Health x Wellness
Can extracorporeal shockwave therapy treat erectile dysfunction?
Extracorporeal shockwave therapy is a pain management solution gaining interest and traction worldwide in treating common sports injuries, foot pain and even erectile dysfunction.
Extracorporeal shockwave therapy (ESWT) is used in the treatment of musculoskeletal problems.
In more recent times, it has been increasingly applied to the field of sports rehabilitation, and treating common sports injuries and foot pain resulting from plantar fasciitis.
The Active Age had a discussion with Dr. Zeng Shanyong from DTAP Clinic about what is ESWT, and what does it involve from a treatment perspective, as well as what patients can expect post-treatment.
the Active Age (AA): What is extracorporeal shockwave therapy and why is it gaining in popularity?
Dr. Zeng Shanyong (ZSY): Extracorporeal Shockwave therapy, or ESWT is a treatment that is widely used in many fields of medicine for treatment for various conditions. It has a long history of use, with the first clinical trials of ESWT for treatment of kidney stones performed in 1985. Since then, various other applications of shockwave therapy have been discovered and well established in other fields of medicine.
AA: What are the common conditions and contexts that ESWT treats?
ZSY: The use of ESWT depends on the strength of the shockwaves.
High intensity Shockwave is used for lithotripsy because of its focused mechanical destructive properties and is used as a non-invasive treatment for kidney stones, by breaking up large stones in-vitro and allowing the body to pass out the stones fragments naturally.
Medium intensity shockwave has anti-inflammatory properties and is used in a wide variety of orthopedic conditions, ranging from non-union fractures, tendonitis and bursitis.
Finally, Low Intensity Shockwave (Li-ESWT) has garnered the most interest because of its angiogenic properties and is used in chronic wounds, peripheral neuropathy as well as Erectile Dysfunction.
AA: ESWT seems to be used to treat erectile dysfunction. How did this come about, and is it effective?
ZSY: The data for Li-ESWT for treatment of erectile dysfunction has been very encouraging as well. Several small scale studies have demonstrated the effectiveness of the treatment, with patients either regaining good erections and normal vaginal penetration with or without PD5I. Moreover, none of the studies report any adverse effect as a result of the treatment, making it a safe and effective treatment for erectile dysfunction. The effects are long lasting as well, with 50 percent of patients still reporting good erections 1 to 2 years after treatment.
The treatment itself is simple and unobtrusive for the patient as well. A probe is applied to the penis with a gel underneath to enhance the transmission of shockwave. Around 1500 to 3000 pulses are then given overall to several areas of the penis and groin. The treatment is painless and some patients might just experience some slight tingling on the areas of treatment. It takes around 15 to 20 minutes for each treatment cycle and the whole treatment course will consist of 6 treatments overall.
However, Li-ESWT may not work for everybody. It shows the best promise in patients with vasculogenic erectile dysfunction, with 60 to 70 percent of patients showing improvement.
Vasculogenic Erectile Dysfunction is one of the possible causes of erectile dysfunction in men, which is caused by reduced blood supply to the penis due to aging, atherosclerosis, chronic diseases like diabetes, high cholesterol, high blood pressure.
However, not all erectile dysfunction is vasculogenic in nature and some erectile dysfunction might be psychological or due to other conditions such as a low testosterone state. Li-ESWT might not be as effective in this group of patients.
AA: What does ESWT involve, from a treatment perspective?
ZSY: Good and effective treatment for erectile dysfunction has existed for a long time. These include oral medications like Phosphodiesterase 5-Inhibitors (PD5I) which include Sildenafil (Viagra), Tadalafil (Cialis) and injectables like Intracorporeal Alprostadil (Caverject) Injection. These treatments have been proven to be safe and effective for treatment of Vasculogenic Erectile Dysfunction.
However, all these treatments have one thing in common: they do not treat the underlying cause of erectile dysfunction.
Most patients with vasculogenic erectile dysfunction have to rely on their treatment to maintain normal sexual function. Li-ESWT, due to its angiogenic properties can help to restore good blood flow to the penis and hence offer a rehabilitative and even curative treatment for vasculogenic erectile function.
Potentially, this can offer patients a possibility of regaining spontaneous sexual activity with normal intimacy without any of the side effects of the medications.
AA: What should patients that opt for ESWT expect?
ZSY: Overall, Li-ESWT is a safe and effective approach to treating erectile dysfunction.
Many patients, despite the effectiveness of tablets like sildenafil or tadalafil, would prefer not to have to take a medication each time they want to have sex.
Li-ESWT offers a possible alternative treatment, with noticeable improvement and even a possible cure for erectile dysfunction.
Dr Zeng Shanyong is the resident doctor at DTAP Clinic. He firmly believes that holistic patient care is at the very heart and soul of his medical practice. He feels that good patient-physician communication is important and believes in working closely with patients to achieve their desired goals and outcomes.
Photo by Womanizer Toys on Unsplash and by charlesdeluvio on Unsplash
