The efficacy of Low-intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction (ED) in patients undergoing radical prostatectomy (RP) remains poorly recognized. To address this, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of this intervention.
From January 2000 to May 2025, five RCTs were selected, involving a total of 297 patients from PubMed, EMBASE, and the Cochrane Library to evaluate the efficacy of Li-ESWT for ED in patients undergoing RP.
At the 8- and 12-week assessments following Li-ESWT, participants who underwent Li-ESWT demonstrated significantly greater improvements in IIEF scores compared with those in the control group (8-week: MD 2.80, P < 0.0001; 12-week: MD 2.10, P = 0.004). In contrast, no significant differences in IIEF scores were detected between the Li-ESWT and control groups at 24 weeks and beyond post-treatment.
Li-ESWT significantly improves short-term erectile function in patients following RP. However, this therapeutic benefit was not sustained beyond 24 weeks. Accordingly, further research is warranted to investigate novel strategies and combination therapies aimed at preserving long-term erectile function after RP.
International urology and nephrology. 2026 Jul 03 [Epub ahead of print]
Zhongbao Zhou, Zhuoqi Cheng, Guangzhu Wei, Yong Zhang
Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China., Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany., Department of Urology, Beijing Luhe Hospital, Capital Medical University, Beijing, China., Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China. .