Low frequency shock waves therapy in the treatment of erectile dysfunction

Autore: Prof. A. Natali

Topic: Medical therapies in andrology

Is it time to say goodbye to" love pills"?

Shock waves are acoustic waves that are generated and propagated in the air and transfer energy. When they pass through an organ they give up this energy and the consequence is a biological change in the organ itself. There are shock waves of varying intensity. In urology their first use, for high-intensity shock waves, occurred in the 1980s due to the crushing of kidney stones. Recently it has been seen that shock waves with low intensity in organs such as the heart, activated a process of "neoangiogenesis", the formation of new blood vessels in addition to those already existing, improving in these cases the circulation and functioning of the heart, perhaps made less efficient by the obstruction of a coronary artery. From these results obtained in the cardiology field, starting in 2010, in andrology these low-intensity shock waves were used to improve penile microcirculation in patients with an erectile dysfunction of vascular origin. And the results were surprising. This is demonstrated by preliminary data of the first Italian multicenter study coordinated by the Italian Society of Andrology (SIA), conducted in 2017 on about 100 men and still in progress, with positive results in 70% of patients with mild / medium erectile dysfunction, who he stopped using drugs for erection, to return to spontaneous sexuality, while in more serious patients the response to oral therapy improved in 40% of cases. The shock waves are applied through a handpiece (Fig.1) created specifically to adapt to the anatomy of the penis and are applied in six different points of the organ. There are various treatment protocols, but the amount of blows and therefore of total shock waves in the cycle, which usually lasts for six weeks with a fifteen-minute session per week, averages 3000 waves with a power of 0.10 - 0.25 micro joules per square millimeter. The positive effect of treatment on erectile function occurs after about four weeks and tends to gradually regress after two years. But the procedure can be safely repeated, given its absolute non-invasiveness. It is still early to say goodbye to "love pills" but low intensity shockwaves are a candidate for a new therapeutic option for patients with mild and moderate erectile dysfunction, equal to one third of the more than three millions of patients in our country. The treatment does not cause side effects, is not invasive and is quick and painless



(Fig.1)Low frequency shock waves in the treatment of erectile dysfunction

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