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An update in improving erectile dysfunction therapy in Indonesia by using Li-ESWT and tadalafil combination — vascular endothelial growth factor and peak systolic velocity comparison: a randomized clinical trial

  • Androniko Setiawan1
  • Andrian Japari1,*,
  • Rosy Nur Febriani1
  • Silvia Werdhy Lestari2
  • Tjahjo Djojo Tanojo3
  • Maria Paulina Budyandini Dyah Pramesti4
  • Agustinus Agustinus4
  • Mu-hammad Hidayat Surya Atmaja5
  • Munawaroh Fitriah6
  • Budi Utomo7

1Andrology Specialist Program, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Aca-demic Hospital, 60286 Surabaya, Indonesia

2Department of Medical Biology, Faculty of Medicine, Universitas Indonesia, 16424 Jakarta, Indonesia

3Andrology Clinic, Dr. Soetomo General Academic Hospital, 60286 Surabaya, Indonesia

4Department of Medical Biology, Faculty of Medicine, Universitas Airlangga, 60115 Surabaya, Indonesia

5Radiology Unit, Dr. Soetomo General Academic Hospital, 60286 Surabaya, Indonesia

6Clinical Pathology Lab, Dr. Soetomo General Academic Hospital, 60286 Surabaya, Indonesia

7Department of Public Health, Faculty of Medicine, Universitas Airlangga, 60115 Surabaya, Indonesia

DOI: 10.31083/j.jomh1805118 Vol.18,Issue 5,May 2022 pp.1-8

Submitted: 09 November 2021 Accepted: 08 December 2021

Published: 31 May 2022

*Corresponding Author(s): Andrian Japari E-mail: andrian-2017@fk.unair.ac.id

Abstract

Background: Erectile dysfunction (ED) affects men’s life desperately and the incidence increases continuously. There are a few lines of ED therapy, but there are still many ED cases that have not treated utterly. Therefore, research is needed to obtain the most appropriate line of ED therapy, based on the underlying mechanism of ED. The aim of this study is to analyze the effect of oral daily 2.5 mg of tadalafil administration and twice weekly Low Intensity Extracorporeal Shockwave Therapy (Li-ESWT) for 4 weeks in erectile dysfunction patients, based on Peak Systolic Velocity (PSV) and Vascular Endothelial Growth Factor (VEGF). Methods: A 26-sample clinical trial was conducted with pre and post-test control group design. Random allocation was done to divide the samples into two groups. Control group was given 2.5 mg oral daily tadalafil, while the experimental group, additional twice weekly Li-ESWT was given. Therapies were given for 4 weeks. All subjects were assessed using Erection Hardness Score (EHS) score, International Index of Erectile Function (IIEF-5) score, and Color Doppler Ultrasonography (CDUS) penis for PSV, and plasma level of VEGF twice, prior to and after therapy. Results: The experimental group showed significant improvement compared to the control group in EHS (delta) 2 (1–2) vs 1 (0–2); IIEF-5 (delta) 7 (3–15) vs 4 (0–11); PSV (delta) 2.60 ± 1.34 vs 1.28 ± 1.86; and VEGF (delta) 26.69 ± 24.23 vs 6.32 ± 25.43. Conclusions: Li-ESWT and tadalafil combination therapy improved erectile dysfunction, specifically based on PSV and VEGF parameters.


Keywords

Erectile dysfunction; Li-ESWT; Tadalafil; PSV; VEGF


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Androniko Setiawan,Andrian Japari,Rosy Nur Febriani,Silvia Werdhy Lestari,Tjahjo Djojo Tanojo,Maria Paulina Budyandini Dyah Pramesti,Agustinus Agustinus,Mu-hammad Hidayat Surya Atmaja,Munawaroh Fitriah,Budi Utomo. An update in improving erectile dysfunction therapy in Indonesia by using Li-ESWT and tadalafil combination — vascular endothelial growth factor and peak systolic velocity comparison: a randomized clinical trial. Journal of Men's Health. 2022. 18(5);1-8.

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