EVALUATION OF THE EFFICACY OF INNOVATIVE SHOCKWAVE THERAPIES FOR ERECTILE DYSFUNCTION AND FALSE PENILE SHORTNESS: A RANDOMIZED STUDY

Abstract Objectives To compare the effectiveness of penile-focused shockwave therapy (Group A) with combined penile and adipose tissue shockwave therapy (Group B) in treating vasculogenic erectile dysfunction and false penile shortness. Additionally, the study investigates the relationship between adipose reduction and improvements in erectile function, sexual outcomes, and quality of life. Methods Twenty patients aged 18 to 65 with vasculogenic erectile dysfunction and excess adipose tissue in the lower abdomen and pubic region were randomly assigned to Group A (penile shockwave therapy) or Group B (combined penile and adipose shockwave therapy). Assessments included BMI, abdominal skinfold thickness, pubic plicometry, sexual performance (IIEF-5), urinary symptoms (IPSS), and quality of life (EQ-5D VAS and PH-Q9). Li-ESWT was performed weekly using Duolith SD1 T-TOP “ultra” (Storz Medical AG). Data analysis focused on changes in erectile function, adipose reduction, and quality of life. Results Group A: IIEF-5 improved by 4 points (30.19%, p = 0.00000988); IPSS reduced by 4 points (-39.02%, p = 0.000206); EQ-5D VAS increased by 30 points (55.81%, p = 0.00000214); PH-Q9 decreased by 0.5 points (-10.53%, p = 0.0656). No significant changes in pubic plicometry, BMI, or waist circumference. Group B: IIEF-5 improved by 5.5 points (62.86%, p < 0.000001); IPSS reduced by 6.5 points (-32.91%, p = 0.0002); EQ-5D VAS increased by 32.5 points (72.2%, p = 0.000002); PH-Q9 decreased by 1.75 points (-20.59%, p = 0.0666). Significant prepubic fat reduction; no significant changes in BMI or waist circumference. Conclusions Combined penile and adipose shockwave therapy appears to be more effective than penile therapy alone in improving erectile function, urinary symptoms, and quality of life in patients with vasculogenic erectile dysfunction and false penile shortness. Adipose reduction may play a key role in these improvements, though further studies are needed to fully understand its contribution and long-term effects. This innovative approach could open new avenues for more comprehensive treatment of erectile dysfunction. Conflicts of Interest The authors declare no conflicts of interest related to this study.