Effect of physical exercise combined with shockwave therapy on erectile dysfunction in diabetic patients

Abstract

IntroductionThe aim of the study was to evaluate whether physical exer�cise (PE) in addition to extracorporeal shockwave therapy (ESWT) is more effective in improving erectile function as compared to ESWT and PE alone in diabetic patients with erectile dysfunction (ED).Material and methodsForty-five patients with type 2 diabetes mellitus (DM) and ED were divided into three equal groups: group 1 (ESWT group) received treatment with ESWT twice weekly for 6 weeks, comprising 3000 shockwaves at an energy density of 0.25 mJ/mm2 and an emission frequen�cy of 6 Hz; group 2 (PE group) received treatment with physical exercise three times per week for 12 weeks; and group 3 (combined group) was treat�ed using physical exercise in the form of the program followed by the PE group, plus ESWT in the form of the same parameter and protocol as that of the ESWT group. Treatment outcomes were measured by International Index of Erectile Function-5 (IIEF-5) score variations recorded at 4 and 12 weeks after the end of treatment with respect to the baseline.ResultsThe mean IIEF-5 scores significantly improved in all groups at the 4-week follow-up without intergroup differences. At the 12-week follow-up, the mean IIEF-5 improvement and durability were significantly higher among patients in combined groups.ConclusionsThe combined approach of ESWT and PE provides significant advantages in erectile dysfunction improvement and durability as compared to ESWT or PE alone in diabetic patients with ED.