Fundamentals of the Treatment of Male Erectile Dysfunctions with Low Intensity Shock Waves

Abstract

Male erectile dysfunction (ED) is one of the most common problems among men worldwide. No single diagnostic method evaluates all the variables of this complex condition. To achieve good therapeutic results, it is essential to base the treatment on an accurate diagnosis. Hemodynamic exploration by echo Doppler of the cavernous arteries, especially since the incorporation of intracavernous administration of vasoactive drugs, is a useful tool that allows the evaluation of erectile dysfunction in the arterial phase. It is also considered to be the choice in the assessment of the corporoveno-occlusive mechanism. Different treatment methods are used, being PDE5 (sildenafil and tadalafil), the treatment of the first choice in several conditions. The number of publications of low-intensity extracorporeal shockwave treatment (LIESWT) for ED has increased dramatically in recent years. Scientific evidence regarding the application of LI-ESWT for the treatment of erectile dysfunction is still controversial. Inclusion criteria of the studies and the wide variety of treatment protocols have been criticized. On the other hand, most of these studies report encouraging results with no short-term adverse effects, regardless of variation in LI-ESWT setup parameters or treatment protocols.