Comparative Efficacy of Low-Intensity Extracorporeal Shockwave Therapy with/without Daily Tadalafil for Erectile Dysfunction Stratified by Severity: A Prospective Multi-center Study
Abstract
Abstract Tadalafil administration and low-intensity extracorporeal shockwave therapy (Li-ESWT) are both effective treatments for erectile dysfunction (ED), but the option of monotherapy or combination therapy for patients with varying severities of ED remains uncertain. This study aimed to compare the efficacy of Li-ESWT monotherapy versus Li-ESWT combined with daily tadalafil across different ED severity subgroups. A total of 188 men aged 18–60 years with ED were enrolled from three clinical centers between June 2018 and March 2020. Demographic data, International Index of Erectile Function-5 (IIEF-5), erectile hardness score (EHS), Clinical Global Impression scale (CGI), and minimal clinically important difference (MCID) were collected. Li-ESWT was delivered using the Renova system with standardized parameters (once weekly for a total of four sessions). Patients in the combination therapy group received 5 mg of tadalafil daily for one continuous month during the Li-ESWT treatment period. Statistical analyses compared pre- and post-treatment outcomes within and between groups. The study population comprised 53 patients in the Li-ESWT monotherapy group and 135 in the combination therapy group. Compared to baseline, IIEF-5 scores improved by 2.92 ± 2.57 points with Li-ESWT monotherapy and by 4.60 ± 4.24 points with combination therapy. In patients with moderate to severe (Mo-Se) ED, combination therapy yielded significantly higher IIEF-5 scores (13.26 ± 5.59 vs. 9.65 ± 3.38,…
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