Aksonov P. Low-energy shockwave therapy (LESWT) in the treatment of the patients with erectile dysfunction.

The dissertation is devoted to solving the actual problem of urology - to increase the effectiveness of treatment of the patients with vascular erectile dysfunction by using LESWT and to develop the most effective algorithm for the management of this category of patients. It was proved that using of LESWT with phosphodiesterase-5 inhibitors have the greatest impact on improving the erectile function (EF) and cavernous hemodynamics in patients with moderate and severe vascular erectile dysfunction (ED) and this effect lasts during the full period of the treatment and for a long time after the treatment. It was proved that LESWT promotes the expression of vascular endothelial growth factor (VEGF), which induces the angiogenesis processes in the vascular endothelium. The clinical diagnostic algorithm was designed for the management of patients with moderate and severe vascular ED by using LESWT method. A protocol of the conservative treatment of moderate and severe vascular erectile dysfunction was proposed and used in clinical practice with using LESWT method. This method consists of combined treatment with phosphodiesterase-5 inhibitors (sildenafil citrate 50 mg every other day for 8 weeks orally) and the LESWT method ( the intensity of 0,09 mJ / mm2 , 1600 pulses in the projection of each corpus cavernosum and 900 pulses for each segment of the crura penis; full course of 8 sessions spread over eight weeks - 1 session per week during 8 weeks of treatment, a single session of 15 minutes) which enhances the effectiveness of the therapy by 67,8 % compared with the standard treatment.