Introduction. According to data acquired in studies worldwide, erectile dysfunction (ED) incidence is about 16% to 52% among males aged 20-70 years. Vasculogenic ED is found in about 70% of all ED cases with 30% being arteriogenic, 20-40% being venogenic and 30% being combined arteriogenic-venogenic ED. Shock wave therapy (SWT) is a new and promising modality of treatment for patients with erectile dysfunction. Lack of consensus regarding SWT efficacy in various types of ED and duration of its effect necessitates further studies.
Aim of the study: to evaluate the results of combined treatment (shock wave therapy and endovascular embolization of deep dorsal vein) in patients with mixed vasculogenic ED.
Materials and methods: 30 patients aged 26-45 years with clinically diagnosed arteriogenic-venogenic ED underwent endovascular embolization of deep dorsal vein of penis with subsequent 9-week course of shock wave therapy. Treatment efficacy was evaluated using International index of erectile function (IIEF-5) questionnaire and penile doppler ultrasound with pharmacologically induced erection.
Results: after the second stage of treatment mean IIEF-5 score has increased from 16,7 at baseline to 22,2. Twenty six of 30 (81%) patients have reported a stable improvement of erectile function. Penile doppler ultrasound hasrevealed an improvement of penile circulation: there was an increase from 17,7 mmHg to 28,3 mmHg in right cavernosal artery, from 13,2 mmHg to 28,3 mmHg in left cavernosal artery, from 18 mmHg to 32 mmHg in right dorsal artery and from 16 to 33 mmHg in left dorsal artery
Conclusion. Shock wave therapy combined with venous leak reduction is a possible alternative for penile revascularization.
Authors declare lack of the possible conflicts of interests.