low-intensity extracorporeal shockwave therapy (Li-ESWT) and erectile dysfunction (ED)

Last edited 05/2023 and last reviewed 05/2023

Low-intensity extracorporeal shockwave therapy (Li-ESWT) and erectile dysfunction (ED)

Low-intensity extracorporeal shockwave therapy (Li-ESWT) is noninvasive and uses acoustic waves, which can pass through tissue and be focussed to target specific areas or organs to induce the desired effects

• has previously been described in other disease contexts, such as ischaemic heart disease, bone fractures, and burns, in which it improves neoangiogenesis
  
  
• Li-ESWT has also been suggested to improve the effect of PDE5I in nonresponders, reducing the need for more invasive treatments (1)
  
  
• flaccid penile Li-SWT appears to be safe and efficacious for treating ED based on statistically significant changes from baseline between sham and active treatments (2)
  
  
• mechanisms by which this therapy enhances erectile function are unclear, but hypotheses include stimulation of neoangiogenesis, recruitment of stem cells and Schwann cell activation leading to nerve regeneration (3)

Reference:

• Young Academic Urologists Men's Health Group; Fode M, Hatzichristodoulou G, Serefoglu EC, Verze P, Albersen M. Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough? Nat Rev Urol. 2017 Oct;14(10):593-606.
• Goldstein I et al. MP79-11 A Sham-Controlled Randomized Trial Of Low Intensity Shockwave Therpay For Erectile Dysfunction.The Journal of Urology April 2023.
• Young Academic Urologists Men's Health Group. Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough?. Nat Rev Urol 14, 593-606 (2017). https://doi.org/10.1038/nrurol.2017.119