Treating erectile dysfunction with shockwave therapy

This article is created for Top Doctors by Dr Nadia Yousri, the leading sexual health specialist, Fellow of The Royal College of Obstetricians and Gynaecologists, FRCOG, MRCOG, Ph.D. and Masters degree, London, UK.

Erectile dysfunction (ED)

Definition: Inability to initiate or sustain a firm erection throughout the intimate relationship to attain satisfaction.

Prevalence: It affects many men especially those advancing in age. It’s reported that around 50 per cent of men above 40 report this issue, and it can have both physical and psychological causes.

Cause: Advance in age, diabetes, vascular insufficiency conditions, heart diseases, post prostatectomy, anxiety/depression/stress, excessive alcohol intake, recreational hard drugs, medications like minoxidil, antihypertensives, antidepressants, hypercholesterolaemia, obesity, lichen sclerosis, Peyronie’s disease, testosterone and other hormonal deficiencies, general health conditions, etc.

While medications such as phosphodiesterase 5 inhibitors [PDE 5-Is] like sildenafil (Viagra) or Tadalafil (Cialis) are commonly prescribed, they are not enough in their own, besides their significant side effects let alone losing their effect due to developing tolerance to their effect over the time as they work.

Here come the latest treatment options which help in regenerating new tissues including formation of new blood vessels in the male organ such as low-intensity extracorporeal focal shockwave therapy (LiESWT), the P-Shot & Bocox shot, etc. Recently, shockwave therapy has been approved by NICE as a formal treatment option for ED for its potential to restore natural erectile function without the need for ongoing medication.

What is shockwave therapy and how does it work?

Shockwave therapy involves the use of low-intensity sound waves directed at the penile tissue. These waves help stimulate blood flow by:

Encouraging the formation of new blood vessels (angiogenesis)
Regenerating existing blood vessels
Supporting the repair of erectile tissue

By improving circulation in the penis, shockwave therapy is successful in treating ED, particularly the vasculogenic type, but it’s helpful in all other causes of ED. However, the result depends on various factors namely, the patient’s age, the duration and cause of ED - and more importantly the body’s response to the stimulation of regeneration. Hence, the result takes between six weeks to three months, after completing the course sessions, to evaluate the body response related result.

Who is it suitable for? (Indications)

Shockwave therapy is beneficial in all kinds of ED, mostly with significant results in mild and moderate ED, and those with vasculogenic causes, causing reduced blood flow and tissue shrinkage. It’s most effective in men with mild to moderate erectile dysfunction caused by reduced blood flow (vascular ED), such as:

Age-related ED
ED associated with diabetes or high blood pressure
Early-stage ED not yet requiring medication
Medication-caused ED
Peyronie’s disease

It may be less effective for men with severe ED, nerve-related causes (such as after prostate surgery), or psychological factors. A full assessment by Dr Nadia, the leading specialist in shockwave therapy, is necessary to determine if the bespoke treatment course plan/sessions/technique based on individual cases.

Contraindications

It isn’t performed in active infections (fever, STIs or bacterial or viral infections) until they are fully treated, or in patients diagnosed with penile or prostate cancer until completion of their surgical/chemo/radio-therapy. Also, it isn’t performed in patients with implanted electronic devices near the treatment area.

What happens during the treatment?

Shockwave therapy is performed by Dr Nadia herself, in order to give the best chance of successful results in her clinic. An ESWT session is painless, doesn’t require any analgesia and has no downtime. Patients can resume normal activities immediately afterwards. A typical session takes about 20 minutes.

The procedure involves:

Applying a conductive gel to the penis
Dr NY applies the hand piece at special points to deliver pulses of sound energy to target tissues.
A standard course includes six to 10 sessions over a few weeks.

What are the benefits and limitations?

Benefits of shockwave therapy include:

Non-invasive and drug-free
Can improve natural erectile function
Minimal or no side effects
No recovery time needed

However, results vary between individuals and may take a few weeks to become noticeable. Some men experience significant improvement, while others may need to have top up additional sessions or combine it with other treatment procedures e.g. P-Shot. Otherwise, it’s up to the patients if they would like to consider other alterative options, for example; surgery.

What are the risks or side effects?

There are no side effects. Patients could notice:

Mild and temporary redness or bruising
Slight discomfort during the procedure
Increased sensitivity in the male organ

Shockwave therapy for erectile dysfunction