Villa Stuart Private Clinic

Low-intensity shock waves to treat erectile dysfunction

This physical treatment uses low-intensity shock waves and consists of treating the penis at different sites by delivering about 750 shock waves to each corpus cavernosum for a total of about 1,500 “blasts,” in the space of about 20′. Delivery is via a gel-coated handpiece that is placed on the penis. The treatment causes no pain.

The treatment is repeated for 8-10 sessions, twice a week for 4-6 weeks.

WHAT ARE SHOCK WAVES?

Shock waves are the sequence of single pulses of acoustic energy propagating at supersonic speed in a liquid medium (1550 m/sec in water). They are characterized by a rapid rise of a positive pressure peak (<10 nanoseconds), with a high peak pressure (100MPa) and a short cycle life (10 microseconds).

Results reported in the literature have provided scientific evidence that low-intensity shock waves (LISWT) stimulate the formation of new blood vessel networks (neoangiogenesis) in the treated tissue. This process leads to the formation of a new vascular system in organs exposed to shock waves; however, physicians have not yet fully elucidated all the biological mechanisms of action of shock waves.

When applied to the corpora cavernosa, low-intensity shock waves activate mechanosensors, induce neoangiogenesis, reactivate and activate vessel progenitor cells, improve microcirculation, and promote nerve regeneration-the overall effect is to remodel cavernous tissue and increase blood flow to the erectile tissue.

Unlike all other therapies existing today for erectile dysfunction that do not change the pathophysiology of the erectile mechanism, shock wave therapy regenerates the erectile mechanism so that patients can have spontaneous erections.

Studies to date have shown that low-intensity shock waves can help both males with erectile dysfunction who respond to drug therapy and males with erectile dysfunction so severe that they cannot respond to oral drug therapy. In the event that drugs are still to be used a better result will probably be obtained from them.

No treatment-related inconveniences or complications beyond temporary redness of the skin have been reported.

Low-intensity shockwaves for the treatment of erectile dysfunction constitute the greatest revolution since the 1998 marketing of Sildenafil, the first molecule studied as a 5-Phosphodiesterase inhibitor capable of increasing the mediator (nitric oxide) necessary to achieve vasodilation of the vascular tissue in the corpora cavernosa, and thus an erection. Other molecules with the same action were studied and marketed in later years (Vardenafil, Tadalafil, Avanafil).

When there is a lack of response to oral medications, intracavernous injections of papaverine or prostaglandins can be used to induce an erection of varying duration, independent of stimulation: these injections, however, are burdened by the risk of excessive prolongation of the erection, which may require intracavernous administration of antagonist drugs or, in some cases, emergency surgery.

Another therapy is vacuum, that is, a cylinder in which the penis is placed by making a vacuum so as to draw blood passively into the organ: here the blood is held for the necessary time thanks to an elastic band placed at the base of the penis. The mechanism, as contrived, has not been very successful in our country.

Artificial penile prosthesis implantation is also a definitive alternative to the problem.

The Villa Stuart Clinic is affiliated with major insurance companies and supplementary health care funds.

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