S238
Greece; 21st Department of Urology and Center for Sexual and
Reproductive Health, Aristotle University of Thessaloniki,
Thessaloniki, Greece
Objective: There is lack of evidence-based protocol for Low-
intensity Shockwave Therapy (LiST) for erectile dysfunction
(ED). Furthermore, safety and efficacy of repeating shockwave
therapy has not been explored. This 2-phase study a) compares
the efficacy and safety of 6 and 12 treatment sessions within a
6-week treatment period and b) investigates the effect of re-
treatment after 6 months period.
Material and Methods: Patients with vasculogenic ED,
responders to PDE5 inhibitors, were randomized into 2 groups:
LiST sessions once (Group A) or twice (Group B) per week for
6 consecutive weeks (Phase 1). Patients who completed 6-month
follow-up were offered 6 additional sessions (Phase 2); Group A
received 2 sessions per week, and Group B received 1 session per
week. Patients were then followed up for 6 months. IIEF-EF
domain score, Minimally Clinical Important Differences
(MCID), Sexual Encounter Profile (SEP) and triplex ultraso-
nography parameters were assessed.
Results: In Phase 1, both groups improved in IIEF-EF, MCID,
SEP3 and mean peak systolic velocity (PSV) compared to baseline.
MCID were achieved in 62% (Group A) and 71% (Group B),
while SEP3 “Yes” response was 47% in Group A, and 65% in
Group B (Group A vs Group B p-value ¼ 0.02). Mean PSV at
baseline and 3m-FU-1 were 29.5 and 33.4 cm/s for Group A and
29.6 and 35.4 cm/s for Group B (p ¼ 0.06). In phase 2, Group A
experienced a greater increase in SEP3 %Yes responses (Group A ¼
+14.9; Group B ¼ +0.3). When the impact of the total number of
sessions received was examined, minimal clinically important dif-
ference (MCID) in IIEF-EF domain from baseline were achieved in
62%, 74% and 83% of patients after 6, 12 and 18 sessions,
respectively. No treatment-related side-effects were reported.
Conclusion: Total number of LiST sessions impacts the efficacy
of ED treatment. Retreating patients after 6 months may further
improve erectile function, without side effects. 12 sessions may
be delivered within 6 weeks without a 3-week break period.
Patients may benefit more in sexual performance from 12 ses-
sions, twice per week, compared to 6 sessions, once a week. It is
meaningful and safe to repeat shockwave therapy, up to a total of
18 sessions.
Disclosure: Work supported by industry: yes, by Dornier
MedTech Systems, GmbH (Wessling, Germany) (industry
funding only - investigator initiated and executed study).
286
EFFICACY OF AUTOLOGOUS PLATELET-
RICH PLASMA FOR THE TREATMENT OF
ERECTILE DYSFUNCTION
Epifanova, M.V.1; Chaliy, M.E.2; Gvasalia, B.R.3; Repin, A.M.2;
Artemenko, S.A.2
1
Research Institute for Uronephrology and Reproductive Health,
Sechenov First Moscow State Medical University (Moscow, Russia);
2
Department of Urology, Sechenov First Moscow State Medical
Proceedings of the 21st World Meeting on Sexual Medicine
University (Moscow, Russia); 3Central Military Clinical Hospital
(Moscow, Russia)
Objective: Phosphodiesterase type 5 inhibitors (PDE5Is) are the
leading drugs for the treatment of erectile dysfunction (ED),
being recommended as a first line treatment by urological
guidelines. However, some patients do not respond to drug
therapies. Platelet-rich plasma (PRP) has been suggested to be
effective in the management of ED. The aim of this study was to
assess the efficacy of autologous platelet-rich plasma (PRP) for
the treatment of ED.
Methods: 60 patients aged 43.7 (SD¼13.7) with ED (mean
duration of ED was 7.7±1.7 months) were randomly sepa-
rated into 2 groups. Group A received 4 ml activated PRP
(aPRP) intracavernosal injection weekly (totally 3 times),
while Group B received PRP injections according to the same
schedule plus 5 mg of tadalafil daily during 28 days. The
International Index of Erectile Function (IIEF), Erection
Hardness Scale (EHS), EndoPAT, Penile duplex Doppler ul-
trasound (PDDU), Sexual Encounter Profile (SEP) and com-
plications (if any) were evaluated at 4 weeks, 3 and 6 months.
Data sets were statistically compared and p<0.05 was consid-
ered as significant.
Results: At week 4 and at 3 months Group B shows significant
improvement in IIEF score compared to baseline (p¼0.001).
There was no apparent difference in results between groups at 6
months. SEP score was similar in both groups during the study,
but EHS score was higher in group B at 3 months (p¼0.002).
EndoPAT - endothelial function was significantly improved in
both groups at 6 months compared to baseline (p¼0.018) as well
as resistive index (RI) in the cavernosal arteries (p¼0.001). The
treatment was well tolerated and none of the men experienced
treatment related discomfort or reported any adverse effects from
the treatment.
Conclusion: PRP seems to be able to improve vascular endo-
thelial function and erection hardness to treat erectile dysfunc-
tion with less adverse effects and better safety. Longer followup is
needed to establish the place of PRP in restoring of erectile
function.
Disclosure: Work supported by industry: no.
287
INTRACAVERNOUS PROSTAGLANDIN
INJECTION MIGHT BE A GOOD METHOD
TO EVALUATE OBJECTIVELY THE
RESPONSE TO LISWT AND TO PREDICT
THE NUMBER OF LISWT SESSIONS
NEEDED IN ED PATIENTS
Feghali, J.1
1
KMC-AUB Hospital, Jounieh-Lebanon
Objective: Since 2010 Low Intensity Shock Wave Therapy
(LISWT) is used for treating patients with Erectile Dysfunction.
Till now there is no objective method to evaluate objectively the
response to LISWT and predict the number of LISWT sessions
needed in vasculogenic Erectile Dysfunction (ED) patients which
J Sex Med 2018;15:S123eS407