Principle
Shock waves are high-energy audible sound waves. They have been used in medicine since 1980 for the effective treatment of various conditions. Shock wave therapy, originally used to break up kidney stones, has since developed into a recognized therapeutic method in orthopedics and cardiology, and since 2010 has also been used to treat erectile dysfunction (ED) of vascular origin.
LISWT is a non-invasive, painless treatment. Using specialized equipment, low-intensity shock waves are applied to different areas of the penis over a series of sessions (typically 6 to 12).
- These waves produce a mild micro-stimulus in the tissue.
- This stimulus triggers a natural response in the body that promotes the formation of new blood vessels (neovascularization or neoangiogenesis).
- The goal is to improve blood flow in the penis and stimulate the natural mechanisms of erection, rather than simply relieving symptoms.
- The treatment requires no anesthesia or hospitalization and can be performed in an outpatient office setting.
Expected results
The efficacy of extracorporeal low-intensity shock wave therapy in treating erectile dysfunction has been the subject of numerous studies. Several systematic reviews, rated at the highest level of evidence according to the Oxford Centre for Evidence-Based Medicine, concluded that LISWT promotes improvement in erectile dysfunction, as measured by the IIEF (International Index of Erectile Function) and the EHS (Erection Hardness Score). According to a systematic review based on 14 studies involving a total of 833 patients, LISWT “may represent the first-choice non-invasive treatment for patients suffering from erectile dysfunction.”
In summary
- Improvement in erection quality, assessed through validated questionnaires (IIEF score) and erection firmness (EHS score).
- Measurable improvement in penile blood flow, confirmed by objective examinations (peak systolic velocity on ultrasound).
- Possible effect as early as the first month, with benefits that may persist for several months after the end of treatment (3 to 12 months depending on the study).
- Among certain patients who do not respond to oral treatments, about 6 out of 10 regain a positive response, with the benefit maintained in the vast majority of them one year later.
- Safety and tolerability: long-term follow-up studies (up to 5 years) have reported no pain or penile deformity related to the treatment.
- Non-invasive treatment, performed in the urology office, with no anesthesia or recovery time required.
Who is this treatment suitable for
LISWT is particularly suited to certain patient profiles:
- Patients with mild to moderate erectile dysfunction of vascular origin (related to insufficient blood flow). This is the profile that responds best to this treatment.
- Patients who do not respond satisfactorily to standard drug treatments (PDE5 inhibitor tablets such as sildenafil or tadalafil) and who are seeking an alternative before considering more invasive treatments.
- Patients wishing for first-line management, particularly in cases of contraindication or reluctance to take oral medications.
- Patients undergoing penile rehabilitation after radical prostatectomy (prostate surgery), particularly in the first months following the procedure.
This treatment is currently recommended as a priority for men with mild to moderate vascular erectile dysfunction.