Where is the latest research.....make noise!

[hoosierphilly]

I plan to see if the Alpha-Stim (from Texas) will aid my ED! I have stents (not in the penis), and Type 2 diabetes, and ED recently if performance with discomfort????

Any thoughts out there.


Shock waves may improve penile vasculature.
LYON, FRANCE—Israeli researchers have reported promising preliminary results using low-intensity shock wave therapy to treat vasculogenic erectile dysfunction (ED).

In fact, 15 of 20 patients with mild or moderate ED who have been treated thus far had a significant improvement in erectile function and in most cases were able to discontinue treatment with phosphodiesterase-5 (PDE-5) inhibitors. There were no reports of pain or other adverse effects.

Yoram Vardi, MD, chief of the neuro-urology unit at Rambam Medical Center in Haifa, presented the findings here at the annual meeting of the European Society for Sexual Medicine.

Low-energy shock wave therapy is being increasingly used to induce regeneration of small coronary vessels in patients with angina who are not suitable for coronary surgery or angioplasty, Dr. Vardi explained.

His group had hypothesized that if the therapy can improve the vasculature of the heart, it might also be effective in the penis because 80% of ED cases are of vascular origin.

Participants in the trial had a score of 12 to 20 on the Erectile Function domain of the International Index of Erectile Function (IIEF-ED) and abnormal nocturnal penile tumescence (NPT). In all cases, ED had a vascular origin. The mean duration of ED was 35 months.

During each treatment session, low-energy shock wave therapy was applied on the penile shaft and crus for three minutes in each of five anatomical sites. The shock waves were are one-tenth the level of intensity as the shock waves used to pulverize kidney stones.

The men underwent a three-week course of two weekly treatment sessions and a second identical round of therapy starting three weeks later. Erectile function was assessed at the time of enrollment and four weeks after the end of treatment.

“The protocol used to enhance vasculogenesis of the ischemic heart is the same one we used to treat ED,” Dr. Vardi said.

Results showed that the IIEF-ED score improved by more than five points in 15 patients (75%). Seven of 20 patients (35%) had an improvement of more than 10 points.

Six-month follow-up data show that 12 of the 15 patients who improved significantly with treatment said they no longer needed to use PDE-5 inhibitors to treat their condition.

Scores on several other validated ED questionnaires including Quality of Erection Questionnaire, Self-Esteem and Relationship Questionnaire, and Erectile Dysfunction Inventory of Treatment Satisfaction also improved significantly.

The analysis additionally showed a significant improvement in baseline and maximal flow values on a penile endothelial function test.

“We are very excited by our findings but it's important to emphasize that they are preliminary and that further evaluation is needed using sham control and long-term follow-up,” Dr. Vardi said. “And what has been especially gratifying is that patients have told us that they are very pleased with the results and they tell us that they are again having morning erections and that they can perform better.”

From the January 2010 Issue of Renal And Urology News »


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This coverage is not sanctioned by, nor a part of, the European Association of Urology.



Medscape Medical News

Penile Shock Wave Therapy Helps Men With Severe Erectile Dysfunction

Jill Stein
March 22, 2011







Editors' Recommendations
•Phosphodiesterase Inhibitors in Clinical Urology
•Assessing Satisfaction in Men and Their Female Partners After Treatment With Phosphodiesterase Type 5 Inhibitors for Erectile Dysfunction
•Zotarolimus-Eluting Peripheral Stents for the Treatment of Erectile Dysfunction in Subjects With Suboptimal Response to Phosphodiesterase-5 Inhibitors



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Drug & Reference Information
•History Taking in the Erectile Dysfunction Patient
•Physiology of Erectile Dysfunction
•Erectile Dysfunction








March 22, 2011 (Vienna, Austria) — Low-intensity shock wave therapy to the penis can help men with severe erectile dysfunction (ED) that is unresponsive to conventional phosphodiesterase type 5 (PDE-5) inhibitor treatment, according to data released here at the European Association of Urology 26th Annual Congress.

"Our earlier randomized double-blind placebo-controlled study demonstrated that low-intensity shock wave therapy can help men who respond to PDE-5 inhibitor therapy, and our new data show that the treatment is also beneficial when given to nonresponders with severe ED," Yoram Vardi, MD, head of the neuro-urology unit at Rambam Medical Center in Haifa, Israel, told Medscape Medical News.






Dr. Yoram Vardi

The new findings confirm that the treatment exerts a genuine physiological effect on the erectile mechanism when applied directly to the cavernosal tissue, he added.

Dr. Vardi reported results in 29 men with vasculogenic ED who had a mean baseline International Index of Erectile Function (IIEF-ED) domain score of 8.8 and a rigidity score of 2 or lower. Their mean age was 62.8 years.

"While the introduction of PDE-5 inhibitors undeniably represents a major advance in ED treatment, these agents are a symptomatic treatment and are associated with unpleasant side effects and poor compliance," Dr. Vardi said. "These limitations become magnified when the treatment is intended for a pleasurable biological function rather than a life-threatening disease."

