PS-5-9 Erectile Dysfunction after Radical Prostatectomy: Low-Intensity Extracorporeal Shockwave Therapy (LIESWT) Plays a Role?

Recent studies show that the modalities for the erectile rehabilitation after radical prostatectomy (RP) include the phosphodiesterase-5 inhibitor (PDE5i) as first-line treatment, then intracavernous injections, and penile implants. Erectyle dysfunction stills representing the main and frequent adverse effect following RP despite the development of its technique and technology behind this procedure. To compare the standard of care (early introduction of PDE5i) with the combination therapy enrolling both early PDE5i use and low intensity extracorporeal shockwave therapy (LiESWT) in patients submitted to RP. Our study is a randomized clinical trial (RCT), open-label, with two parallel arms and allocation ratio of 1:1. The primary endpoint was ≥ 4-point difference between the study arms considering the final mean IIEF-5 at the last follow-up. The second endpoint was the proportion of those who reach IIEF-5 ≥17 at last follow-up was assessed. Both arms started tadalafil 5 mg/day after the removal of the transurethral catheter, and the experimental group received 2,400 shocks/session-week distributed on 4 different penile regions. The full treatment consisted of 19,200 impulses across eight weeks.