Penile implant: Till recently this was the only hope for a potential cure for ED. However, this is invasive and requires surgical expertise.
Shockwave therapy uses the same science used for shock wave treatment for stones in urology. In a nutshell, the shock waves promote angiogenesis and help restore normal blood flow to the penis. This therapy is bordering LEVEL 1 evidence but is still experimental. I have personal experience in using it and believe there is a role for it.
Recently there was a review paper published in Natures urology reviews which critically analyze this. I commend the authors for the extensive work.
Some excerpts from that are the following:
“The available systematic reviews suggest the presence of level 1 evidence”
“Both the scientific community and the companies promoting this technology must take responsibility to speed up and improve research in order to produce and publish robust evidence on Li-ESWT for ED.”
“In addition, the long-term effects of Li-ESWT treatment are still not understood — in particular, any harmful effects of Li-ESWT, such as fibrosis, or development of Peyronie’s disease due to repeated microtrauma, must be assessed.”
“Shockwave therapy has been shown to induce immediate vasodilatation which gives rise to the hypothesis that shockwave treatment could modulate the production of NO or other vasodilators.”
“Li-ESWT is the first treatment option for ED that has the potential to improve pharmacologically unassisted erectile function. The concept is unprecedented and revolutionary, and the effects at molecular and tissue level are largely unknown, although neoangiogenesis might have a key role. Following a series of single-arm trials, which almost unanimously show a benefit, several monocentric RCTs have now been published with mixed results.”
(Excerpts from Nature reviews in urology: Low-intensity shockwave therapy for erectile dysfunction: is the evidence strong enough? Mikkel Fode 1, Georgios Hatzichristodoulou 2, Ege Can Serefoglu 3, Paolo Verze 4 and Maarten Albersen 5 on behalf of the Young Academic Urologists Men’s Health Group)
Colin tiong
I’m 60+ ages, having ED problem for at least 2 years. Also HIgh BP, diabetes patients. Frequent pee at night.