Abstract
A non-pharmacological method of treating erectile dysfunction uses the linear application of a low-intensity shock wave. This method of treatment is mainly indicated for patients with mild and moderate vasculogenic erectile dysfunction.
The rate of patients reporting satisfactory improvement is between 40-80%. Study results show that low intensity shock wave therapy could improve erectile function even in patients with severe erectile dysfunction who are either unresponsive or insufficiently responsive to oral phosphodiesterase type 5 inhibitors, thereby reducing the immediate need for more invasive treatment.
The effect of treatment appears to be clinically evident starting 1-3 months after the end of treatment, with a subsequent progressive decline of the achieved benefit in terms of erectile function over time, although some effects have been detected up to 5 years after treatment. Recently, the impact of shock waves has also been tested in penile rehabilitation after radical prostatectomy.
Overall, larger prospective randomized controlled trials and long-term follow-up data are needed to give clinicians more confidence in the use and efficacy of shock wave therapy in patients with erectile dysfunction. Another goal should be to define treatment protocols that can lead to greater clinical benefits.