{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:23:46Z","timestamp":1790742226266,"version":"4.1.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although several reports have documented the subjective improvement of erectile function after low-intensity extracorporeal shockwave therapy (LI-ESWT) in patients with vasculogenic erectile dysfunction (ED), objective assessment data of penile hemodynamics are lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To assess penile hemodynamics before and 3 months after LI-ESWT in a group of patients with documented vasculogenic ED.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a double-blinded, randomized, sham-controlled trial. Forty-six patients with ED were randomized; 30 underwent LI-ESWT and 16 had a sham procedure in double-blinded fashion. All patients underwent penile triplex ultrasonography by the same investigator immediately before and 3 months after treatment. Patient demographics, International Index of Erectile Function erectile function domain (IIEF-ED) score, and minimal clinically important difference were assessed at baseline and 1, 3, 6, 9, and 12 months after treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Changes in peak systolic velocity and resistance index as measured by triplex ultrasonography at baseline and 3 months after treatment were the main outcomes of the study. Secondary outcomes were changes in the IIEF-EF score from baseline to 1, 3, 6, 9, and 12 months after treatment and the percentage of patients reaching a minimal clinically important difference during the same period for the two groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>IIEF-EF minimal clinically important differences for the active vs sham group were observed for 56.7% vs 12.5% (P\u00a0= .005) at 1 month, 56.7% vs 12.5% (P\u00a0= .003) at 3 months, 63.3% vs 18.8% (P\u00a0= .006) at 6 months, 66.7% vs 31.3% (P\u00a0= .022) at 9 months, and 75% vs 25% (P\u00a0= .008) at 12 months. Mean peak systolic velocity increased by 4.5 and 0.6 cm\/s in the LI-ESWT and sham groups, respectively (P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Such results offer objective and subjective documentation of the value of this novel treatment modality for men with vasculogenic ED.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>Strengths include the prospective, randomized, sham-controlled type of study and the assessment of penile hemodynamics. Limitations include the small sample and strict inclusion criteria that do not reflect everyday clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The present study confirms the beneficial effect of LI-ESWT on penile hemodynamics and the beneficial effect of this treatment up to 12 months.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2017.05.012","type":"journal-article","created":{"date-parts":[[2017,6,30]],"date-time":"2017-06-30T11:17:08Z","timestamp":1498821428000},"page":"891-897","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":71,"title":["Low-Intensity Shockwave Therapy Improves Hemodynamic Parameters in Patients with Vasculogenic Erectile Dysfunction: A Triplex Ultrasonography-Based Sham-Controlled Trial"],"prefix":"10.1093","volume":"14","author":[{"given":"Dimitrios","family":"Kalyvianakis","sequence":"first","affiliation":[{"name":"Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki Greece , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Hatzichristou","sequence":"additional","affiliation":[{"name":"Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki Greece , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,7,1]]},"reference":[{"key":"2023011111053973000_bib1","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.eururo.2010.02.020","article-title":"Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation","volume":"57","author":"Hatzimouratidis","year":"2010","journal-title":"Eur Urol"},{"key":"2023011111053973000_bib2","first-page":"465","article-title":"Pharmacotherapy for erectile dysfunction: recommendations from the Fourth International Consultation for Sexual Medicine (ICSM 2015)","volume":"13","author":"Hatzimouratidis","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023011111053973000_bib3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2165\/11592760-000000000-00000","article-title":"Extracorporeal shock wave therapy for ischemic cardiovascular disorders","volume":"11","author":"Ito","year":"2011","journal-title":"Am J Cardiovasc Drugs"},{"key":"2023011111053973000_bib4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1471-2474-10-54","article-title":"The management of neuropathic ulcers of the foot in diabetes by shock wave therapy","volume":"10","author":"Moretti","year":"2009","journal-title":"BMC Musculoskelet Disord"},{"key":"2023011111053973000_bib5","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1159\/000460503","article-title":"Extracorporal shock waves activate migration, proliferation and inflammatory pathways in fibroblasts and keratinocytes, and improve wound healing in an open-label, single-arm study in patients with therapy-refractory chronic leg ulcers","volume":"41","author":"Aschermann","year":"2017","journal-title":"Cell Physiol Biochem"},{"key":"2023011111053973000_bib6","doi-asserted-by":"crossref","first-page":"1241.e11","DOI":"10.1016\/j.urology.2015.07.026","article-title":"Low-intensity pulsed ultrasound improves erectile function in streptozotocin-induced type I diabetic rats","volume":"86","author":"Lei","year":"2015","journal-title":"Urology"},{"key":"2023011111053973000_bib7","first-page":"22","article-title":"Low-energy shock wave therapy ameliorates erectile dysfunction in a pelvic neurovascular injuries rat model","volume":"13","author":"Li","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023011111053973000_bib8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1177\/1756287212470696","article-title":"Shockwave treatment of erectile dysfunction","volume":"5","author":"Gruenwald","year":"2013","journal-title":"Ther Adv Urol"},{"key":"2023011111053973000_bib9","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.eururo.2010.04.004","article-title":"Can low-intensity extracorporeal shockwave therapy improve erectile function? 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