Stratified Outcomes of Li-SWT in Erectile Dysfunction: A Systematic Review & meta-analysis

Abstract

Background Erectile dysfunction (ED) is a common condition affecting men, characterized by the inability to achieve or maintain an erection sufficient for sexual intercourse. Low-Intensity Shockwave Therapy (Li-SWT) has emerged as a promising non-invasive treatment for ED, particularly in cases with vasculogenic etiology. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Li-SWT in improving erectile function in men with ED.

Objective To systematically assess the effectiveness of Li-SWT in improving erectile function and overall quality of life in patients with erectile dysfunction, with a focus on stratified outcomes by ED etiology and follow-up duration.

Methods A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and other relevant databases for studies published from 2000 to 2024. The search included randomized controlled trials (RCTs), cohort studies, and observational studies that evaluated Li-SWT for ED. Studies were included if they reported outcomes related to erectile function improvement (e.g., IIEF score, Erection Hardness Score) and adverse events. A meta-analysis was conducted to calculate the pooled mean difference (MD) and 95% confidence intervals (CIs) for erectile function improvement. Subgroup analyses were performed based on treatment parameters and ED etiology.

Results A total of 5 studies were included in the meta-analysis, involving a total of 1,200 participants with ED. Li-SWT demonstrated statistically significant improvements in erectile function, with a pooled mean difference of 2.4 in the IIEF score (95% CI: 1.9 to 2.8). Improvements were consistently observed across studies, with the best outcomes seen in patients with vasculogenic ED. Li-SWT was well-tolerated, with minimal side effects, such as temporary penile discomfort. However, most studies had short follow-up periods (3–6 months), and long-term data on efficacy and durability were limited.

Conclusions Li-SWT appears to be an effective treatment for erectile dysfunction, particularly in vasculogenic ED, with significant short-term improvements in erectile function and a favorable safety profile. However, further long-term studies with standardized treatment protocols and a larger sample size are needed to confirm its long-term efficacy and establish optimal treatment parameters. Future research should also explore the effects of Li-SWT on psychogenic and mixed-etiology ED.