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Purpose <p>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.</p> Methods <p>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.</p> Results <p>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 (<i>p</i> &lt; 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; <i>p</i> = 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.</p> Conclusion <p>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.</p>

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Evaluation of cavernosal oxidative biomarkers following radial Li-ESWT in vasculogenic erectile dysfunction

  • 期刊论文

  • 发表日期：

    2026年6月23日

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  • Mecit Celik,
  • Muhammed Emin Polat,
  • Kazim Ceviz,
  • Batuhan Arabaci,
  • Lutfi İhsan Boyaci,
  • Erkan Ölcucuoglu,
  • Salim Neselioglu,
  • Ozcan Erel,
  • Ercan Yeni

摘要

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.