What Is Shockwave Therapy?

Extracorporeal shockwave therapy (ESWT) is a non-invasive technique for the treatment of vasogenic (related to impaired blood flow) erectile dysfunction (ED). During the treatment, a small wand-like device uses targeted sound waves to stimulate penile tissue, encourage blood flow, and grow new blood vessels. Improved blood flow in the penis is essential for quality erections. During the treatment, which takes 15-20 minutes, you can feel a pulse or a light snap on the skin. It is described by most men as a mild discomfort. If intolerable discomfort occurs during the treatment a slight adjustment of the handheld device or a reduction in the energy input will reduce the discomfort.

ESWT is a medical treatment that has been used extensively since the mid-1980s in the United States. It is often used as a non-invasive treatment option for kidney stones and orthopedic injuries. ESWT is still considered experimental in the United States for the treatment of (ED) however the European Association of Urology guidelines do recommend the use of ESWT in patients with mild vasculogenic ED or as an alternative first-line therapy for patients who do not wish to have or are not suitable for, oral vasoactive therapy medications such as Viagra, Sildenafil, Cialis or Tadalafil.

There is extensive data available on both the basic science and the clinical improvements using ESWT for vasculogenic ED. ESWT is less likely to work for men with severe ED resulting from prostatectomy, cystectomy, pelvic trauma, or genital/pelvic radiation. ESWT has not been well-studied in men with severe vasculogenic ED, psychosocial causes of ED such as performance anxiety or other health conditions that can cause ED such as diabetes, prostate cancer, or heart disease. At Willow Health and Aesthetics we offer ESWT as an option for patients with mild to moderate ED and/or who desire erectile enhancement.

Candidates For Shockwave Therapy

This procedure works best for men with mild to moderate vasculogenic ED who are not responding to ED medications adequately, who are not interested in taking ED medications, who are interested in trying regenerative therapy to reverse some of the root causes of ED or are interested in erectile enhancement. It is recommended you meet with your primary care or urology provider to discuss your ED if applicable as it can be a symptom of a serious underlying health condition.

Risks For Shockwave Therapy

ESWT has been performed on many thousands of patients and the risks are very low. The most common risks associated with ESWT are swelling, reddening of skin, and soreness. Less common risks are hematoma (bruising) and petechiae (minor broken blood vessels). Lastly, results vary amongst patients and therefore ESWT may not work to improve the symptoms of your ED.

Shockwave Therapy Cost and Expectations

ESWT is not covered by insurance plans, and it may or may not qualify for your HSA dollars. Your out-of-pocket costs are $395 per treatment. There are multiple options for ED treatment protocols studied in the scientific literature, but most suggest, at the very least six treatments, and many suggest up to 12 treatments for maximum therapeutic effect. There is a large range of experiences from men noting erectile improvement after one treatment to some men needing all 12 treatments. How many Shockwave treatments you will need to notice erectile improvement is unknown at the beginning of the treatment. Note that the regeneration of penile tissues and subsequent improved erection benefit can take up to three months after your last ESWT treatment.

To assess your baseline functioning, create treatment recommendations and measure treatment success for those patients with ED you will be asked to fill out The Erectile Hardness Score below at each visit.

The Erectile Hardness Score (EHS) [Circle one]
0. Penis does not enlarge – not a good candidate for ESWT
1. Penis is larger but not hard – not a good candidate for ESWT
2. Penis is hard, but not hard enough for penetration – 12 treatments suggested
3. Penis is hard enough for penetration, but not completely hard – 6-12 treatments suggested
4. Penis is completely hard and fully rigid – as needed treatments

For ED treatment:
Option 1 Fast track: One treatment every third day for a total of six treatments. Rest for three weeks. Repeat one treatment every third day for an additional six treatments. This is twelve treatments in total. At least 72 hours must separate each treatment.
Option 2: One treatment weekly for six treatments. Rest for three weeks. Repeat one treatment weekly for an additional six treatments. This is twelve treatments in total.
Option 3: One to two treatments weekly for six treatments. Rest for three months then assess if more treatments are needed. This is six treatments in total.

For erection enhancement and not ED treatment:
Option 4: One treatment as needed. Many men report erection improvement after just one or two treatments.

How Long Does Shockwave Therapy For ED Last?

Individual results will vary; however, studies have shown that a positive response can last up to two years. There is no clear guidance for how to maintain a positive response to treatment in scientific literature. The ranges vary from returning to ESWT when ED symptoms start to return to having a single monthly or quarterly ESWT treatment. Most protocols also recommend a daily very low dose oral medication for ED such as Tadalafil 2.5-5 mg daily to enhance ESWT’s positive effects on blood vessels.

To learn more, call us today at 541-653-9158 to schedule a consultation.