock wave therapy plus tadalafil 5 mg once daily for 4 weeks (n = 50). Main outcome measures were: erectile function (evaluated through the shortened version of the International Index of Erectile Function), pain during erection (evaluated through a Visual Analog Scale), plaque size, penile curvature and quality of life (evaluated through an internal questionnaire). Follow-up evaluations were performed after 12 and 24 weeks. In both groups, at 12 weeks follow-up, mean Visual Analog Scale score, mean International Index of Erectile Function score and mean quality of life score ameliorated significantly while mean plaque size and mean curvature degree were unchanged. Intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and quality of life score in patients receiving the combination. After 24 weeks, intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and mean quality of life score in patients that received extracorporeal shock wave therapy plus tadalafil. In conclusion extracorporeal shock wave therapy plus tadalafil 5 mg once daily may represent a valid conservative strategy for the management of patients with Peyronie’s disease and erectile dysfunction.