Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Is low-intensity shockwave therapy for erectile dysfunction ready for clinical practice?

International Journal of Impotence Research volume 31, pages 204–205 (2019)Cite this article

Subjects

Over recent years, Low-intensity Shockwave Therapy (Li-ESWT) has emerged as a potential cure for erectile dysfunction (ED) and this has created considerable excitement [1]. The predominate theoretical background for improvements in erectile function with Li-ESWT is that the treatment may promote the formation of new blood vessels and improve endothelial function in the corpora cavernosa [2]. However, in spite of promising pilot studies, the results of randomised controlled trials have been mixed with some finding effect on ED and some showing no differences between active treatment and sham control [3]. Therefore, Li-ESWT remains controversial.

In this month’s issue of International Journal of Impotence Research, Yamaçake et al. [4] published the results of a randomised, double blinded, sham-controlled study investigating the effects of Li-ESWT for ED in Kidney Transplant Recipients [4]. This study is the first of its kind to evaluate the treatment in this specific group of patients. The study is also the first to investigate the specific Li-ESWT device used, the Dolorclast® Smart (Electro Medical Systems, Switzerland). The authors find an apparent effect of 6 treatments sessions with 7/10 patients in the treatment group experiencing an improvement of at least 5 points on the IIEF-5 scale vs. only 1/10 in the sham group. At first glance this seems to confirm a possible effect of Li-ESWT and suggests that the treatment could be offered specifically to patients with kidney transplants. However, when examining the study closer, there may be reason for caution.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Fode M, Lowenstein L, Reisman Y. Low-Intensity extracorporeal shockwave therapy in sexual medicine: a questionnaire-based assessment of knowledge, clinical practice patterns, and attitudes in sexual medicine practitioners. Sex Med. 2017;5:e94.

    Article  Google Scholar 

  2. Assaly-Kaddoum R, Giuliano F, Laurin M, Gorny D, Kergoat M, Bernabe J, et al. Low intensity extracorporeal shock wave therapy improves erectile function in a model of type ii diabetes independently of NO/cGMP pathway. J Urol. 2016;196:950.

    Article  Google Scholar 

  3. Fode M, Hatzichristodoulou G, Serefoglu EC, Verze P, Albersen M. Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough? Nat Rev Urol. 2017;14:593.

    Article  CAS  Google Scholar 

  4. Yamaçake K, Carniero F, Cury J, Lourenco R, Piovesan A, Srougi M, et al. Low-intensity shockwave therapy for erectile dysfunction in kidney transplant recipients. a prospective, randomized, double blinded, sham controlled study with evaluation by penile Doppler ultrasonography. Int J Impot Res. 2018. https://doi.org/10.1038/s41443-018-0062-2.

  5. Fojecki GL, Tiessen S, Osther PJ. Effect of low-energy linear shockwave therapy on erectile dysfunction-a double-blinded, sham-controlled, randomized clinical trial. J Sex Med. 2017;14:106.

    Article  Google Scholar 

  6. Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol. 2011;60:1010.

    Article  Google Scholar 

  7. Cutter, GR. Statistical cures and other fallacies. Mult Scler J. 2012;18:387–90.

    Article  Google Scholar 

  8. Hanson-Divers C, Jackson SE, Lue TF, Crawford SY, Rosen RC. Health outcomes variables important to patients in the treatment of erectile dysfunction. J Urol. 1998;159:1541.

    Article  CAS  Google Scholar 

  9. de Araujo AC, da Silva FG, Salvi F, Awad MC, da Silva EA, Damiao R. The management of erectile dysfunction with placebo only: does it work? J Sex Med. 2009;6:3440.

    Article  Google Scholar 

  10. Vardi Y, Appel B, Kilchevsky A, Gruenwald I. Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol. 2012;187:1769.

    Article  Google Scholar 

  11. Kitrey ND, Gruenwald I, Appel B, Shechter A, Massarwa O, Vardi Y. Penile low intensity shock wave treatment is able to shift pde5i nonresponders to responders: a double-blind, sham controlled study. J Urol. 2016;195:1550.

    Article  Google Scholar 

  12. Kalyvianakis D, Hatzichristou D. Low-intensity shockwave therapy improves hemodynamic parameters in patients with vasculogenic erectile dysfunction: a triplex ultrasonography-based sham-controlled trial. J Sex Med. 2017;14:891.

    Article  Google Scholar 

  13. Olsen AB, Persiani M, Boie S, Hanna M, Lund L. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol. 2015;49:329.

    Article  Google Scholar 

  14. Yee CH, Chan ES, Hou SS, Ng CF. Extracorporeal shockwave therapy in the treatment of erectile dysfunction: a prospective, randomized, double-blinded, placebo controlled study. Int J Urol. 2014;21:1041.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of urology, Herlev and Gentofte Hospital, Herlev, Denmark

    Mikkel Fode & Peter Busch Østergren

  2. Department of urology, University Hospitals Leuven, Leuven, Belgium

    Maarten Albersen

Authors
  1. Mikkel Fode
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maarten Albersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Busch Østergren
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mikkel Fode.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fode, M., Albersen, M. & Østergren, P.B. Is low-intensity shockwave therapy for erectile dysfunction ready for clinical practice?. Int J Impot Res 31, 204–205 (2019). https://doi.org/10.1038/s41443-018-0081-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-018-0081-z

This article is cited by

Search

Advanced search

Quick links