Erectile Function Recovery Using Shockwave and Platelet-Rich Plasma: A Single-Centre Prospective Comparative Study.

BACKGROUND

The study aimed to analyse the comparative effect of low-intensity extracorporeal shockwave therapy (Li-ESWT), platelet-rich plasma (PRP), and their combination for treating arteriogenic erectile dysfunction (ED).

METHODS

This prospective observational study involved men diagnosed with arteriogenic ED over six months. Four hundred men aged 35-65 with ED, diagnosed using the International Index of Erectile Function (IIEF-5) and penile colour Doppler ultrasonography (USG), joined the research. The participants were divided into four groups: Li-ESWT, PRP, Li-ESWT + PRP, and Control. Outcomes were assessed at baseline and at one, three and six months post-treatment, focusing on changes in IIEF-5 scores and penile haemodynamics, including peak systolic velocity (PSV) and end-diastolic velocity (EDV).

RESULTS

Li-ESWT significantly improved IIEF-5 scores from baseline to three months (p = 0.001), with sustained but reduced effects at six months (p = 0.001). PRP alone showed mild improvement at one month (p = 0.028), with no significant effect persisting at six months (p = 0.119). Combination therapy demonstrated the most pronounced and sustained improvement in IIEF-5 scores, particularly at three and six months (p = 0.001). Haemodynamic analysis revealed a significant increase in PSV at three months in the Li-ESWT and combination groups (p = 0.001) with mild regression at six months (p = 0.003). EDV changes were negligible across all groups and time points (p > 0.05).

CONCLUSIONS

Combining Li-ESWT and PRP provided the most substantial and sustained improvement in erectile function and arterial haemodynamics. While Li-ESWT demonstrated notable efficacy, PRP alone showed limited and transient benefits.