Shockwave Therapy on Treating Erectile Dysfunction Following Nerve-sparing Radical Prostatectomy.

Condition(s) studied

Investigational drug(s) / intervention(s)

Low-Intensity Extracorporeal Shockwave Therapy: LiESWT will be administered using the SoftWave UroGold system (SoftWave TRT, Inc., USA). Participants randomized to the experimental arm will receive eight LiESWT sessions in two treatment blocks during postoperative weeks 3-4 and 10-11, with two sessions per week separated by 2-3 days. During each approximately 15-minute session, 3,000 shockwave impulses will be delivered at a frequency of 5 Hz and an energy flux density of 0.09 mJ/mm². Shockwaves will be applied to six penile treatment sites: the right and left crura and the right and left proximal and distal penile shaft. LiESWT will be administered in addition to standard postoperative penile rehabilitation.

Standard of Care: Participants will receive standard postoperative penile rehabilitation following NSRP, as prescribed by the treating physician. Standard rehabilitation may include phosphodiesterase type 5 inhibitors (PDE5i) and/or intracavernosal injections (ICI) at the discretion of the treating physician.

Study summary

This study will investigate whether low-intensity extracorporeal shockwave therapy (LiESWT) can help men recover erectile function after nerve-sparing prostate cancer surgery. Erectile dysfunction is common after this surgery, and current rehabilitation treatments mainly help manage symptoms rather than directly promoting recovery of the affected penile tissues. LiESWT is a non-invasive treatment that uses low-intensity shockwaves and may help improve blood flow and tissue recovery.

The study will include 80 men undergoing nerve-sparing radical prostatectomy. Participants will be randomly assigned to receive either standard penile rehabilitation alone or standard rehabilitation plus eight LiESWT treatments. Erectile function, urinary function, pain, and potential side effects will be assessed throughout the 36-week study period. The main goal is to determine whether adding LiESWT increases the number of men who recover normal erectile function 24 weeks after surgery. The findings may help improve penile rehabilitation and sexual health outcomes for men recovering from prostate cancer surgery.

Eligibility

Primary outcome measure(s)

• Proportion of Participants Achieving Normal Erectile Function — 24 weeks following nerve-sparing radical prostatectomy
  The proportion of participants achieving normal erectile function will be compared between the LiESWT plus standard of care (experimental) group and the standard of care alone (control) group. Erectile function will be assessed using the 6-item International Index of Erectile Function-Erectile Function (IIEF-EF) domain. Scores range from 1 to 30, with higher scores indicating better erectile function. Normal erectile function is defined as an IIEF-EF score ≥26.

Trial sites (1)

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