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This study retrospectively examined the effects of low-intensity extracorporeal shockwave therapy and tadalafil on erectile dysfunction patients. 116 patients got low-intensity extracorporeal shockwave therapy twice weekly for 3 weeks, 5 mg of tadalafil daily for 3 weeks, and adjuvant therapy for 6 months. Group A (1 year), Group B (2 years), Group C (3 years), and Group D (4+ years) were treated patients’ follow-up groups. The patients’ International Index of Erectile Function-5 (IIEF-5) scores were gathered at the start of treatment via face-to-face interviews and at the end of follow-ups by telephone conversations. IIEF-5 scores and the minimal clinically significant differences were the main outcomes. Mean follow-up length, age, and IIEF-5 scores of the patients were 2 ± 1.16 years, 47.34 ± 12.65 years, and 12.09 ± 3.66 points, respectively. Compared to baseline, treatment increased the median IIEF-5 scores of patients in groups A, B, C, and D by 7 [3–12], 6 [0–8], 7 [1–9], and 6.5 [2.5–10] points, respectively (p = 0.001). 71%, 63%, 65.8%, and 65% of treated patients in groups A, B, C, and D met the minimal clinically significant differences criteria (n = 77). Mild disease patients were 9.14 times more likely to respond to treatment than severe illness patients (OR, 9.14; 95% CI, 1.28–65.46; P = 0.02). Low-intensity extracorporeal shockwave therapy and 5 mg of tadalafil can treat erectile dysfunction for up to 4 years with sustained outcomes. This treatment is optimal for mild illnesses.

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Urology Clinic of Private Umit Visnelik Hospital, Eskişehir, Turkey

Yurdaer Kaynak

Neuro-Urology Unit, Rambam Healthcare Campus, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel

Ilan Gruenwald

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Yurdaer Kaynak designed the study and contributed to data extraction. The study was written by Yurdaer Kaynak. Ilan Gruenwald contributed to the writing of the paper and editing. Both of them approved the final version and submitted the paper to the journal.

Correspondence to Yurdaer Kaynak or Ilan Gruenwald.

The authors declare no competing interests.

The study was done under ethical approval (approval number: ESH/GOEK2022/1).

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Kaynak, Y., Gruenwald, I. Long-term effects of combination treatment comprising low-intensity extracorporeal shockwave therapy and tadalafil for patients with erectile dysfunction: a retrospective study. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00757-7

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Received: 11 March 2023

Revised: 11 August 2023

Accepted: 17 August 2023

Published: 29 August 2023

DOI: https://doi.org/10.1038/s41443-023-00757-7

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