Low Intensity Electro Shock Wave Therapy (Li-ESWT or just ESWT for short) was introduced as a treatment for erectile dysfunction (ED) in 2009. In 2014, this treatment was approved for use in Singapore. I was the 2nd Doctor in Singapore to purchase and use the ED1000 by Medispec in 2014 and have treated thousands of patients with it ever since.
Who will benefit from ESWT for ED?
Anyone who has mild or mild to moderate ED due to poor blood flow. ESWT may be all the treatment you need and you do not have to take medicines for ED. Not sure if you suffer from ED or not? Click on this link to take the IIEF questionnaire to find out.
If you have been on medicines for ED like Viagra and you find that you have to take ever increasing doses to achieve the same effect. Or if you are already taking the maximum dose and still not getting the best results. ESWT can improve or restore the body’s reaction to ED medications.
ESWT has also been used successfully to treat curved or bent penis. This condition is known as Peyronie’s Disease.
How it works
Shock Wave therapy is not new. One of the first medical uses of shock wave treatment was to break up kidney stones. It was then used successfully to treat orthopedic conditions such as ligament, tendon and muscle injuries. It has also been used to open up blocked blood vessels in the heart.
In the field of Urology, ESWT has been used successfully to treat ED, Peyronie disease and prostatitis.
It works by shooting multiple painless shock waves into the erectile tissue of the penis (the Corpus Cavernosa). The shock waves triggers the body to initiate its own healing process. This results in the formation of new blood vessels. Consequently improving blood flow into the penis and reversing the symptoms of ED.
There is also some evidence to show ESWT improves nerve function in the penis.
The procedure
The treatment itself is very simple, painless and only takes about 15 minutes. There are no special preparations necessary prior to the treatment. After the treatment there is no downtime and my patients immediately resume their normal activities.
A full treatment course requires between 6 to 12 sessions. The recommended frequency is 2 treatment sessions a week. However, this can vary considerably and you should discuss with your Doctor what the appropriate treatment frequency is for you. Patients can continue having sexual intercourse while undergoing the therapy series. In fact I would encourage them to as I believe encouraging more blood flow into the penis will help extract the maximum benefits from the treatments.
The follow up
After the initial 6 to 12 sessions, I would usually recommend that my patients come back for a maintenance session every 6 to 18 months. Again this varies considerably between patients and you need to ask your Doctor what is right for you.
Are there any other treatments required?
That would depend on the severity of the ED and if there are any other underlying conditions. Sometimes, co-treatment with PRP injections or ED Medicines such as Cialis is required. Also, Testosterone levels should be normalized in order for patients to benefit most from ESWT treatments. This has to be individualized to the patient and is best to discuss with your Doctor.
Is it painful and are there any side effects?
Treatment with the ED1000 is completely painless. There are also no side effects.
What if I do not have ED? Can I still get the treatment?
Some patients who do not actually have ED still are keen to undergo ESWT to maintain optimum function of their penis. This is commonly known as Penile Rejuvenation. We will discuss this in detail in a separate article.
Can ESWT increase penis size?
No. There is no evidence that ESWT increases either penis length or girth. Some patients do report an increase in penis size after ESWT treatment. These patients probably have been suffering from poor blood flow to the penis for an extended time resulting in some shrinkage of the penis due to atrophy of the penile tissue. ESWT treatment will re-establish a healthy blood flow resulting in the penis returning to its original healthy size. It is not an actual increase in penis size.
I see that different clinics use different machines. What is the difference?
To date I know of 4 different machines available in Singapore. In my practice, I use the ED1000 by Medispec. I use the ED1000 because as far as I know, it has the most robust available data on humans. 2 large meta-analyses done in 2017 both found significant improvement in symptoms of ED and also improvements in measured velocity of blood flow in the penis. I have been using the ED1000 to treat my patients with ED since 2014 and my experience and that of my patients have been very positive.
Also, treatment with the ED1000 is completely painless. I have been told by my patients that treatment with some of the other brand machines caused them some discomfort.
I am currently using the 2nd generation ED1000 with improved functionalities and performance.
What do I do if I think I need ESWT?
Talk to a Doctor who is familiar with treating patients with ED with ESWT. If you have mild or mild to moderate ED caused by poor blood flow you would likely benefit from ESWT. (Click here to do the IIEF questionnaire to see if you have mild to moderate ED or not).
If you have been using ED medicines like Viagra or Cialis and they are no longer working as well for you. Or you are taking increasing doses to achieve the same effect. And you do not wish to use penis injections. ESWT can restore or improve your response to ED medicines.
The Doctor will assess you and give you the best recommendation for treatment.
ESWT is also used to treat Peyronie Disease and Prostatitis. I will discuss this in separate articles.
Have a question? Please put it in the comments section below and I’ll get back to you as soon as I can.