Comparative effectiveness of focused shockwave therapy and radial wave therapy for erectile dysfunction: a two center prospective cohort study

Background: Focused shockwave therapy (fSWT) has now taken its place in the algorithm for the treatment of vascular erectile dysfunction (ED) in current guidelines. Radial wave therapy (rWT) has started to be applied with the same indication in recent years and positive results have been reported. We aimed to compare the long-term effectiveness of fSWT and rWT in ED. Methods: A two-center study enrolled 200 patients aged 40 to 70 years with ED complaints. Patients were non-randomly allocated to either fSWT or rWT groups based on the clinic they visited. Results: After 3 months, the mean International Index of Erectile Function (IIEF) score for patients in the fSWT group was significantly higher compared with the baseline (13 ± 2.9 vs. 20.4 ± 4.7, p < 0.001), and the same trend was observed at 1 year (13 ± 2.9 vs. 18.1 ± 4.9, p < 0.001). Similarly, in the rWT group, the mean IIEF score was significantly higher at 3 months (13.1 ± 3 vs. 22.8 ± 4.6, p < 0.001) and 1 year (13.1 ± 3 vs. 19.4 ± 4.9, p < 0.001) compared with the baseline. However, there was no significant difference in the mean IIEF score changes between the two groups at both 3 months and 1 year. The proportion of patients giving a positive response to the Sexual Encounter Profile-2 (SEP-2) question was 81% at 3 months and 63.2% at 1 year in the fSWT group, and 88.9% at 3 months and 71.6% at 1 year in the rWT group, with no significant difference between the groups. Conclusions: Both fSWT and rWT are effective treatments for vascular-related ED, showing comparable efficacy in improving IIEF scores. Clinical Trial Registration: The study was retrospectively registered with https://www.isrctn.com/ as: ISRCTN14000407.