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Dong Wang,* Shi-Jun Wang,* Ying-Jie Li, Chun-Hui Liu, Yong-Qiang Li, Yin-Sheng Zhang, Su Yan Department of Urology, Peking Union Medical College Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Su Yan, Department of Urology, Peking Union Medical College Hospital, No. 1 of Shuaifuyuan, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel +86 13801326306, Fax +86 10 69152520, Email yansudrob@outlook.comBackground: Phosphodiesterase 5 inhibitors (PDE5Is) and other more invasive options merely provide symptomatic relief rather than a permanent improvement in erectile dysfunction (ED), whereas the long-term improvement in ED via low-intensity extracorporeal shockwave therapy (Li-ESWT) has been confirmed. So far, no comparative study of sildenafil versus Li-ESWT has been conducted with respect to treatment satisfaction.Objective: In this study, we aim to compare erectile function status and satisfaction rates in patients who received sildenafil or Li-ESWT for ED.Methods: Patients complaining of ED were considered candidates. Participants chose to enter one of two active treatment groups according to their treatment intention—either a 9-week Li-ESWT regimen or 100 mg on-demand sildenafil. The erectile function was evaluated using the erectile function domain of the International Index of Erectile Function questionnaires (IIEF-EF), while the treatment satisfaction was evaluated using the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaires (EDITS).Results: We enrolled 72 participants in the study (42 in the Li-ESWT group and 30 in the sildenafil group). Patients in both groups were young men. Four weeks after the last session, the IIEF-EF score for Li-ESWT and sildenafil was 16.3± 5.5 and 18.3± 6.5 (P > 0.05), respectively. The total EDITS index of the patient version and the partner version were similar in the two groups. Among EDITS questions