Thursday, August 31, 2023

A New Treatment method for Erectile Dysfunction: No Pills, Injections or Surgery!

The past two decades have borne witness to astonishing technological advancements, spanning from the emergence of the internet and the introduction of tablets to the prevalence of texting and the proliferation of wearable extensions of our smartphones. Similarly, there have been profound breakthroughs in enhancing men's capacity to attain erections.

The inflatable penile prosthesis, although decades old, has endured the test of time, granting men unable to achieve erections the capability to do so at their convenience and for an extended duration, even when other alternatives fall short.



Following the evolution and refinement of this implant, penile injections with pharmacologically active medications entered the scene. Among these, prostaglandin E2 stands as the most common choice. This therapeutic approach has enabled many men to bypass the need for implants and has remained a viable option for the past three decades.

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Non-invasive methods, such as vacuum erection devices, have also been available for approximately three decades. These devices utilize negative pressure or suction to stimulate blood flow into the penis, thereby inducing an erection. They then maintain this engorgement using an elastic band.

A paradigm shift in the treatment of erectile function unfolded with the advent of pharmaceutical agents that inhibit an enzyme known as phosphodiesterase type 5 (PDE5). These PDE5 inhibitors facilitate spontaneous erections, making it easier for them to occur. This category includes medications like Viagra, Levitra, Cialis, Staxyn, and Stendra, which have been accessible for over fifteen years.

Since that time, few developments have had a significant impact, until possibly now. A novel therapy for erectile dysfunction has emerged, primarily enhancing blood circulation into the penile tissue through the application of energy pulses or shockwaves. This innovation may potentially restore the ability to achieve erections.

How LI-SWT Works

LI-SWT, or low-intensity shockwave therapy, employs acoustic waves that generate a pressure impulse, transmitting energy through a medium or tissue to promote improved blood flow through a process known as neo-vascularization. Neo-vascularization entails the formation of new blood vessels, enhancing circulation within the target organ.

High-intensity shockwave therapy, previously employed to assist patients with kidney stones, has given way to the newer, low-intensity version, which has found a role in rehabilitation, particularly for patients dealing with joint and extremity inflammation. Recently, researchers have delved into the potential application of LI-SWT as a therapy for erectile dysfunction (ED).

The capacity to achieve erections hinges on sufficient blood flow. When a man experiences sexual stimulation, cavernous arteries expand, facilitating blood entry and filling the erectile structures of the penis. An ample blood inflow is imperative for the penis to attain the necessary rigidity for sexual activity. In cases of inadequate blood flow, a man may encounter weaker erections or an inability to achieve erections altogether.

Shockwave therapy carries the promise of being a revolutionary treatment by actively participating in the repair of vascular damage that the penis may have incurred, damage that contributes to erectile dysfunction. This potential breakthrough could potentially offer men who rely on PDE5 inhibitors the chance to regain the spontaneity of erections or rekindle responsiveness to PDE5 inhibitors for patients who have previously been unresponsive to oral medications.

How LI-SWT is Administered

LI-SWT is administered in an office setting with the patient awake.  Trials have most commonly employed five or six weekly treatments which last about fifteen to twenty minutes.   The probe that administers the energy is hand held and applied directly to different areas of the penis and its  root (or crus). 

Results of clinical trials have been encouraging. Almost no complications have been reported and the treatment is well tolerated. There are few restrictions; however, patients who are receiving anticoagulation are not currently candidates for this treatment.   This new shockwave therapy has created a lot of “buzz” and excitement and will likely be coming soon to New Jersey.