International urology and nephrology · 2026
Low-intensity shock wave therapy for penile rehabilitation in patients with erectile dysfunction following pelvic fracture urethral injury: a pilot study.
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Fathi Atef, Alsagheer Gamal, Talaat Mohammed, AbdelRazek Mostafa
Аннотация
PURPOSE: Pelvic fracture urethral injury (PFUI) frequently results in long-term erectile dysfunction (ED), severely impacting quality of life. Low-intensity shockwave therapy (LiSWT) promotes neovascularization and tissue perfusion via VEGF and nitric oxide pathways, offering a potential regenerative treatment for post-traumatic ED. This study aims to evaluate the efficacy and safety of LiSWT for ED secondary to urethral injury from pelvic fractures.
METHODS: This pilot study included 25 men with ED post-PFUI. Participants received six weekly sessions of LiSWT (24,000 shocks total) using a piezoelectric device. Assessments included the International Index of Erectile Function (IIEF) and Erectile Hardness Scale (EHS) at baseline and at 3, 6, and 12 months' post-treatment, while penile Doppler ultrasound was done at baseline and 12 months' post-treatment.
RESULTS: IIEF scores improved significantly from 14.4 ± 3.2 at baseline to 17.4 ± 3.2 (p = 0.002) post-LiSWT, 16.4 ± 3.2 (p = 0.036) at 3 months, 17.4 ± 3.2 (p = 0.002) at 6 months, and 17.8 ± 3.7 (p < 0.001) at 12 months. EHS increased significantly at all follow-ups (p < 0.001), with a further rise between 3 months 2.35 ± 0.53 and 12 months 2.74 ± 0.58 (p = 0.009). PSV increased from 23.4 ± 6.1 at baseline to 34.1 ± 9.1 (p < 0.001) at 12 months, EDV decreased from 6.68 ± 2.95 at baseline to 3.84 ± 2.70 (p = 0.002) at 12 months, and RI increased from 0.66 ± 0.22 at baseline to 0.86 ± 0.13 (p < 0.001) at 12 months.
CONCLUSION: LiSWT is safe and effective for ED after PFUI, producing sustained improvements in erectile function, penile rigidity, and hemodynamics, representing a promising noninvasive therapeutic option for post-traumatic ED.
TRIAL REGISTRATION: ClinicalTrials.gov NCT07460167, registered 10 March 2026, retrospectively registered.
METHODS: This pilot study included 25 men with ED post-PFUI. Participants received six weekly sessions of LiSWT (24,000 shocks total) using a piezoelectric device. Assessments included the International Index of Erectile Function (IIEF) and Erectile Hardness Scale (EHS) at baseline and at 3, 6, and 12 months' post-treatment, while penile Doppler ultrasound was done at baseline and 12 months' post-treatment.
RESULTS: IIEF scores improved significantly from 14.4 ± 3.2 at baseline to 17.4 ± 3.2 (p = 0.002) post-LiSWT, 16.4 ± 3.2 (p = 0.036) at 3 months, 17.4 ± 3.2 (p = 0.002) at 6 months, and 17.8 ± 3.7 (p < 0.001) at 12 months. EHS increased significantly at all follow-ups (p < 0.001), with a further rise between 3 months 2.35 ± 0.53 and 12 months 2.74 ± 0.58 (p = 0.009). PSV increased from 23.4 ± 6.1 at baseline to 34.1 ± 9.1 (p < 0.001) at 12 months, EDV decreased from 6.68 ± 2.95 at baseline to 3.84 ± 2.70 (p = 0.002) at 12 months, and RI increased from 0.66 ± 0.22 at baseline to 0.86 ± 0.13 (p < 0.001) at 12 months.
CONCLUSION: LiSWT is safe and effective for ED after PFUI, producing sustained improvements in erectile function, penile rigidity, and hemodynamics, representing a promising noninvasive therapeutic option for post-traumatic ED.
TRIAL REGISTRATION: ClinicalTrials.gov NCT07460167, registered 10 March 2026, retrospectively registered.