Low intensity shock wave therapy has emerged as a game-changing technology in multiple medical disciplines. As high tech applications have evolved, patients suffering from cardiac, musculoskeletal and sexual disorders have reaped the benefits of regenerative therapy. Now that LiSWT has been used to treat patients for several years, meta-analysis of the data is allowing for a more refined approach to choosing which protocols are most successful, and which patients are most likely to benefit.
The Use Of PRP (Platelet Rich Plasma)
Injections of platelet rich plasma into the penis, commonly known as “the P-shot,” is utilized by some clinicians in hopes of enhancing the regenerative process, which is the cornerstone of low intensity shock wave therapy. A recently published study found that those patients who were treated with PRP in addition to LiSWT did not show additional gains compared to patients treated only with shock waves when graded for erectile dysfunction. However, they did demonstrate improved intravaginal ejaculatory latency time (they lasted longer.) https://onlinelibrary.wiley.com/doi/abs/10.1111/and.14197
Long-Term Results From Low Intensity Shock Wave Therapy For ED
The Journal of Sexual Medicine reported the results of patients who had been treated five years prior. https://www.sciencedirect.com/science/article/pii/S2050116121000647 As might be expected, the results of treatment tend to fade over time. The study also found that the long-term safety profile of the treatment was excellent, with patients not experiencing any signs of penile deformity from the treatment. As such, patients who are likely to eventually require retreatment can do so safely, knowing that the long-term safety profile is quite favorable.
Treatments in doctor’s offices are quite expensive, and are not covered by most insurances at this time. Patients who own their own units, such as Uroshock, do not accrue additional expenses when they purchase the extended warranty.
Wide Variance In Protocols Are Reported In The Literature
There are a variety of types of shock wave units:
High pressure acoustic waves
2)Hand-held units for home-use
Energy Flux Density
The energy flux density is the metric most commonly employed to measure the force delivered. Favorable outcomes have been reported with:
Again, a wide variance noted.
Number of Shocks Per Session
Frequency of Sessions
There seems to be a trend towards 3000 shocks per sessions, which are performed 2/week.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261418/ As the authors note in their review, there is an absence of direct head to head studies, so making definitive guidelines is unlikely soon. While some studies have reported limited success in patient who have had prior pelvic surgery, in general, patients with milder forms of ED are the most likely to benefit from shock wave therapy at this time.