Shock Wave Therapy for E.D.
Low Intensity Shock Wave Therapy (LISWT)
The holy grail in all fields of medicine has been the ability to restore or regenerate the function of normal healthy tissues. The discovery of stem cells holds much promise to this end. Stem cells are pluri-potential cells in our body that have the ability to differentiate into healthy new cells, tissue or organs. Erectile dysfunction has been an area of scientific research for stem cells now for over a decade. Researchers have tried injecting stem cells into the penis for many years. The difficulty was keeping those stem cells localized to the penis making regenerative injection therapy ineffective for E.D.
Shockwaves are sound waves that carry energy. When LISWT is applied to the penis, relatively weak but focused sound waves interact with the targeted deep tissues causing stress and micro trauma. This process tricks the penis into releasing angiogenic factor that cause the penis to produce new blood vessels (Neovascularization) improving the blood supply. This form of therapy has been used in many different fields of medicine for the same purpose of producing new blood vessels. In 2010, the first study looking at LISWT for the treatment in E.D. was published (Vardi et al 2010). Since then, there have been many (>100) published studies evaluating the effectiveness of LISWT for the treatment of E.D. A recent meta-analysis showed that LISWT is effective for the treatment of E.D. Overall, the studies have shown that approximately 76% of men will report improved erectile function following LISWT and 72% of men that have failed “Viagra-like” drugs will become responders to these drugs after LISWT.
Dr Karpman and El Camino Urology Medical Group have been monitoring the developing literature regarding LISWT for E.D. since 2010. As the leading expert and clinic in male sexual dysfunction in California, we have started offering patients LISWT for E.D. LISWT is currently an FDA approved treatment for poor wound healing and orthopedic conditions. LISWT has not yet gained FDA approval for the treatment of E.D., Peyronie’s disease or prostatitis.
The medical literature is replete with a variety of approaches and machines for the use in LISWT for E.D. First of all, not all LISWT machines are the same. Sound waves generated by these machines vary in focal size, wave form and depth of penetration. Many commercially available machines use radial wave therapy instead of focused/unfocused pulse waveforms. The advantages of focused/unfocused pulse waveforms is that the the depth of penetration is much deeper and the treatment field is much larger than radial waveform therapy. Radial waves have a very shallow depth of penetration and are only effective at the skin level. The soft wide focused technology used by Dr Karpman has a depth of penetration to 10 cm which can reach the deeper proximal tissues of the penis.
Additionally, the number of shocks and the number of treatment cycles is variable in the literature. Most commonly, protocols have used 1,500 shocks per session with weekly sessions for 6 weeks. The shocks are evenly distributed in the distal, mid and proximal part of the penis. The procedure does not require any anesthesia and can be done in approximately 8 minutes.
You can further discuss LISWT for erectile dysfunction with Dr Karpman. Since the treatment is not currently FDA approved for the treatment of ED, Peyronie’s disease or prostatitis, insurance carriers do not reimburse for this procedure and the financial responsibility is solely on the patient. The treatment cost is reasonable and we offer specials for this treatment at El Camino Urology.