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Low-intensity shockwave therapy for erectile dysfunction due to diabetes mellitus or coronary artery disease: An individual participant data meta-analysis from a single center

Pyrgidis N, Kalyvianakis D, Mykoniatis I, Hatzichristou D

Andrology, 2026

208 participants · 3 citations

Abstract

Background: Low-intensity shockwave therapy (LiST) is a first-line treatment for vasculogenic erectile dysfunction (ED). However, its efficacy in challenging cases, such as ED solely due to type 2 diabetes mellitus (DM) or coronary artery disease (CAD), has not been adequately assessed. Materials and methods This study presents an individual participant data meta-analysis of five double-blind randomized controlled trials involving 208 patients treated in a single academic center using a standardized LiST protocol (ARIES 2 generator, 5000 impulses/session). Results For outcomes, including International Index of Erectile Function-Erectile Function Domain scores, sexual encounter profile question 3 responses, resistance index, and minimal clinically important differences, LiST was equally effective in patients with ED due to DM or CAD compared to other causes. Subgroup analyses showed equivalent efficacy for 6 versus 12 LiST sessions. No adverse events were reported. Conclusions These findings confirm LiST's safety and effectiveness across different causes of vasculogenic ED, supporting its broader application in clinical practice.

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 208 participants or records.

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