Overview
Erectile dysfunction (ED) is reported in up to 85% of men who have undergone a radical prostatectomy for prostate cancer. A few small studies have recently shown that low-intensity shockwave therapy may improve sexual performance in men with ED. However, the optimal dosage and length of treatment is yet to be determined. The investigators propose a randomised trial evaluating the efficacy and safety of low-intensity shockwave therapy in men with ED following prostatectomy surgery.
Description
Erectile dysfunction (ED) is reported in up to 85% of men who have undergone a radical prostatectomy for prostate cancer. At present, this debilitating consequence of surgery is managed in a step-wise approach including oral medication, injections and in severe cases, insertion of a penile prosthesis. A few small studies have shown that low-intensity shockwave therapy may improve sexual performance in men with ED. However, the optimal dosage and length of treatment is yet to be determined. The investigators propose a randomised trial evaluating the efficacy and safety of low-intensity shockwave therapy in men with ED following prostatectomy surgery. Low-intensity shockwave therapy would be a non-invasive treatment to preserve and improve patient's sexual function.
Eligibility
Inclusion Criteria:
- Age 40 - 65
- Diagnosed with low/intermediate-risk prostate cancer:
- PSA < 20 ng/ml
- Gleason score < 8
- PCa stage =< T2b
- Baseline IIEF-ED 17-30 without erectogenic aids
- No pre-operative urinary incontinence (no usage of urinary pads)
- Sexually active
- Able to understand and complete patient questionnaires
- Consent to participate
Exclusion Criteria:
- Anatomical abnormalities in the genitalia or pelvic region
- Post-RP complications that could impact safety or effectiveness of ESWT (eg. hematoma, fistula, unresolved anastomotic leak)
- Incomplete tumor removal (positive surgical margin)
- Tumor upstaging beyond T2b
- Nerve sparing score > 5
- Previous or scheduled treatment with pelvic radiotherapy and/or androgen deprivation therapy
- Untreated hypogonadism (serum total testosterone < 300 mg/dL)
- Anti-coagulant medication, except acetylsalicyclic acid up to 100mg daily
- Any other condition that would prevent the patient from completing the study, as judged by the principle investigator