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Efficacy of low-intensity shockwave therapy with different tadalafil regimens in patients with PDE5 inhibitor-resistant erectile dysfunction: a retrospective cohort study

  • Urology - Original Paper
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Abstract

Purpose

Currently, there is a lack of research comparing tadalafil treatment protocols recommended during low-intensity shock wave therapy (LI-SWT) for patients with erectile dysfunction (ED) who are unresponsive to phosphodiesterase type 5 inhibitors (PDE5i). The objective of this study is to compare the efficacy of only LI-SWT versus LI-SWT plus 5 mg tadalafil daily versus LI-SWT plus 20 mg tadalafil alternate-day in PDE5i -resistant ED.

Materıals and methods

In this study, a cohort of 105 patients with PDE5i-resistant ED was recruited and divided into three groups labeled as A (only LI-SWT), B (LI-SWT plus 5 mg tadalafil daily), and C (LI-SWT plus 20 mg tadalafil alternate-day), comprising 27, 42, and 36 patients, respectively. The patients' International Index of Erectile Function-5 (IIEF-5) scores and the Erection Hardness Score (EHS) were evaluated at the baseline, three months and six months following the treatment.

Results

After three months post-treatment, the IIEF-5 scores in group A, B, and C increased by 4.1 ± 0.6, 7.3 ± 0.6, and 8.2 ± 0.6, respectively. These improvements were maintained at six months with IIEF-5 scores increasing by 3.7 ± 0.6, 7.3 ± 0.6, and 8.5 ± 0.7 in groups A, B, and C, respectively. At 3 and 6 months post-treatment, groups B and C showed significant improvement in IIEF-5 scores and EHS values compared to group A (p < 0.001). The rate of patients with EHS ≥ 3 and IIEF-5 ≥ 17 was significantly higher in groups B and C compared to group A, while there was no significantly different between groups B and C.

Conclusıon

In patients with PDE5i-resistant ED, PDE5i combined with LI-SWT is superior to LI-SWT monotherapy. The statistical analysis failed to demonstrate any difference between two distinct tadalafil regimens when administered with LI-SWT treatment.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Funding

The authors declare that they have no relevant financial.

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Authors and Affiliations

  1. Department of Urology, Ankara University School of Medicine, Ankara, Turkey

    Muhammed Arif İbis, Fatih Ozkaya, Cagri Akpinar & Onder Yaman

  2. Department of Urology, Private Cankaya Yasam Hospital, Ankara, Turkey

    Zafer Tokatli

Authors
  1. Muhammed Arif İbis
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  2. Fatih Ozkaya
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  3. Zafer Tokatli
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  4. Cagri Akpinar
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  5. Onder Yaman
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Contributions

MAI & FO performed the research, CA & ZT analyzed the data and wrote the paper, and OY designed the research study and wrote the paper. All authors approve the final version of the text.

Corresponding author

Correspondence to Muhammed Arif İbis.

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Conflict of interest

No conflict of interest was declared by the authors.

Ethical approval

The study was approved by the Ankara University Faculty of Medicine Ethics Committee (protocol number [i06-397–23]).

Informed consent

This is a retrospective analysis based on electronic medical record data. According to the requirements of ethics committee of Ankara University, informed consent can be exempted after anonymization of medical record data.

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İbis, M.A., Ozkaya, F., Tokatli, Z. et al. Efficacy of low-intensity shockwave therapy with different tadalafil regimens in patients with PDE5 inhibitor-resistant erectile dysfunction: a retrospective cohort study. Int Urol Nephrol 56, 407–413 (2024). https://doi.org/10.1007/s11255-023-03769-w

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  • DOI: https://doi.org/10.1007/s11255-023-03769-w

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