Shockwave therapy for Erectile Dysfunction
A great number of our patients have been inquiring about the role of low intensity shock wave therapy (which you may have seen as LiSWT, Acoustic wave, Gainswave or True Pulse Protocol) in treating ED or Peyronies disease. Various clinics are offering this and, while it is an exciting new approach with a lot of promise (see below), it is NOT (despite what you hear) FDA approved as a treatment for ED or Peyronies disease, nor is the true success really known.
How does it work?
In 2010, now 9 years ago, LiSWT was first used in Europe as a novel and minimally invasive treatment approach for ED. Shockwave therapy has been used therapeutically in other fields of medicine, including in the treatment of insufficient blood flow to the heart or limbs, diabetic foot ulcers, and wound healing. It has been proposed that LiSWT restores erectile function by increasing penile stem cells and by releasing vascular growth factors and by directly increasing nitric oxide (NO) synthesis in penile tissues. Over the years, multiple other studies and clinical trials in Europe and other regions have endorsed the therapeutic potential of LiSWT for the treatment of ED. The European Urological Association has listed Li-SWT as a treatment for ED. The low-intensity shockwaves used in most LiSWT treatment protocols published to date emit an energy density of approximately 0.09 mJ/mm2. In contrast, shockwave machines that are used to destroy kidney stones energy densities are approximately 0.9 mJ/mm2 – this is 10 times higher that used for ED. In general, LiSWT treatment protocols provide 1-2 sessions per week over the course of 6 sessions. In general, several thousand shockwaves are delivered to multiple areas of the penis, with each treatment session lasting approximately 15 – 30 minutes. Shockwaves are delivered by a hand-held probe. Treatment is offered in an outpatient setting with no analgesia needed.
Does it work well?
Yes and no. Although the LiSWT is very promising and has the most basic science and animal research data of all the regenerative therapies, it is still unknown exactly how individual patients will respond to it. Many factors likely go into it, including how severe the ED is and what the cause is (if known).
Is it for me?
As with all conditions we treat at Summit Urology, we start by getting a history and physical examination to understand what’s going on with you, what your goals are, and what has worked or not worked for you in the past. In many cases, there is additional testing that you may desire or require to help you and us understand why your erections are not as good as you would like. Based on our evaluation, we can then discuss whether LiSWT is a good option for you.
How much does it cost?
At Summit Urology, we have been disappointed to see various clinics offer a new, unapproved technology at high costs ($3000-6000 for a 6 treatment course). We make sure we track your progress and outcomes carefully and charge a price that covers our costs but no more, in line with the recommendations of the Sexual Medicine Society of North America position statement.
Currently, our cost is $999 for a course of 6 treatments.
Are there any risks?
Fortunately, the risks of LiSWT seem to be very minimal, and consist mainly of soreness in the area easily treated with over the counter medication if necessary. Undergoing LiSWT does NOT prevent you from using or undergoing any of the FDA-approved therapies for ED or Peyronies disease.
What if it doesn’t work?
Unlike other clinics that offer LiSWT or other new therapies but do not offer the gamut of “tried and true” therapies, at Summit Urology we can offer the full spectrum of care. After all, the best treatment is the one that works for you! We will make sure you know all your options and will be able to work with you to make sure you make a fully informed decision about any treatment you choose.