Shockwave Therapy—New Hope for Erectile Dysfunction

Posted by Medical Board on August 5, 2021 in Uncategorized Last updated on August 5, 2021

Shockwave Therapy—New Hope for Erectile Dysfunction

According to a recent John’s Hopkins study over 18 million American men over age 20 have difficulty getting and maintaining an erection healthy enough for sexual activity.

Numbers go underreported, however because many men are reluctant to discuss erectile dysfunction with physician’s or other healthcare providers. Some men are even unable to address ED with a close sexual partner. Though 80% of cases involve some underlying medical cause, the stigma surrounding erectile dysfunction still remains.

What is Erectile Dysfunction?

Erectile dysfunction affects many men as they age. Blood vessels become thinner and blood supply to the penis is reduced. There are many reasons men may not be able to achieve or maintain a full erection necessary for healthy sexual intercourse.[6]

Erectile dysfunction involves the malfunction of any of the components of the erectile response including organic, relational, or psychological. Historically treatment for ED has consisted of diet and other lifestyle modifications, oral medications, vacuum devices and injected vasodilator drugs. In the past erectile dysfunction was thought to be more of a psychogenic disorder. We now know that a large majority of ED cases involve some sort of organic aetiology.[7]

Who is at risk for Erectile Dysfunction?

There are many underlying physical and psychological causes for erectile dysfunction.

These include:

• Prostate illness
• Type 2 diabetes
• Hypogonadism (failure to produce hormones by the testicles)
• High blood pressure
• Vascular disease/surgery
• Heart disease/failure
• High cholesterol
• Low levels of HDL (high-density lipoprotein)
• Disorders of the nervous system
• Peyronie disease (penis curvature)
• Depression/anxiety
• Excessive alcohol consumption
• Difficulties within a relationship
• Kidney failure/dialysis
• Smoking

Some medications used to treat other health conditions may cause erectile dysfunction.[5] These may include Diuretics, high blood pressure medications, antihistamines, antidepressants, tranquilizers, muscle relaxants, drugs for irregular heart activity, and Parkinson’s medications.

Shockwave therapy for erectile dysfunction is a new treatment for men who do not respond well to pharmaceutical options or who prefer noninvasive treatment.

Shockwave Therapy—What is it?

For some men, erectile dysfunction is caused by decreased blood flow to the penis.

Low-intensity Shock Wave Therapy (LI-SWT) works by targeting specific tissue in the penis with shock waves. This stimulates overall blood flow and supports growth of new blood vessels that carry blood to the penis. This is necessary to get or maintain a full erection. A physician or other healthcare practitioner guides shock waves using a small, wand-like device.[4]

The Science of Shockwaves—How It Works

Shockwaves (SWs) are acoustic waves that can be focused on a small specific region of the body. These are noninvasive and carry energy that can be applied through a medium used to pinpoint organs or tissue. When shockwaves in the form of LI-ESWT (low intensity extra corporeal shockwave therapy) target deep tissue mechanical stress and microtrauma take place. In response to this, neovascularization of the tissue occurs and the blood supply to and within the penis improves.[2]

Is Shockwave Therapy the Same as Radial Wave Therapy?

No. Unlike radial wave therapy, shockwave therapy is administered by a licensed medical healthcare professional specifically trained to give the treatment. It is also monitored by the FDA. Radial wave therapy is only effective at a superficial depth and is administered with a class I medical device, not monitored by the FDA.

Am I a Candidate for Shockwave Therapy?

Those who will benefit most from shockwave therapy with erectile dysfunction include:
Men who have not previously responded well to other ED therapies including medications
Men who want to try regenerative therapy that might reverse some of the causes of ED
Men who cannot or do not wish to Take medication for ED

Low Intensity Shockwave Treatment—The Procedure

Shockwave therapy is performed by a urologist or other licensed healthcare practitioner in an exam room. Gainswave is one specific brand of shockwave therapy and treatment lasts about 15 minutes. Numbing cream is applied to the penis before the procedure and no anesthesia is needed.

The procedure involves the practitioner slowly moving a wand-like device emitting gentle pulses around different areas of the penis. Treated areas will increase blood flow in the penis and support new growth of blood vessels.

After The Treatment

Once the treatment session is complete the patient may return home. In most cases men feel well enough to drive themselves home and can return to normal activity the following day. Over-the-counter medications such as acetaminophen or ibuprofen may be taken for mild pain relief after returning home.

Side Effects

Most men tolerate low intensity shockwave therapy very well with few if any side effects after treatment.

