The Efficacy and Safety of Thrice vs Twice per Week Low-Intensity Pulsed Ultrasound Therapy for Erectile Dysfunction: A Randomized Clinical Trial

Effects of low-intensity pulsed ultrasound on clinical parameters in atherosclerotic peripheral artery disease patients with chronic limb-threatening ischemia

Chronic limb-threatening ischemia (CLTI) is a major public health problem. Low-intensity pulsed ultrasound (LIPUS) has been shown to improve ischemic limb conditions in patients with CLTI. However, the possible mechanisms of these benefits require further understanding. A total of 37 atherosclerotic peripheral artery disease patients with CLTI (Fontaine class III or IV) who were not suitable for standard revascularization therapies were enrolled. Patients were treated with LIPUS daily for 20 min. Clinical parameters were evaluated at baseline and after 4 weeks and 12 weeks of treatment with LIPUS. Rest pain intensity on a visual analog scale (P = 0.018), walking impairment questionnaire score (P < 0.001), skin perfusion pressure (P < 0.001), flow-mediated vasodilation (P < 0.001), nitroglycerine-induced vasodilation (P = 0.002), white blood cell count (P = 0.013), ALT (P = 0.001), AST (P = 0.017), and high-sensitivity C-reactive protein (P = 0.011) were significantly improved after LIPUS treatment. None of the patients withdrew from the study due to adverse effects associated with LIPUS. During a mean follow-up period of 91.4 ± 49.0 months, the rate of survival was 88.9% at 1 year and the rate of limb survival was 88.6% at 1 year. LIPUS exposure may have favorable effects on clinical symptoms, inflammation, perfusion parameters, and vascular function in patients with CLTI and it can be used safely.Clinical Trial Registration Information: URL for Clinical Trial: https://www.umin.ac.jp/ctr/index.htm ; Registration Number for Clinical Trial: UMIN000004901, UMIN000014757; https://jrct.niph.go.jp/search ; Registration Number for Clinical Trial: jRCTs062200008.

Evaluation of efficacy and safety of low-intensity pulsed ultrasound in patients with concurrent erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized controlled study

OBJECTIVE

The primary objective of this clinical trial is to investigate the effect of low-intensity pulsed ultrasound (LIPUS) on patients suffering from comorbid erectile dysfunction (ED) and chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).

METHODS

The clinical trial was conducted in the andrology outpatient treatment room of the Department of Urology, Xiangya Hospital, Central South University from August to November 2022 A total of 60 patients who met the research criteria for comorbid ED combined with CP/CPPS were recruited and randomly assigned to three treatment groups. They were treated with LIPUS (Group A), drug therapy(Group B), and LIPUS combined with drug therapy (Group C), respectively. Each group comprised 20 patients. Statistical analysis was performed on the five-item version of International Index of Erectile Function (IIEF-5), Erection Hardness Score (EHS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the incidence of adverse events to comprehensively evaluate the efficacy and safety of LIPUS.

RESULTS

The positive response rate of ED and CP/CPPS treatment in Group A is 40%(8/20) and 45%(9/20), while those in Group B is 55%(11/20) and 60%(12/20), and those in Group C is 85%(17/20) and 85%(17/20). A notable increase in IIEF-5 scores was observed across the three groups post-treatment (10.45 ± 2.50 vs. 13.65 ± 3.03, P = 0.008; 11.80 ± 3.21 vs. 16.40 ± 3.20, P = 0.011; 12.90 ± 3.92 vs. 19.40 ± 2.35, P = 0.042) with a concomitant significant decrease in NIH-CPSI scores (16.75 ± 4.53 vs. 14.65 ± 4.51, P = 0.016; 16.35 ± 4.32 vs. 12.20 ± 4.74, P = 0.007; 16.00 ± 4.40 vs. 8.15 ± 4.28, P = 0.021). Notably, the most pronounced changes were seen in the group receiving LIPUS combined with tadalafil and doxazosin. Additionally, all groups exhibited marked improvements in anxiety and depression symptoms post-treatment. No adverse events were observed during treatment.

CONCLUSION

LIPUS can improve erectile function and CP/CPPS symptoms with good safety, and LIPUS combined with tadalafil and doxazosin is more effective during the treatment. However, its long-term efficacy remains to be seen.

TRIAL REGISTRATION

Chinese Clinical Trial Registry; approval number: ChiCTR2200063038 ( https://www.chictr.org.cn/ ) on August 29, 2022.

Knowledge mapping and global trends in the field of low-intensity pulsed ultrasound and endocrine and metabolic diseases: a bibliometric and visual analysis from 2012 to 2022

Background

Low-intensity pulsed ultrasound (LIPUS) is a highly promising therapeutic method that has been widely used in rehabilitation, orthopedics, dentistry, urology, gynecology, and other multidisciplinary disease diagnoses and treatments. It has attracted extensive attention worldwide. However, there is currently a lack of comprehensive and systematic research on the current status and future development direction of the LIPUS field. Therefore, this study comprehensively analyzed LIPUS-related reports from the past decade using bibliometrics methods, and further conducted research specifically focusing on its application in endocrine and metabolic diseases.

Methods

We downloaded LIPUS literature from 2012 to 2022 reported in the Web of Science Core Collection Science Citation Index-Expanded and Social Sciences Citation Index, and used bibliometric analysis software such as VOSviewer and CiteSpace to execute the analysis and visualize the results.

Results

We searched for 655 English articles published on LIPUS from 2012 to 2022. China had the highest number of published articles and collaborations between China and the United States were the closest in this field. Chongqing Medical University was the institution with the highest output, and ULTRASOUND IN MEDICINE AND BIOLOGY was the journal with the most related publications. In recent years, research on the molecular mechanisms of LIPUS has continued to deepen, and its clinical applications have also continued to expand. The application of LIPUS in major diseases such as oxidative stress, regeneration mechanism, and cancer is considered to be a future research direction, especially in the field of endocrinology and metabolism, where it has broad application value.

Conclusion

Global research on LIPUS is expected to continue to increase, and future research will focus on its mechanisms of action and clinical applications. This study comprehensively summarizes the current development status and global trends in the field of LIPUS, and its research progress in the field of endocrine and metabolic diseases, providing valuable reference for future research in this field.

Recent advances in stem cell therapy for erectile dysfunction: a narrative review

INTRODUCTION

While phosphodiesterase type 5 inhibitors (PDE5is) and others are used to treat Erectile dysfunction (ED), many patients are either unresponsive or resistant to it. Stem cell therapy (SCT) is a promising alternative approach. Numerous preclinical trials have demonstrated improved erectile function in animal models using SCT, although the number of clinical trials investigating SCT for men with ED is limited. Nonetheless, findings from human clinical trials suggest that SCT may be a useful treatment option.

AREAS COVERED

Biomedical literature, including PubMed, ClinicalTrials.gov, and European Union Clinical Trials Registry, were analyzed to summarize and synthesize information on stem cell therapy for ED in this narrative review. The achievements in preclinical and clinical evaluations are presented and critically analyzed.

EXPERT OPINION

SCT has demonstrated some benefits in improving erectile function, while further studies are urgently needed. Such studies would provide valuable insights into the optimal use of stem cell therapy and its potential as a therapeutic option for ED. Taking advantage of different mechanisms of action involved in various regenerative therapies, combination therapies such as SCT and low-energy shock waves or platelet-rich plasma may provide a more effective therapy and warrant further research.