The Effect of Combination Therapy Using Li-ESWT and PDE-5 Inhibitor in Patients With Erectile Dysfunction

Primary outcomes

1. Erectile Hardness Score (EHS)

   Time frame: 4 weeks

   Developed in 1998, the EHS is a single-item Likert scale that men can use on their own.

   The tool asks them to consider the question "How would you rate the hardness of your erection?" and select one of the following options:

   0 Penis does not enlarge

   • Penis is larger, but not hard
   • Penis is hard, but not hard enough for penetration
   • Penis is hard enough for penetration, but not completely hard
   • Penis is completely hard and fully rigid

   The EHS score was taken pre and post intervention

2. International Index of Erectile Function (IIEF-5) score

   Time frame: 4 weeks

   IIEF-5 is a tool for ED (Erectile Dysfunction)diagnosis. The possible scores for the IIEF-5 range from 5 to 25, and ED was classified into five categories based on the scores: severe (5-7), moderate (8-11), mild to moderate (12-16), mild (17-21), and no ED (22-25)

   IIEF-5 score was taken pre and post intervention

3. Peak Systolic Velocity (PSV)

   Time frame: 4 weeks

   PSV was measured in cm/s, by using Doppler Ultrasonography. The probe is located at the penis, to be precise in the penoscrotal junction, to measure the velocity of the blood flow in the cavernous arteries.

   The test was done in flaccid state of the penis Measurement was taken by an experienced ultrasonographer in the radiology unit. Measurement was taken pre and post intervention

4. Vascular Endothelial Growth Factor (VEGF) level in plasma

   Time frame: 4 weeks

   VEGF was measured in pg/ml. VEGF test were done by blood test in the laboratory using the VEGF-A ELISA Kit.

   Blood for tests were drawn pre and post test