Impact of aging and comorbidity on the efficacy of low-intensity shock wave therapy for erectile dysfunction

Int J Urol. 2016 Jan;23(1):80-4. doi: 10.1111/iju.12955. Epub 2015 Oct 26.


Objectives: To evaluate the efficacy of low-intensity shock wave therapy and to identify the predictive factors of its efficacy in Japanese patients with erectile dysfunction.

Methods: The present study included 57 patients with erectile dysfunction who satisfied all the following conditions: more than 6-months history of erectile dysfunction, sexual health inventory for men score of ≤ 12 without phosphodiesterase type-5 inhibitor, erection hardness score grade 1 or 2, mean penile circumferential change by erectometer assessing sleep related erection of < 25 mm and non-neurological pathology. Patients were treated by a low-energy shock waves generator (ED1000; Medispec, Gaithersburg, MD, USA). A total of 12 shock wave treatments were applied. Sexual health inventory for men score, erection hardness score with or without phosphodiesterase type-5 inhibitor, and mean penile circumferential change were assessed at baseline, 1, 3 and 6 months after the termination of low-intensity shock wave therapy.

Results: Of 57 patients who were assigned for the low-intensity shock wave therapy trial, 56 patients were analyzed. Patients had a median age of 64 years. The sexual health inventory for men and erection hardness score (with and without phosphodiesterase type-5 inhibitor) were significantly increased (P < 0.001) at each time-point. The mean penile circumferential change was also increased from 13.1 to 20.2 mm after low-intensity shock wave therapy (P < 0.001). In the multivariate analysis, age and the number of concomitant comorbidities were statistically significant predictors for the efficacy.

Conclusions: Low-intensity shock wave therapy seems to be an effective physical therapy for erectile dysfunction. Age and comorbidities are negative predictive factors of therapeutic response.

Keywords: erectile dysfunction; low intensity shock wave treatment; low-intensity shock wave therapy; predictive factor.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Diabetes Complications / complications
  • Dyslipidemias / complications
  • Erectile Dysfunction / complications
  • Erectile Dysfunction / physiopathology
  • Erectile Dysfunction / therapy*
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications
  • Penile Erection / physiology*
  • Phosphodiesterase 5 Inhibitors / therapeutic use
  • Prospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome
  • Ultrasonic Therapy*


  • Phosphodiesterase 5 Inhibitors