Some men may experience:

• Mild pain at the treatment site while the procedure is being performed
• Mild bleeding or bruising on the penis or surrounding tissue
• Blood in the urine
• Infection on the penile skin
• Erection that is mildly painful
• Worsening penile curvature (Peyronie’s Disease)

How Long Does Shockwave Therapy Take to Work?

Most men who undergo shockwave therapy for the treatment of erectile dysfunction will notice the benefits of treatment in about 1 to 3 months. Within the first weeks of treatment, some men experience dramatic initial results. A few even report spontaneous erection within 24 hours of the first treatment.

How Successful is Shockwave?

According to recent studies Shockwave has demonstrated a 75% success rate in the treatment of erectile dysfunction.

How Many Shockwave Treatments Will I Need?

In general most male patients get 6-12 treatments in total.

How Long Does Shockwave Treatment Last?

Most men report that treatment lasts between 2 and 3 years.

FDA Approval for Shockwave Treatment

The U.S. Food and Drug Administration has approved low intensity shockwave therapy for the treatment of erectile dysfunction in men.[4]

How to Prepare for Shockwave

• Low intensity shockwave therapy will be performed in a physician’s treatment room.

• About 30 minutes prior to the first treatment numbing cream will be applied to the penis and surrounding tissue.

• The physician or other health practitioner will apply light pressure to the treatment area using a wand-like device that delivers low intensity acoustic shockwaves.

• The entire therapy appointment usually lasts about 20-30 minutes.

• For subsequent visits numbing cream may be applied at home.

• Patients may resume normal activity the next day.[1]

Self Care and Erectile Dysfunction

While erectile dysfunction can be serious and may require 1 or more types of treatment, there are a few things men can do to help improve or eliminate mild erectile dysfunction.

Lose Weight

Weight loss will improve the blood flow to and through the penis. Excess weight can damage blood vessels, decrease testosterone and cause inflammation in the body. All of these contribute to ED.

Get Exercise

Exercise helps reduce stress that may be a partial cause for ED in some men. It also leads to weight loss and increased blood flow throughout the body. Exercise may improve other medical conditions that contribute to erectile dysfunction as well.

Quit Smoking

Smoking causes or exacerbates a number of different physical conditions that may be partly causing erectile dysfunction.

Get Help for Relationship Issues

Seek the help of a marriage counselor or other professional to help guide you as a couple through difficult relationship issues. Some of these may be part of the overall issue of erectile dysfunction.

Eat Good Food

Leafy greens such as celery and spinach are natural vasodilators that help stimulate greater blood flow in the body.

Dark chocolate offers flavonoids that help improve overall circulation.
Eat pistachios, which help relax blood vessels through a protein called arginine.

Raw shellfish contains zinc, which helps stimulate testosterone in men.
Lycopine in tomatoes is good for sexual health issues and is good for circulation.[3]

While erectile dysfunction may be difficult to discuss with a partner or healthcare professional, many times a physical underlying condition is the root cause (or major contributing factor) of ED. Even in cases where no coexisting medical condition is present, there are many excellent options for men in the treatment of erectile difficulties.

References

1Erectile dysfunction (impotence). Erectile Dysfunction (Impotence) – Health Encyclopedia – University of Rochester Medical Center. (n.d.). https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P01482.
2Gruenwald, I., Appel, B., Kitrey, N. D., & Vardi, Y. (2013, April). Shockwave treatment of erectile dysfunction. Therapeutic advances in urology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607492/.
3Patient Education for Erectile Dysfunction. Us Department of Veteran’s Affairs. (n.d.). https://www.mirecc.va.gov/cih-visn2/Documents/Patient_Education_Handouts/Erectile_Dysfunction_Version_3.pd.
4Shockwave therapy for erectile DYSFUNCTION (ED). Shockwave Therapy: Erectile Dysfunction (ED) Treatment | University of Utah Health. (n.d.). https://healthcare.utah.edu/menshealth/conditions/erectile-dysfunction/shockwave-therapy.php.
5U.S. Department of Health and Human Services. (n.d.). Erectile dysfunction (ED). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction.
6U.S. National Library of Medicine. (2020, December 10). Erectile dysfunction | ed | impotence. MedlinePlus. https://medlineplus.gov/erectiledysfunction.html.
7Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., Maggi, M., Nelson, C. J., Parish, S., Salonia, A., Tan, R., Mulhall, J. P., & Hellstrom, W. J. G. (2016, February 4). Erectile dysfunction. Nature reviews. Disease primers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/.

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