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.
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.
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.
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.
World journal of urology. 2026 Jun 23*** epublish ***
Mecit Celik, Muhammed Emin Polat, Kazim Ceviz, Batuhan Arabaci, Lutfi İhsan Boyaci, Erkan Ölcucuoglu, Salim Neselioglu, Ozcan Erel, Ercan Yeni
Department of Urology, Ergani State Hospital, Diyarbakir, Turkey. ., Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey., Ankara Bilkent City Hospital, Medical Biochemistry Laboratory, Yıldırım Beyazıt University, Ankara, Turkey.