Pulses activate better blood flow and tissue remodeling in the penis. Both of these changes can lead to enough erections for sexual intercourse. Several clinical trials and studies have shown that penile shockwave therapy can improve erectile function. To date, there have been 11 randomized controlled studies investigating the effects of penile shockwave therapy on erectile function.
The results are promising and, under the right conditions of the patient, penile shockwave therapy can help and improve erectile function, blood flow, reduce penile pain and increase penile sensation. The energy from shockwave therapy stimulates the growth of new blood vessels through a process called angiogenesis. This increases blood flow to the penis, which can improve erectile function. Studies have shown that low-energy shockwave therapy can improve the response to oral medications for erectile dysfunction.
It can also provide some return of spontaneous erections by increasing blood flow to the penis. Unlike medications or injections, which are the other common treatments for ED, shockwave therapy has few side effects. No cases of long-term physical harm have been reported and there is no evidence that it causes permanent sexual dysfunction. With LISWT, a doctor uses a rod-like device to deliver light shockwaves to the penis.
Studies have found that treatment is associated with the growth of new blood vessels and (in animal studies) the recruitment of stem cells into the penis. When an ultrasound wave is in contact with specific cells, mechanical vibration of the shock wave in cells can induce cell proliferation. Shockwave therapy works by sending high-energy shockwaves to the penis, causing the body's natural healing process to begin to form blood vessels and capillaries. All patients undergoing penile shockwave therapy should be aware that this therapy modality is not approved by the FDA and that the results, treatment protocols, and side effects are not fully understood.
The most prominent hypotheses behind shockwave therapy for the treatment of ED stem in part from the therapeutic uses of shockwaves to induce angiogenesis (growth of new blood vessels). Penile shockwave therapy for erectile dysfunction, also called low-intensity shockwave therapy (LISWT), is a painless, non-invasive therapy that can improve erectile response, stiffness, sensation, break penile plaques, and improve response to oral erectile dysfunction medications. The second is that although shockwave therapy has yielded improvements in some studies, not all men who undergo shockwave therapy notice positive results. The adjusted ORs for cointerventions were 5.7 (3.16 to 10.2) and 2.5 (1.28 to 4.8), respectively, indicating that shock wave therapy increases the likelihood that the patient will regain their penetrating ability independently of the other therapies received.
Although no shockwave therapy protocol has been published or standardized, it is often a general rule of thumb. Doctors may refer to shockwave therapy for ED as low-intensity extracorporeal shockwave treatment (LI-ESWT). Shockwave therapy for Peyronie's disease is still being investigated, but several well-documented and published studies have achieved excellent results with therapy to improve penile pain. The studies are encouraging and suggest that shockwave therapy could play a new role in the ED algorithm to improve response to standard guideline therapies.
It is important to distinguish shock wave therapy from radio wave therapy, which is commonly advertised as a non-invasive treatment for erectile dysfunction available in both medical and non-medical facilities. All patients undergoing low-intensity penile shockwave therapy should be advised that treatment. Current lines of research on new therapies for ED are based on the Rho-kinase pathway, as well as exploring the feasibility of gene therapy through intracorporeal injections of plasmids and regenerative stem cell therapy. Shockwaves (SW) are acoustic waves that carry energy and, when propagated through a medium, can be non-invasively directed and focused to affect a distant selected anatomical region.