Focused ShockWave ESWT

Extracorporeal Shockwave Therapy (EWST), also known as Low-Intensity Shockwave Therapy (LiSWT), has been increasingly recognized in clinical settings for its effectiveness in treating various urological conditions, particularly erectile dysfunction (ED), Peyronie’s disease (PD), and chronic pelvic pain syndrome (CPPS). Below is a clinical insight into the use of EWST:

1. Mechanism of Action

  • Microtrauma and Neovascularization:
    • EWST delivers focused acoustic waves to targeted tissues, creating controlled microtrauma. This process stimulates the body’s natural healing response, leading to the formation of new blood vessels (neovascularization) and improved blood flow in the treated area.
  • Reduction of Inflammation:
    • The therapy also has anti-inflammatory effects, which can help reduce pain and discomfort in conditions like CPPS and PD.
  • Stimulation of Cellular Repair:
    • EWST promotes the release of growth factors and the activation of stem cells, which aid in tissue repair and regeneration, particularly in penile tissue for ED treatment.

2. Clinical Applications

  • Erectile Dysfunction (ED):
    • Evidence: Multiple studies have demonstrated the effectiveness of EWST in improving erectile function, especially in men with vasculogenic ED. It is considered a safe and non-invasive alternative or adjunct to pharmacological treatments like PDE5 inhibitors (e.g., Viagra).
    • Outcome: Patients often experience improved erectile function, with results lasting several months to a year after treatment.
  • Peyronie’s Disease (PD):
    • Evidence: EWST has been used to break down fibrous plaques in the penile tissue, reducing curvature and pain associated with PD. It is most effective in the early stages of the disease before the plaque hardens.
    • Outcome: Many patients report a reduction in penile curvature and an improvement in sexual function.
  • Chronic Pelvic Pain Syndrome (CPPS):
    • Evidence: EWST has shown promise in reducing pain and improving quality of life for patients with CPPS by targeting inflamed and damaged tissues in the pelvic region.
    • Outcome: Patients often experience a significant reduction in pelvic pain and improvement in urinary and sexual symptoms.

3. Treatment Protocols

  • Duration and Frequency:
    • The typical EWST protocol involves multiple sessions, usually once a week for 4-6 weeks, depending on the condition being treated. Each session lasts about 15-20 minutes.
  • Customization:
    • Treatment protocols can be tailored based on the severity of the condition, the specific area being treated, and the patient’s response to therapy.

4. Safety and Side Effects

  • Non-Invasive and Painless:
    • EWST is non-invasive and generally well-tolerated by patients. It is performed without the need for anesthesia, and most patients experience little to no discomfort during the procedure.
  • Minimal Side Effects:
    • Side effects are rare and typically mild, including temporary redness, swelling, or bruising at the treatment site. There is no downtime required, and patients can resume normal activities immediately after treatment.

5. Limitations and Considerations

  • Effectiveness:
    • While EWST is effective for many patients, it may not work for everyone. The success of the treatment can depend on the underlying cause of the condition and the patient’s overall health.
  • Combination Therapy:
    • For optimal results, EWST is often combined with other treatments, such as pharmacotherapy, lifestyle changes, or physical therapy, particularly in complex cases like CPPS or severe ED.
  • Extracorporeal Shockwave Therapy (EWST) is a versatile and effective treatment modality for various urological conditions. Its ability to improve blood flow, reduce inflammation, and promote tissue repair makes it a valuable tool in the management of ED, PD, and CPPS. With minimal side effects and a non-invasive approach, EWST offers a promising alternative or adjunct to traditional therapies. Ongoing research and clinical experience will continue to refine its use and expand its applications in sexual and pelvic health.

A study conducted in 2017 tested the effects of shockwave treatment for ED on 710 people. Every participant received five 20-minute sessions in a week. The study showed that it caused a significant improvement in erection quality. 

 

More clinical trials 

Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials – published January 2019 – https://pubmed.ncbi.nlm.nih.gov/30664671/

Erectile Dysfunction A Prospective Randomised Placebo-Controlled Study Evaluating the Effect of Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Men With Erectile Dysfunction Following Radical Prostatectomy – published June 2021 – https://pubmed.ncbi.nlm.nih.gov/33789173/

Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis – February 2017 – http://europeanurology.com/article/S0302-2838(16)30259-7/abstract/low-intensity-extracorporeal-shock-wave-treatment-improves-erectile-function-a-systematic-review-and-meta-analysis

Safety and efficacy of low intensity shockwave (LISW) treatment in patients with erectile dysfunction – published Sept – Oct 2015 – https://www.scielo.br/j/ibju/a/4w8VKf5CHKTPWcNV7N5HNSp/?lang=en

Erectile dysfunction may improve with exercise – published Oct 2016 – https://www.reuters.com/article/us-health-erection-fitness/erectile-dysfunction-may-improve-with-exercise-idUSKCN12I2PD

Twelve-Month Efficacy and Safety of Low-Intensity Shockwave Therapy for Erectile Dysfunction in Patients Who Do Not Respond to Phosphodiesterase Type 5 Inhibitors – published December 2016 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121537/

Shockwave treatment of erectile dysfunction – published April 2013 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607492/

Clinical trails - Peter Bill Juul Ladegaard, MD, Jonas Mortensen, MD, Sune Møller Skov-Jeppesen, MD, PhD, and Lars Lund, MD

Low-intensity extracorporeal shock wave therapy improves erectile . Dysfunction - a pilot study with 2 years follow-up

Professor lars lund DEPARTMENT OF UROLOGY ODENSE UNIVERSITY HOSPITAL

Scandinavian Journal of Urology

 

Shockwave before and after.

