Shockwave Therapy
LI-ESWT (Low Intensity- Extracorporeal Shockwave Therapy) is a relatively new, painless method for treatment of ED. It has been proven, in the past 10 years, to be extremely effective, in improving ED in most men.
The extraordinary feature of LI-ESWT is that it is the first potential non-surgical curative treatment for ED. Current treatment of ED, using pills or injections, is extremely successful, but they have always relied on ongoing management of the condition. That is, anyone using pills or other treatments must plan to use them before each sexual activity. LI-ESWT treatment potentially improves a man’s sexual functioning whenever he is sexually active. This may allow him to get and maintain a good erection without requiring an immediate intervention, or improve his function so that he can use a less powerful method to be successful (i.e., function with using pills as opposed to injections).
Frequently Asked Questions
What is LI-ESWT (Shockwave Therapy)?
Shockwave Therapy, also known as Pressurewave Therapy or LI-ESWT (Low Intensity-Extracorporeal Shockwave Therapy) is a relatively new, painless method for treatment of erectile dysfunction (ED). It has been proven, in the past 10 years, to be very effective in improving ED in most men.
The extraordinary feature of LI-ESWT is that it is the first potential non-surgical curative treatment for ED. Current treatment of ED, using pills or injections, is successful, but has always relied on ongoing management of the condition. That is, anyone using pills or other treatments must plan to use them before each sexual activity. LI-ESWT treatment potentially improves a man’s sexual functioning whenever he is sexually active. This may allow him to get and maintain a good erection without requiring an immediate intervention, or improve his function so that he can use a less invasive method to be successful (e.g., function with using pills as opposed to injections).
LI-ESWT treatment is currently approved for ED in Europe, South America, China, and Canada. In the US, LI-ESWT treatment is not currently FDA approved as a treatment method for ED, but Shockwave Therapy is approved as a treatment for plantar fasciitis. However, there is at least one company that is currently planning a US trial for FDA approval.
How does LI-ESWT work?
The principle is that shock waves are applied to the penis through a probe on the skin. It is believed that the shock waves cause mild trauma to the blood vessels, which then release growth factors. These growth factors stimulate the formation of new blood vessels (neoangeogenesis) as well as repair of the lining of the existing blood vessels (the endothelium). Other theories suggest that it may break up the plaque blocking the blood flow in small vessels, or it may cause stem cells to migrate to the area, which then create new blood vessels.
Is this treatment backed by research?
There is an extensive body of scientific research17 that shows LI-ESWT’s effectiveness. The most widely used scale to measure a man’s satisfaction with his erection is called the IIEF-5 (International Index of Erectile Function). It consists of 5 questions, with a possible score of 1-5 on each. If a man improves by five points, his erectile dysfunction improves one level, for example “from moderate to mild.”
An aggregate of the major studies (termed a “meta-analysis”), found that an average man’s erectile status improved by a full 5 points (or level) after treatment with LI-ESWT, moving from severe to moderate, from moderate to mild, from mild to normal.
The exciting thing about these studies is the quality of the research design. The studies are randomized double-blind placebo-controlled (RDBPC’s), which are considered the gold standard in study design. Patients are randomly assigned to the treatment or non-treatment group. The physicians conducting the study do not know which patient is in which group. Each patient receives either treatment or a sham treatment, but is unaware of which he is receiving.
The RDBPC studies performed internationally on LI-ESWT show significant differences between the treated and non-treated group.
How does LI-ESWT compare to other treatments for erectile dysfunction?
Who is a candidate?
Most Erectile Dysfunction is caused by vascular problems. Patients either have a problem getting the blood into the penis (inflow) or keeping it inside the penis (trapping). The men who are most likely to be successfully treated by LI-ESWT are those who have “inflow” problems. These are men who have decreased blood flow through the arteries into the penis.
However, published studies have also included men with more severe ED, those who have both inflow and trapping issues, and they have also been successfully treated.
One limitation of the research concerning LI-ESWT is that is has not been tested on men with erection issues that are primarily neurologic, such as dysfunction caused by surgery. It is not known whether the LI-ESWT is effective for ED with a neurological cause. However, it is possible that LI-ESWT may still have a positive response on penile nerves.
Is it safe?
Yes. Fortunately, safety is not an issue. There is no evidence of any short or long-term negative effects of treatment. The only question is whether you will be one of those men for whom it works, but that is the majority of men.
How many treatments would I need?
There are a total of twelve treatments, spread out over nine weeks. Each treatment lasts for approximately 10-15 minutes.
We follow the published protocol which consists of two treatments per week, for three weeks (for a total of six treatments.) This is followed by a break of three weeks. It is then followed by another set of six treatments over three weeks.
How long do the results of treatment last?
Do the treatments hurt?
Most patients describe only a mild buzzing sensation during treatment.