Shock wave therapy against impotence

Shock wave therapy for erectile dysfunction is sometimes advertised as a miracle cure for impotence. In fact, it can be a valuable alternative or supplement to a therapy concept. Therefore, the low-energy extracorporeal shock wave therapy (ESWT) is included in the treatment spectrum at the Institute for Erectile Dysfunction. But shock wave therapy is not a miracle cure. Read everything of importance here and form your own opinion.

What is shock wave therapy for erectile dysfunction?

You may have heard that kidney stones or gallstones are in many cases crushed by shock waves during a non-surgical intervention? Shock wave therapy for erectile dysfunction is also based on this procedure. The main difference: During the treatment of erectile dysfunction only about one tenth of the energy used in the crushing of kidney stones or gallstones is used.  Therefore, this form of shock wave therapy is referred to as low-energy extracorporeal shock wave therapy or LESWT. The abbreviation LESWT stands for Low Energy Shock Wave Therapy.

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Effect of shock wave therapy for erectile problems

The concept for shock wave therapy has its origin in the heart medicine, more precisely in the treatment and prevention of angina pectoris. Like many cases of erectile dysfunction, angina pectoris is caused by circulatory disorders. In the case of the heart, it is mainly about the very fine coronary arteries that supply the heart. In the case of erectile dysfunction, the penis arteries with impaired function are the aim of treatment.

Shock wave therapy can induce obstructed or weakened blood vessels to recover permanently. This effect occurs while shock waves stimulate the release of an important growth substance.  This messenger substance called Vascular Endothelial Growth Factor (VEGF) promotes growth and regeneration of endothelial- and muscle cells. Endothelial cells line the blood vessels from the inside and are indispensable for a healthy functioning of the blood vessels. The increased formation of muscle cells raises the contractility of the blood vessels - and thus their function. As a result shock wave therapy has the effect that certain forms of erectile dysfunctions caused by circulatory disorders can not only be reduced but also cured.


Duration of shock wave therapy for erectile dysfunction

The treatment takes place on an outpatient basis in the practice rooms of the Institute for Erectile Dysfunction. The shock waves are transmitted to the penis via a probe. In every session between 3 to 6 areas on the stretched penis are treated for several minutes. A session usually lasts between 15 and 20 minutes. The application is painless. You can leave the practice directly after the treatment - and you are not restricted in any way.

As a rule, it takes about six weeks with one application per week until the shock waves fully unfold their effect and sustainably alleviate erectile problems. With otherwise healthy people without increased risk factors for cardiovascular diseases or metabolic diseases affecting the blood circulation such as diabetes, the erectility is often permanently maintained after the shock wave therapy. However, it is also possible that the shock wave therapy has to be repeated after a few months or years.

Professor Dr. med. Nicolas Diehm:
For whom is shock wave therapy suitable?

“Shock wave therapy can be a good choice for the treatment of erectile dysfunction. However, like the other treatment options, it is not suitable for every man. That has a simple background: The causes for erectile dysfunction are extremely diverse - and a careful diagnosis is therefore the decisive step on the way to the goal. Shock wave therapy, for example, can only avail, if the blood vessels leading to the penis are not yet excessively damaged. In our experience, this is particularly the case at an early stage of erectile dysfunction. In addition, shock wave therapy is a good alternative for men who do not respond to medical treatment with PDE5 inhibitors such as Viagra and Co. or for whom medical treatment is out of the question due to the side effects.

Advantages of shock wave therapy in comparison

It can be generally stated that shock wave therapy can have some advantages compared to drug therapy with PDE5 inhibitors or stent implantation for erectile dysfunction.  But please remember: Shock wave therapy is not suitable for every man, but only under certain conditions.

Studies on the effectiveness of shock wave therapy for erectile dysfunction

There are numerous scientific studies that prove the benefits of low-energy extracorporeal shock wave therapy (LESWT). The most meaningful studies are those that compare an actual therapy with a sham therapy. Such studies - and others - were evaluated by a group of researchers at the University of Wroclaw in an overview study (see sources).

75 percent with a spontaneous erection

Accordingly, the positive effect of shock wave therapy has been clearly demonstrated in several studies. In one study 135 men with erectile dysfunction were examined. One group received a real shock wave therapy, the other group received a sham treatment. The result: 75 percent of the previously impotent men were capable of a spontaneous erection after the shock wave therapy.

Erection score clearly improved

Another study examined 59 men who had previously taken PDE5 inhibitors with success. In 65 percent of the participants, erectility improved by at least 5 points according to the so-called IIEF score. IIEF stands for «International Index of Erectile Function». In medicine, the IIEF-score is not only used for the diagnosis of erectile dysfunction, but also for success monitoring of therapies. You can find the corresponding self-test on our website: “Do you suffer from pathological erectile dysfunction?”.

But also with men who do not respond to PDE5 inhibitors, the proof for effectiveness has been provided. Thus, with half of the 55 participants, shock wave therapy induced an erection that was sufficiently hard and lasting for sexual intercourse.

Shock waves as a viable alternative to PDE5 inhibitors

Until now, the result of the study evaluations can be briefly summarized as follows: Considering all men with erectile dysfunction, as a whole, the drug therapy with PDE5 inhibitors is more effective. For men who do not tolerate PDE5 inhibitors, shock wave therapy is an interesting alternative.  Moreover, the fact that this form of treatment not only symptomatically alleviates erectile dysfunction, but can even cure it, speaks in favor of shock wave therapy.



Dr. Dariusz Kalka (Universität Breslau): Low-energy Shock Wave Therapy—A Novel Treatment Option for Erectile Dysfunction in Men With Cardiovascular Disease

Further studies on the subject
Yee, C.-H.; Chan, E. S.; Hou, S. S.-M. & Ng, C.-F., Extra-corporeal shockwave therapy in the treatment of erectile dysfunction: A prospective, randomized, double-blinded, placebo controlled study, International Journal of Urology, Wiley Online Library, 2014.
Chung, E. & Cartmill, R., Evaluation of clinical efficacy, safety and patient satisfaction rate after low-intensity extracorporeal shockwave therapy for the treatment of male erectile dysfunction: an Australian first open-label single-arm prospective clinical trial, BJU international, Wiley Online Library, 2015, 115, 46-49.

Olsen, A. B.; Persiani, M.; Boie, S.; Hanna, M. & Lund, L., Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study, Scandinavian journal of urology, Informa Healthcare Stockholm, 2014, 1-5.

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