Effect of ESWT on ED in Type 2 Diabetics

Cairo University (CU)

Status: Unknown

Conditions: Erectile Dysfunction; Diabetes Mellitus, Type 2

Treatments: Device: sham extracorporeal shock wave; Device: active extracorporeal shock wave

Study type: Interventional

Funder types: Other

Identifiers

NCT04219462

P.T.REC/012/002577

Details and patient eligibility

About

Diabetes mellitus (DM) is known not only for its widespread prevalence, but also for its significant complications including cerebrovascular disease, coronary artery disease, renal failure, vision loss, and neuropathy. Of particular importance to sexual medicine, diabetes has also been strongly associated with erectile dysfunction (ED).ED is defined as the inability to obtain and/or maintain the erection firm enough to achieve a successful sexual intercourse on a regular basis. It is a more common condition in males with type 2 DM. In the field of sexual medicine numerous studies have shown that extracorporal shock wave therapy (ESWT) is safe, noninvasive, and, most importantly, an effective method for treating vascular ED

Full description

ED in DM is often complex and caused by several mechanisms including vascular disease, autonomic neuropathy, hormonal imbalance, and psychogenic factors. However, as the endothelial dysfunction is an important factor contributing to the development of ED in diabetic patients, such patients can be resistant to phosphodiesterase 5 inhibitors (PDE5I) like sildenafil therapy. There are reports of lower efficacy of sildenafil in DM patients compared to general population.In the field of sexual medicine numerous studies have shown that ESWT is safe, noninvasive, and, most importantly, an effective method for treating vascular ED

Before starting the study, clearance will be obtained from the institutional ethical committee and prior informed consent of all the participants will be obtained before conducting the study. Patients will be recruited from outpatient clinic of andrology (Cairo University Hospitals). The patients were randomly divided into two equal groups:

Group (1): (Study group): Men in this group (n= 20) men receive extracorporeal shock wave (ESWT) twice weekly for 3 consecutive weeks and repeated after a 3-week rest period, for a total of 12 treatment sessions+sildenafil 5mg) Group (2): (Control group):) will receive sham treatment underwent identical therapy with ESWT application with a similar appearance and sound as the active low intensity ESWT+sildenafil 5mg

Enrollment: 40 estimated patients

Sex: Male

Ages: 40 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Forty married diabetic type 2 men with mild and moderate ED score (21-8) on Five-Item Version of the International Index of Erectile Function.
2. Patients who will have erectile dysfunction ( ED) from 6 months.
3. Patients with diabetes mellitus ( DM )duration ≥ 5 years with fasting blood glucose level of ≥ 126 mg/dl and glycosalyated haemoglobin (HbA1c ) ≥ 6.5% mg dl.
4. Body mass index ( BMI) will be < 30 kg/m²
5. The age of patients will be between 40- 60 years.

Exclusion criteria

• History of pelvic trauma, pelvic surgery, psychiatric disease.
• Patients with neuromuscular disorders, cardiovascular or pulmonary problems and spinal cord injuries.
• Vascular surgical intervention that recommended for the patients.
• Other renal conditions, respiratory disease, liver failure.
• Prostatectomy and patients with prostatic disease.
• Patients lacking complete follow-up data.
• hypogonadism.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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40 participants in 2 patient groups

study group

Active Comparator group

Description:

twenty men receive extracorporeal shock wave (ESWT) twice weekly for 3 consecutive weeks and repeated after a 3-week rest period, for a total of 12 treatment sessions. The patients will receive ESWT for 15 minutes at an energy level of 0.09 and a frequency of 120 shocks/min (1800 pulses per session). Shockwaves were delivered to the distal, mid, and proximal penile shaft, as well as to the left and right crura +sildenafil 5mg once daily for 3 months.

Treatment:

Device: active extracorporeal shock wave

control group

Sham Comparator group

Description:

twenty men will receive sham treatment underwent identical therapy with Extracorporal shock wave therapy (ESWT) application with a similar appearance and sound as the active low intensity extracorporal shock wave therapy (ESWT), although shock wave propagation to the tissue wills be blocked by a metal plate that will inserted into the sham applicator + sildenafil 5mg once daily for 3 months.

Treatment:

Device: sham extracorporeal shock wave