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首页> 外文期刊>Nature reviews. Urology >Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough?
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Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough?

机译：勃起功能障碍的低强度冲击波治疗：证据足够强大吗？

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Erectile dysfunction (ED) affects similar to 30% of all men above the age of 40 years and its prevalence steadily increases with age. Current nonsurgical treatment options, including phosphodiesterase type 5 inhibitors (PDE5I), provide temporary relief but have failed to provide a permanent improvement of the condition. Low-intensity extracorporeal shockwave therapy (Li-ESWT) is noninvasive and uses acoustic waves, which can pass through tissue and be focussed to target specific areas or organs to induce the desired effects. The use of Li-ESWT has previously been described in other disease contexts, such as ischaemic heart disease, bone fractures, and burns, in which it improves neoangiogenesis; similar principles seem to apply in the erectile tissue. The major potential advantage of the treatment, therefore, is the possibility to restore natural erectile function. Thus, Li-ESWT is the only currently marketed treatment for ED that might offer a cure, which is the most desired outcome for most men with ED. Li-ESWT has also been suggested to improve the effect of PDE5I in nonresponders, reducing the need for more invasive treatments. Several single-arm trials have shown benefit of Li-ESWT on patient-reported erectile function scores, but data from randomized trials are conflicting, and many questions remain to be answered before we can routinely offer this treatment to patients. Thus, the search for the true clinical value of Li-ESWT for ED represents a dynamic and continuing field of enquiry.
机译：勃起功能障碍（ED）影响与40岁以上的所有男性的30％相似，其患病率随着年龄而稳步增加。目前的非静脉治疗方案，包括磷酸二酯酶类型5抑制剂（PDE5i），提供暂时的浮雕，但未能提供永久性改善条件。低强度体外冲击波治疗（LI-ESWT）是非侵入性的，并且使用可以穿过组织并聚焦到靶向特定区域或器官以诱导所需效果的声波。以前已经在其他疾病环境中描述了Li-ESWT，例如缺血性心脏病，骨折和烧伤，其中它改善了新生血管生成;类似的原理似乎在勃起组织中施用。因此，治疗的主要潜在优势是恢复天然勃起功能的可能性。因此，Li-ESWT是目前申请的唯一销售的治疗方法，可能会提供治疗，这是大多数男性的最需要的结果。也提出了Li-ESWT，提高了PDE5i在无反应者中的作用，降低了对更多侵入性治疗的需求。几种单臂试验表明，在患者报告的勃起功能评分上显示了LI-ESWT的益处，但随机试验的数据是冲突的，并且在我们常规向患者提供这种治疗之前仍有许多问题仍有待遇。因此，寻找LI-ESWT for ED的真正临床价值代表动态和持续的询问领域。

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