Low-intensity shock wave treatment (LiSWT) is an option in treatment for ED. Placing a wand against the penis, the doc applies low-intensity shock waves for varying amounts of time. It is the only ED therapy that could repair diseased tissue. And it has been shown to improve spontaneous erections.
Shock waves? Really?
The use of shock waves as therapy is not new. High-intensity shock waves zap kidney stones. Medium-intensity shock waves treat orthopedic conditions, such as tendonitis and bursitis. Low-intensity shock waves treat chronic wounds, peripheral neuropathy, and cardiac ischemic tissue.
Even though they are of low-intensity, the shock waves are highly focused. The targeted tissue undergoes microtrauma and in defense, creates new blood vessels which increase blood flow. Someone had the idea that this would be a good treatment for penises, suffering, as they do, from a lack of blood flow if they’re dysfunctional, erectile-y. So now, low-intensity shock wave therapy is a growing and promising therapy for ED.
Let me count the ways.
You will probably not believe the number of ways there are to measure a penis:
- International index of Erectile Function 15-items questionnaire (IIEF-15) erectile function (ED) domain
- Erection Hardness Score (EHS)
- Global Assessment Questionnaires (GAQ)
- Basal Penile Color-Doppler Ultrasound parameters in the flaccid state (B-PCDU)
- The Sexual Encounter Profile (SEP)
All of these measurements are used when investigators test LiSWT. Investigators do not rely on the reactions of the subjects. Success is not measured by a subject’s opinion of himself and his newly rediscovered erection.
Trials have tested men for response to LiSWT in many ways: testing the blood flow; testing in conjunction with Viagra, etc; testing on men with diabetes, or men with pelvic fractures associated with urethral injury, and men who do not respond to Viagra, etc; testing in an Indian population of men who responded well to Viagra, etc.
And just as many conclusions in each trial have been reached:
- LiSWT is beneficial for blood flow and lasts up to 12 months.
- LiSWT may improve the erectile response to Viagra, etc.
- LiSWT is safe for men with diabetes.
- LiSWT may lessen ED for men with pelvic fractures associated with urethral injury.
- LiSWT may be effective in difficult-to-treat men by improving their response to Viagra, etc.
- LiSWT worked well and was tolerated well by the Indian men with ED caused by low blood flow.
Despite these successes and many more, the medical community has not embraced LiSWT as you would have thought. An online search for information reveals hardly any from large teaching hospitals on LiSWT.
The reason has to do with the quality of the tests. Even though many, many tests have been done, both the American Urological Association (AUA) and the Sexual Medicine Society of North America (SMSNA) have published articles saying that the tests conducted worldwide are not consistent, and it is not possible to draw definitive conclusions from them. AUA News says the shockwave generators vary too much, as do the type of shockwaves, the energy use, the number of pulses, the duration of treatment, the number of sessions per week, and the penile sites of application.
That’s a lot.
Likewise, the SMSNA published a report and reached a similar conclusion about LiSWT. While the therapy shows promise, the reviewers agree, it is too early to offer it in a clinical setting. There have not been sufficient tests or patients.
This lukewarm reaction to LiSWT among urologists doesn’t mean that you can’t have the treatment for yourself. You most certainly can, but you must know what to look for.
Who’s a good candidate?
Since LiSWT increases blood flow to the penis, men with mild to moderate ED caused by lack of blood flow are good candidates for this therapy. A typical course of treatment is a 15-minute session once a week for six weeks. That treatment schedule is somewhat arbitrary and though positive results ensued, it has not been proven to be optimal. No anesthesia is required and usually no pain occurs.
About 62% of men benefit from LiSWT. “Benefit” means either a man who had some difficulty with erections now has less difficulty, or a man for whom Viagra, etc didn’t work, now experiences its effects. The benefits from this course of treatment last about a year. To be clear, LiSWT is unlikely to get a man who is unable to have erections to suddenly have erections sufficient for intercourse. The improvement with this therapy has been mild.
Note: LiSWT for ED is not FDA approved. Insurance doesn’t cover it. Treatments cost several hundred dollars per session.
Side Effects
Possible side effects include
- Blood in the urine
- Pain at the site during a treatment
- Painful erection
- Bleeding or bruising
- Penile curvature that worsens
- Skin infection
Do your research
So how do you go about finding treatment? It’s kind of a wild west out there.
Online you can find many clinics that offer shockwave therapy for erectile dysfunction (even though it is not generally offered at large teaching hospitals). In your search, write a list of requirements for yourself.
- The clinician should be a urologist. A urologist can take your history, do tests, and make the best recommendation for your ED. The best recommendation might not be LiSWT.
- The machine that delivers the waves should be a shock wave machine, also known as a mechanical wave machine. It delivers pulses, as opposed to sound waves. The studies done of LiSWT use mechanical wave machines.
- Avoid stand-alone clinics that offer only LiSWT. They can’t diagnose the cause of your ED or the best treatment. They can only sell LiSWT treatments.
- Have the treatments done under medical supervision, not at home. You can buy acoustic wave machines for home use, but they are not the type which clinical studies have used. At the least, they could be a waste of money. At the worst, they could do damage to your penis.
Go forth with vigor (or Viagra)
LiSWT is not exactly cutting edge, but as you have learned, it is not blessed by the broader medical community or the FDA. Being conservative about new treatments is one of the hallmarks of medicine. All in all, this is a good thing, as you can be assured that therapies and medicine are thoroughly tested before approval. But this caution also creates barriers to the restlessness and dissatisfaction some feel with the current state. You might be such a person. You can seek this “unproven” treatment safely if you know the dangers and how to avoid them.