World Journal of Urology

, Volume 35, Issue 1, pp 167–171 | Cite as

Is there a role for extracorporeal shock wave therapy for erectile dysfunction unresponsive to phosphodiesterase type 5 inhibitors?

  • Zi-jun Zou
  • Zhi-hong Liu
  • Liang-you Tang
  • Yi-ping LuEmail author
Letter to the Editor

Dear Editor

We read with great interest the invited review by Fojecki and colleagues regarding the role of extracorporeal shock wave therapy (ESWT) in urology [1]. The authors systematically reviewed randomized controlled trials (RCTs) published before November 9, 2015, to have examined ESWT in urologic diseases, including Peyronie’s disease, chronic pelvic pain and erectile dysfunction (ED). In the article, they focused on the role of ESWT in patients with ED who had previously responded to a phosphodiesterase type 5 inhibitor (PDE5i). Those with ED unresponsive to PDE5is were not mentioned, likely due to lack of RCTs and the assumption that they probably also benefit from ESWT treatment.

The first double-blind, sham-controlled study examining the role of ESWT for PDE5i non-responders was published at the end of 2015 [2] and reported that penile ESWT can convert a PDE5i non-responder to a responder. In terms of erection hardness score (EHS) and the erectile function (EF) domain of...


Erectile Dysfunction Erectile Function Chronic Pelvic Pain Extracorporeal Shock Wave Therapy Phosphodiesterase Type 
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This work was supported by the Science and Technology Foundation of the Sichuan Province (2014JY0183 to Yi-ping Lu) and the Science and Technology Foundation of the Chengdu City (2014-HM01-00301-SF to Yi-ping Lu).

Authors’ contribution

ZJ Zou and YP Lu wrote and edited the manuscript. ZH Liu and LY Tang collected the data.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Fojecki GL, Tiessen S, Osther PJS (2016) Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain. World J Urol. doi: 10.1007/s00345-016-1834-2 PubMedGoogle Scholar
  2. 2.
    Kitrey ND, Gruenwald I, Appel B et al (2016) Penile low intensity shock wave treatment is able to shift PDE5i nonresponders to responders: a double-blind, sham controlled study. J Urol 195(5):1550–1555CrossRefPubMedGoogle Scholar
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    Gruenwald I, Appel B, Vardi Y (2012) Low-Intensity extracorporeal shock wave therapy-a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy. J Sex Med 9(1):259–264CrossRefPubMedGoogle Scholar
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    Ruffo A, Capece M, Prezioso D et al (2015) Safety and efficacy of low intensity shockwave (LISW) treatment in patients with erectile dysfunction. Int Braz J Urol 41(5):967–974CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Zi-jun Zou
    • 1
  • Zhi-hong Liu
    • 1
  • Liang-you Tang
    • 1
  • Yi-ping Lu
    • 1
    Email author
  1. 1.Urological Institute, Urological Department, West China HospitalSichuan UniversityChengduPeople’s Republic of China

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