Rationale for Shock Wave Therapy in ED

Low-energy shock wave therapy is being increasingly used to induce the regeneration of small coronary vessels in patients with angina who are not suitable for coronary surgery or angioplasty, Dr. Vardi explained.

If the therapy can improve the vasculature of the heart, it might also be effective in the penis, because 80% of ED cases have a vascular origin, he said.

The shock wave therapy protocol involved 2 treatment sessions per week for 3 weeks, which were then repeated 3 weeks later.

During each treatment session, low-energy shock wave therapy was applied to the penile shaft and crus for 3 minutes in 5 different penile anatomical sites. The shock waves are one tenth the level of intensity as shock waves used to pulverize kidney stones.

Patients had a follow-up assessment at 1 month, when they were not receiving a PDE-5 inhibitor, and again at 2 months, when they were receiving active on-demand PDE-5 inhibitor therapy.

The coprimary end points were changes on the IIEF-ED domain score and penile rigidity score.

Significant Improvement

At the end of the study, 21 patients (72.4%; P < .0001) achieved a rigidity score of 3 or higher, meaning they were able to achieve full vaginal penetration.

The mean IIEF-ED domain score of the participants increased to 18.8 ± 1.1 (P < .0001). For 22 patients (75.9%), the IIEF-ED domain scores were increased by 5 or more points, and the average improvement for all 30 patients exceeded 10 points. The erectile function of 8 patients had normalized at the second follow-up visit, and patients were able to function sexually without the use of medication.

In addition, all 3 hemodynamic penile parameters (maximum flow-mediated dilation [FMD]) and area under the curve FMD significantly increased (P = .0001) and were significantly associated with an increase in IIEF-ED domain scores (P < .05).

There were no complaints of pain related to treatment, and no adverse events were reported during follow-up.

"The findings mean that low-intensity shock wave therapy was able to convert most nonresponders into PDE-5 inhibitor responders, thereby enabling men who were not functioning sexually to now achieve vaginal penetration and full intercourse," Dr. Vardi observed.

Importantly, the 21 diabetic patients in this series had significant improvement in ED. "These men are normally very difficult to treat," he said.

Elsewhere at the meeting, Dr. Vardi reported that the results from the first randomized sham-controlled study demonstrated that the application of the device directly to the penis has a significant effect on erectile mechanism and hemodynamics, compared with the sham intervention.






Dr. James Catto

"The biggest problem with ED treatments is that the tablets are used on an on-demand basis and don't work for a proportion of patients; that proportion may be 30% or 70%, depending on the population and the prescribing physician," James Catto, MB ChB, PhD, FRCP, from the academic urology unit and Institute for Cancer Studies at the University of Sheffield, United Kingdom, told Medscape Medical News. "If tablets don't work, we consider options like injections and pumps, which are much less palatable for the patient and his partner."

The potential appeal of shock wave therapy is that, unlike current ED treatments, which are symptomatic and used on an on-demand basis, shock wave therapy aims to provide sustained improvement of the erectile mechanism and cure ED, he said. "Shock wave therapy potentially allows a man to return to a more normal environment, where he doesn't have to use medication. If he does still use medication, he will likely get a better result from it."

The study was partially supported by an unrestricted grant from Medispec, the company that manufactures the ED1000 device that was used in the study. Dr. Vardi and Dr. Catto have disclosed no relevant financial relationships.

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Ther Adv Urol. 2013 Apr;5(2):95-9. doi: 10.1177/1756287212470696.

Shockwave treatment of erectile dysfunction.

Gruenwald I, Appel B, Kitrey ND, Vardi Y.



Author information



Abstract

Low-intensity extracorporeal shock wave therapy (LI-ESWT) is a novel modality that has recently been developed for treating erectile dysfunction (ED). Unlike other current treatment options for ED, all of which are palliative in nature, LI-ESWT is unique in that it aims to restore the erectile mechanism in order to enable natural or spontaneous erections. Results from basic science experiments have provided evidence that LI-ESWT induces cellular microtrauma, which in turn stimulates the release of angiogenic factors and the subsequent neovascularization of the treated tissue. Extracorporeal shock wave therapy (ESWT) has been clinically investigated and applied in several medical fields with various degrees of success. High-intensity shock wave therapy is used for lithotripsy because of its focused mechanical destructive nature, and medium-intensity shock waves have been shown to have anti-inflammatory properties and are used for treating a wide array of orthopedic conditions, such as non-union fractures, tendonitis, and bursitis. In contrast, LI-ESWT has angiogenetic properties and is therefore used in the management of chronic wounds, peripheral neuropathy, and in cardiac neovascularization. As a result of these characteristics we initiated a series of experiments evaluating the effect of LI-ESWT on the cavernosal tissue of patients with vasculogenic ED. The results of our studies, which also included a double-blind randomized control trial, confirm that LI-ESWT generates a significant clinical improvement of erectile function and a significant improvement in penile hemodynamics without any adverse effects. Although further extensive research is needed, LI-ESWT may create a new standard of care for men with vasculogenic ED.


KEYWORDS:

erectile dysfunction, male impotence, shockwaves, therapy


PMID: 23554844 [PubMed] PMCID: PMC3607492 Free PMC Article