  

  • Enhances Erections
  • Improves Sexual Performance
  • Increases Sensation In The Penis
  • More Spontaneous Erections
  • Better Orgasms
  • Faster Recovery Time
  • Increased Erection Time
  • Increased Girth
  • Increased Effects Of ED Meds

 

 

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FAQ's

What is Shockwave Therapy?

Low-Intensity Shockwave Therapy (Li-SWT) is a treatment modality that utilizes acoustic (sound) waves to target damaged or impaired tissue to encourage the body to create healthier tissue. It also helps stimulate blood vessel growth.   Shockwave therapy has been safely used for decades. Today it is being successfully used to treat conditions such as erectile dysfunction (ED), Peyronie’s Disease, and sometimes male or female pelvic pain. 

How Does Shockwave for ED Work?

Shockwave therapy is an alternative to traditional treatments, such as oral medications (Viagra, Levitra, and Cialis), vacuum erection devices, injectable medications, and intra-urethral suppositories. 

When treating ED with shockwave therapy, low-intensity shock waves are applied to different treatment zones on the penis and on the perineum. Using targeted high-energy sound waves, Li-ESWT can speed up tissue repair and improve blood flow, nerve regeneration, and cell growth. This helps improve the strength and quality of erections. 

Is Shockwave Therapy Painful?

While “shockwave” on the surface may sound unpleasant, patients typically tolerate it well. It applies short, frequent, and high-intensity bursts of energy (in the form of ultrasonic sound waves) into soft tissue. Some patients may experience mild discomfort during or after their procedure. 

What Should I Expect for My Appointment?

Prior to your appointment, you may be instructed to shave the affected area. For example, you may be asked to shave the testes and penis prior to treatment for ED. There are no other preparations needed for your procedure. 

Appointments take approximately 30 minutes, and the procedure itself usually takes about 15-20 minutes. However, sessions may be longer depending on the customised treatment for each individual. Patients usually require six (6) treatments, with the effects expected to last for two to three years. The treatment may be repeated, if needed, after that timeframe. 

Treatments are not uncomfortable, and people do not require pain relief or aesthetic; however, patients may have soreness, redness, or some bruising in the treatment area. There are no restrictions following the therapy, but you should take it easy for the rest of the day. 

How Much Does Shockwave Therapy Cost?

Medical aid do not cover Shockwave Therapy, and patients should expect to pay out-of-pocket. At Shockwave Clinic, the cost pr treatment is Rand 2400.00  and 6-8 weekly treatments are normally required as the minimal about of treatments to get the full benefit.

Is Shockwave Therapy Right For You?

Your urologist will discuss your individual situation and help you determine if shockwave therapy is an appropriate treatment option for you.

 

Erectile Dysfunction

Erectile dysfunction (ED) is a very common sexual disorder affecting more than 1 in 5 men. ED is the inability to achieve and/or maintain an erection for sexual intercourse. While most often associated with older men, ED affects a significant proportion of younger men. When treating ED with shockwave therapy, low-intensity shockwaves are applied to different treatment zones on the penis and on the perineum

“Erectile dysfunction is a common disorder of men that increases with age and may profoundly affect their quality of life. Low-intensity shock wave therapy has been proven to be effective treatment for erectile dysfunction. We use the DUOLITH® SD1 to treat patients with vascular erectile dysfunction with good success”
Milad Hanna, M.B., B.Ch. FRCS – NHS Trust, London.

Peyronie’s Disease

Peyronie’s disease is a condition that causes bending of the penis. The problem is caused by scar tissue, called plaques, that forms inside the penis. The disease is generally progressive, most men first notice the presence of the disease when they feel thickened areas (plaques) under the skin of the penis. As the disease progresses further, pain may occur with or without an erection as the penis becomes more curved. The condition can make sexual intercouse difficult or impossible. Shockwave therapy directly targets the pain points and breaks down the plaques within the penis.

“We use the DUOLITH® SD1 to treat several andrological conditions such as erectile dysfunction (ED), chronic pelvic pain syndrome (CPPS) and Peyronie’s. The DUOLITH® SD1 is very easy to operate and provides excellent results. Patients experience safel and gentle treatments”
Professor Lars Lund, MD, DMSci, Head of Research Department of Urology Odense University Hospital and University Denmark.

Chronic Pelvic Pain Syndrome / Prostatitis

Also known aschronic prostatitis, Chronic Pelvic Pain Syndrome (CPPS)is characterized by pain in the region of the pelvic floor and / or urination problems without evidence of urinary tract infection. Some patients experience erectile dysfunction. CPPS is found in men of any age, with the peak incidence in men aged 35 – 45 years. Extracorporeal shockwave therapy (ESWT) is performed using a perineal approach, treating both the prostate and the pelvic floor.

Hard-Flaccid Syndrome

Hard flaccid syndrome is a condition which causes men’s penises to be permanently semi-erect, even if they are not aroused. Erections are typically difficult to achieve, may not be as rigid and men with the condition may find they require more stimulation or arousal than they did before. The condition can be quite painful for those who have it, particularly during ejaculation, urination and erection.

Shockwave therapy for hard flaccid is a treatment that can help treat erection problems associated with the condition and can also relieve pain and repair some of the damage done to the penis.