Shock Wave Therapy

Shock wave therapy is a regenerative therapy FDA cleared for improved blood supply, pain relief and connective tissue activation. Currently we are using the device to improve the blood supply to the penis and activate connective tissue growth in the corpora cavernosa and thereby improving erectile dsyfunction. Please note that there is a difference between an accoustic wave and a shock wave when investigating potential treatments.

In 2010, low-intensity shockwave therapy (Li-SWT) was first used in Europe as a novel, minimally-invasive disease modification treatment strategy for ED.  Li-SWT has been used therapeutically in other fields of medicine, including in the treatment of cardiac or limb ischemia, diabetic foot ulcers,and wound healing.  Li-SWT has been shown in multiple publications to improve impaired erectile function in a variety of animal models of ED.  It is proposed that Li-SWT acts possibly through stimulation of mechanosensors, inducing the activation of neo-angiogenesis processes, recruitment and activation of stem cell progenitor cells, improvement of microcirculation, nerve regeneration, remodeling of erectile tissue with increase in the muscle/collagen ratio, and reducing inflammatory and cellular stress responses.  The hypothesized biologic effect of Li-SWT would result in a decrease of corporal erectile tissue fibrosis.  This would be evident as reduced erectile tissue inhomogeneity on Grayscale ultrasound.  The other hypothesized biologic effect would be an increase cavernosal arterial perfusion pressure.  This would be evident as increased cavernosal arterial peak systolic velocity on Duplex Doppler ultrasound. The EuropeanUrological Association has listed Li-SWT as a treatment for ED.  

The low-intensity shockwaves used in most Li-SWT treatment protocols published to date emit an energy density of approximately 0.09 mJ/mm2.  In contrast, kidney stone lithotripsy energy densities are approximately 0.9 mJ/mm2 ;this is 10 times higher that used for ED. In general, Li-SWT treatment protocols provide 1 treatment session per week over the course of 6 weeks. In general, several thousand shockwaves are delivered to multiple areas of the penis, with each treatment session lasting approximately 20-30 minutes.   In general, shockwaves are delivered by a hand-held probe. In general, treatment is offered in an outpatient setting with no analgesia needed.  

At San Diego Sexual Medicine we utilize the Urogold 100™ shockwave device which is FDA cleared for improved blood flow,pain amelioration and connective tissue activation.  Several basic science studies examining the effects of low intensity penile shockwave on erectile tissue have utilized the Urogold100™ electrohydraulic shockwave device. Multiple health care providers have presented positive erectile dysfunction outcome data after treatment with Urogold 100™ shockwave device. No side effects have been reported.  

 

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