Low-Intensity Extracorporeal Shock Wave Therapy (LI-ESWT) for Erectile Dysfunction in Patients Post-prostatectomy: A Systematic Review
Abstract
Erectile dysfunction (ED) is a common and distressing complication following radical prostatectomy, significantly affecting patients' quality of life. Low-intensity extracorporeal shock wave therapy (LI-ESWT) has emerged as a non-invasive modality aimed at enhancing erectile function through tissue regeneration and improved neovascularisation. This review aims to systematically evaluate the safety and efficacy of LI-ESWT in the treatment of ED in men following prostatectomy. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed across PubMed, PubMed Central (PMC), MEDLINE, Cochrane Library, and Scopus for studies published between January 2015 and July 2025. Eligible studies included randomised controlled trials (RCTs) and cohort studies evaluating LI-ESWT for post-prostatectomy ED using validated outcome measures such as the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS). Risk of bias was assessed using the Cochrane Risk of Bias (RoB) 2.0 and the Newcastle-Ottawa Scale. Ten studies, of which five were RCTs and five were cohort studies, involving a total of 760 patients met the inclusion criteria. LI-ESWT was associated with statistically significant improvements in erectile function across most studies, particularly when combined with phosphodiesterase-5 inhibitors (PDE5is). IIEF-5 scores improved in both…
How strong is the evidence?
Evidence Hub reads this as a systematic review, 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: 760 participants or records.
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