Shock Wave Therapy Treatment For ED: Does It Work? – Introduction
Erectile dysfunction is a disorder that affects millions of men across the globe. Definition: ED means the inability to have or maintain an erection high enough to engage in sex. ED prevalence: The prevalence of ED increases with age, and ED is present in as much as 52% of 40-70-year-old men. Treatment: Treatment for ED includes the use of a pill, injections of the penis, vaginal contraceptives and surgery. But these approaches may not work for all patients. Diverse side effects, contraindications, and cost factors that contribute to inappropriateness. Over the past few years, shock wave therapy has become a powerful form of ED treatment. Here, the authors will present how SWT can effectively be used to treat ED.
Shock Wave Therapy Treatment For ED: Does It Work?
Shock Wave Therapy:
Shock wave therapy is an effective, non-surgical treatment that has been applied to many disciplines such as urology, orthopedics and cardiology. The treatment involves sending low-frequency shock waves to the affected area, which thereby increases angiogenesis, increases blood flow, and lessens inflammation. With respect to ED, SWT has been suggested to enhance penile hemodynamics, improve erectile function and perhaps even reverse pathology.
Shock wave therapy can be divided into low-intensity shock wave therapy (LI-ESWT) and high-intensity shock wave therapy (HI-ESWT). The LI-ESWT involves applying low-intensity shock waves to the penis, typically in multiple sessions, and HI-ESWT involves applying high-intensity shock waves in a single session. It is not known how shock wave therapy works in treating ED in its precise way. But the shock waves are said to stimulate growth factors and form new blood vessels, thereby improving the flow of blood to the penis.
Mechanism of Action:
Shock wave therapy is a non-invasive treatment that involves delivering low-frequency shock waves to increase blood flow and encourage tissue repair. We still don’t fully know how SWT works on ED, but a number of studies have shown it to increase neovascularisation, enhance endothelial health, and inhibit oxidative stress.
1. Neovascularization:
One of the main effects of SWT on ED is the induction of neovascularisation, or new blood vessels. Shock waves release angiogenic molecules such as vascular endothelial growth factor (VEGF) and stimulate the development of new blood vessels in the corpus cavernosum, the sponge-like tissue that holds the majority of the blood in the penis during an erection. The higher blood supply to the corpus cavernosum also promotes improved erections.
2. Endothelial Function:
Shock waves can also improve endothelial function that is vital for maintaining erectile function. The endothelium, or blood vessel lining, controls vascular tone and circulation. SWT increased the activity of endothelial nitric oxide synthase (eNOS), an enzyme that catalyses nitric oxide, a powerful vasodilator. This increased release of nitric oxide causes the smooth muscle in the corpus cavernosum to relax, which leads to increased circulation and erectile function.
3. Oxidative Stress:
Oxidative stress occurs when the balance between the body’s creation of reactive oxygen species (ROS) and its capacity to detoxify them falls apart. ED is caused by oxidative stress, and SWT alleviates oxidative stress in the corpus cavernosum. Shock waves boost the activity of antioxidant enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GPx), which deplete ROS and shield the tissues from oxidative stress.
Clinical Evidence:
A number of clinical trials have examined the efficacy of SWT in ED. One meta-analysis of nine randomised controlled trials in 632 patients showed that SWT correlated significantly better with erectile function than placebo (1). A separate systematic review of 14 studies, including 833 patients, found SWT to be safe, well-tolerated and beneficial for the improvement of erectile function in ED men (2). Yet they acknowledged poor evidence, and that more high-quality studies were needed to establish SWT’s efficacy.
According to a recent randomised, placebo-controlled, double-blind study of 110 ED patients, SWT led to significant improvements in erectile function (according to the International Index of Erectile Function (IIIEF) questionnaire) (3). The results, the researchers also noted, lasted for up to 12 months after SWT treatment.
But not all studies are so successful. In a randomised placebo-controlled study of 50 patients with ED, SWT did not improve erectile function as significantly as placebo (4). ‘The lack of a larger sample and the presence of psychogenic ED patients might have been contributing to the disappointing findings,’ the authors wrote.
Safety and Tolerability:
1. Safety:
Through many clinical studies, the efficacy of SWT in ED has been well documented. None of these patients experienced serious adverse events, thus supporting the conclusion that SWT is a safe and well-tolerated treatment for ED. Because SWT is non-invasive, it doesn’t involve risks normally involved in surgery, which accounts for the fact that there aren’t any major complications.
2. Transient Side Effects:
Generally, SWT is safe for ED, though some patients might experience temporary side effects, including mild pain, redness, and swelling at the injection site. Typically, the symptoms are mild and go away naturally within a few days of treatment. They do not always show up and can vary with the pain tolerance, location and number of sessions received.
3. Pain Management
The most common adverse reaction reported for SWT-treated ED is mild pain. Typically, it’s mild and is alleviated by non-prescription pain medications or adjusting the treatment settings so that the patient feels as little pain as possible. Afterwards, physicians apply local anaesthetic to minimise the discomfort. Additionally, it can be recommended not to schedule SWTs immediately after or prior to vigorous activity that will exacerbate the pain and discomfort.
4. Redness and Swelling:
These patients may also experience redness and swelling at the treatment site after their ED SWT. This is generally very mild, and will subside without medical treatment within days. Cold packs are used to alleviate symptoms and cool them. We should also urge the patients to contact the physician if they develop signs of infection including pain, swelling, or pus.
Conclusion: Shock Wave Therapy Treatment For ED: Does It Work?
Overall, shock wave therapy is a promising ED remedy. But evidence is still too weak to make any conclusive claims about its long-term efficacy and safety. You should also be aware of the risks and side effects of this therapy. It’s vital that patients keep their healthcare providers updated about the use of this therapy to see if it is needed for the conditions in which they are experiencing ED or not. Either way, the treatment is always decided on the back-of-the-envelope basis.
