World journal of urology · 2026
Evaluation of cavernosal oxidative biomarkers following radial Li-ESWT in vasculogenic erectile dysfunction.
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Celik Mecit, Polat Muhammed Emin, Ceviz Kazim, Arabaci Batuhan, Boyaci Lutfi İhsan, Ölcucuoglu Erkan, Neselioglu Salim, Erel Ozcan, Yeni Ercan
Аннотация
PURPOSE: Vasculogenic erectile dysfunction (ED) is associated with endothelial dysfunction and oxidative stress. This study evaluated the clinical efficacy of radial-type low-intensity extracorporeal shockwave therapy (Li-ESWT) and its effects on cavernosal oxidative stress biomarkers.
METHODS: In this prospective study, 48 men with vasculogenic ED underwent 12 sessions of radial-type Li-ESWT. Erectile function was assessed at baseline, 1 month, and 6 months using the International Index of Erectile Function-Erectile Function domain (IIEF-EF) and Erection Hardness Score (EHS). Cavernosal blood samples were collected before treatment and one week after completion to measure superoxide dismutase (SOD), ischemia-modified albumin (IMA), thiol-disulfide homeostasis, and glutathione redox status.
RESULTS: At 6 months, 43.8% of patients achieved a clinically meaningful improvement in IIEF-EF. Both IIEF-EF and EHS scores improved significantly at 1 and 6 months (p < 0.001). In exploratory multivariable logistic regression analysis, prior PDE5i responsiveness remained independently associated with clinically meaningful improvement (OR 5.59, 95% CI 1.24-25.23; p = 0.025), whereas HbA1c did not retain significance. No significant changes were observed in SOD, IMA, or glutathione redox status. Borderline thiol-disulfide alterations observed in unadjusted analyses did not remain significant after correction for multiple comparisons and were not associated with clinical outcomes.
CONCLUSION: Radial-type Li-ESWT was associated with clinically meaningful improvements in erectile function in men with vasculogenic ED. However, no robust oxidative biomarker changes were observed in cavernosal blood following treatment.
METHODS: In this prospective study, 48 men with vasculogenic ED underwent 12 sessions of radial-type Li-ESWT. Erectile function was assessed at baseline, 1 month, and 6 months using the International Index of Erectile Function-Erectile Function domain (IIEF-EF) and Erection Hardness Score (EHS). Cavernosal blood samples were collected before treatment and one week after completion to measure superoxide dismutase (SOD), ischemia-modified albumin (IMA), thiol-disulfide homeostasis, and glutathione redox status.
RESULTS: At 6 months, 43.8% of patients achieved a clinically meaningful improvement in IIEF-EF. Both IIEF-EF and EHS scores improved significantly at 1 and 6 months (p < 0.001). In exploratory multivariable logistic regression analysis, prior PDE5i responsiveness remained independently associated with clinically meaningful improvement (OR 5.59, 95% CI 1.24-25.23; p = 0.025), whereas HbA1c did not retain significance. No significant changes were observed in SOD, IMA, or glutathione redox status. Borderline thiol-disulfide alterations observed in unadjusted analyses did not remain significant after correction for multiple comparisons and were not associated with clinical outcomes.
CONCLUSION: Radial-type Li-ESWT was associated with clinically meaningful improvements in erectile function in men with vasculogenic ED. However, no robust oxidative biomarker changes were observed in cavernosal blood following treatment.