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Shockwave Therapy (LI-ESWT) for Erectile Dysfunction

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Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT), commonly called shockwave therapy, is used to treat ED caused by vascular problems.  Administering low-intensity sound waves has been found to encourage the development of new blood vessels (angiogenesis), and improve the function of smooth muscle and endothelial cells.  Shockwaves may also break up and reduce blockages in arteries in the penis.

Shockwave therapy is a well-established procedure for promoting healing of injuries and bone fractures, and treating achilles tendinitis and plantar fasciitis.  Its use as a treatment for erectile dysfunction is relatively recent, dating back just a few years.

When treating ED, a portable device is coated with a lubricating gel and applied directly to the penis.  The procedure is painless.  Sessions may last from 10 to 30 minutes.  Treatment requires several sessions per week, over a period of 6-12 weeks.  A follow-up treatment may be scheduled 6 months later.

There are several studies that show promising results1 2 3 4, especially for men with mild to moderate ED caused by vascular problems5.  A review of previous work6, conducted in 2017, found contradictory results, with some studies showing promise, some providing inconclusive findings and some even discouraging.  However, another review conducted in 20197 found overall positive results.

A study published in 2019 looked at the effectiveness of LI-ESWT for men who had undergone a radical prostatectomy8; the results were inconclusive.

A recent study showed that about half the men who have a successful outcome from LI-ESWT lose the beneficial affects after two years9, and require another treatment.

Because this treatment is administered externally, it does not require approval by the US Food & Drug Administration (FDA).

LI-ESWT therapy is marketed under various brand names, including GAINSWave®, REGENAWAVE®,  and SONICWAVE™, each with their own treatment protocol. None of these companies has funded or published any peer-reviewed clinical studies. One consequence of this is that the treatment methodology is not standardized, and may vary from one clinic to another…  so research results may not apply to all practitioners.

Shockwave therapy is also expensive.  A complete course of treatment in a clinical setting typically costs several thousand dollars.

Note:  As of June, 2020, we’ve moved this section from our article on “New and Experimental Treatments for Erectile Dysfunction”  to create this standalone article.  We believe that there is sufficient clinical evidence to consider LI-ESWT a mainstream treatment for erectile dysfunction.

Shockwave Therapy and Peyronie’s Disease

Early studies10 11 12 of the use of LI-ESWT for the treatment of Peyronie’s Disease (PD) have been promising; the treatment shows the potential to significantly reduce plaque, penile curvature, and painful erections.

Shockwave Therapy at Home

A southern California company is now selling a home LI-ESWT unit which they claim provides the same treatment protocol as clinical devices.  This has the potential to make shockwave therapy much more affordable and available.  (See our article on the Phoenix home LI-ESWT device.)


For More Information

Causes of Erectile Dysfunction

Treatments for Erectile Dysfunction


References

  1. Kalyvianakis, D; Memmos, E; Mykoniatis, I; Kapoteli, P; Memmos, D; Hatzichristou, D. “Low-Intensity Shockwave Therapy for Erectile Dysfunction: A Randomized Clinical Trial Comparing 2 Treatment Protocols and the Impact of Repeating Treatment.” Journal of Sexual Medicine. Mar 2018. 15(3):334-345.
    <https://www.ncbi.nlm.nih.gov/pubmed/29396020>
  2. Srini, Vasan Satya; Reddy, Rahul Kumar; Shultz, Tamar; Denes, Bela. “Low intensity extracorporeal shockwave therapy for erectile dysfunction: a study in an Indian population.” The Canadian Journal of Urology. Feb 2015. 22(1).
    <https://gainswave.com/wp-content/uploads/2016/11/Canadian-Journal-of-Urology-Srini.pdf>
  3. Fojecki, GL; Tiessen, S; Osther P.J. “Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction-12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study.” Sexual Medicine. Mar 2018. 6(1):1-7.
    <https://www.ncbi.nlm.nih.gov/pubmed/29275957>
  4. Lu, Z; Lin, G; Reed-Maldonado, A; Wang, C; Lee, Y.C.; Lue, T.F. “Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis.” European Urology. Feb 2017. 71(2):223-233.
    <https://www.ncbi.nlm.nih.gov/pubmed/27321373>
  5. Xin, Zhongcheng; Guan, Ruili; Cui, Wanshou; Zhang, Xiaodong; Tian, Long; Xie, Yi; Lei, Hongen; Liu, Jihong; Wang, Tao. “PD69-04 Safety and Efficacy of Low Intensity Extracorporeal Shockwave in the Treatment of Vasculogenic Erectile Dysfunction: a Multi-Center, Double-Blind, Randomized Sham-Controlled Clinical Trial.” The Journal of Urology. Apr 2017.
    <https://www.auajournals.org/doi/full/10.1016/j.juro.2017.02.3145>
  6. Fode, Mikkel; Lowenstein, Lior; Reisman, Yacov. “Low-Intensity Extracorporeal Shockwave Therapy in Sexual Medicine: A Questionnaire-Based Assessment of Knowledge, Clinical Practice Patterns, and Attitudes in Sexual Medicine Practitioners.” The Journal of Sexual Medicine. Jun 2017. 5(2): e94–e98.
    <https://www.ncbi.nlm.nih.gov/pubmed/28268167>
  7. Sokolakis, Ioannis; Hatzichristodoulou, Georgios. “Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomized controlled trials.” International Journal of Impotence Research. Jan 2019.
    <https://www.nature.com/articles/s41443-019-0117-z>
  8. Baccaglini, Willy; Pazeto, Cristiano Linck; Barros, Eduardo Augusto Corrêa; Timóteo, Frederico; Monteiro, Leonardo; Rached, Raiff Yusser Saad; Navas, Arthur; Glina, Sidney. “The Role of the Low-Intensity Extracorporeal Shockwave Therapy on Penile Rehabilitation After Radical Prostatectomy: A Randomized Clinical Trial.” The Journal of Sexual Medicine. Dec 2019.
    <https://www.jsm.jsexmed.org/article/S1743-6095(19)31886-7/fulltext>
  9. Kitrey, Noam D. ; Vardi. Yoram; Appel, Boaz; Shechter. Arik; Massarwi, Omar; Abu-Ghanem. Yasmin; Gruenwald, Ilan. “Low Intensity Shock Wave Treatment for Erectile Dysfunction—How Long Does the Effect Last?” Journal of Urology. Jul 2018.
    <https://doi.org/10.1016/j.juro.2018.02.070>
  10. Chung, Eric. “Pro: does shockwave therapy have a place in the treatment of Peyronie’s disease?” Translational Andrology and Urology. June 2016.
    <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893523/>
  11. Shimpi, Rajendra Kashinath; Jain, Ravi Jineshkumar. “Role of extracorporeal shock wave therapy in management of Peyronie’s disease: A preliminary report.” Urology Annals. Oct-Dec 2016.
    <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100144/>
  12. Di Mauro, Marina; Russo, Giorgio Ivan; et al. “Extracorporeal Shock Wave Therapy in Peyronie’s Disease: Clinical Efficacy and Safety from a Single-Arm Observational Study.” World Journal of Men’s Health. Mar 2019.
    <https://wjmh.org/Synapse/Data/PDFData/2074WJMH/wjmh-37-e17.pdf>

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