Research Article | | Peer-Reviewed

Low Intensity Shockwave Therapy for Erectile Dysfunction: Keeping Hope Alive

Published in Advances (Volume 6, Issue 4)
Received: 30 September 2025     Accepted: 11 October 2025     Published: 30 October 2025
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Abstract

Introduction: Erectile dysfunction (ED) is defined as persistent inability to achieve and sustain an erection sufficient for satisfactory sexual performance. The prevalence of ED increases with aging from 9% in men younger than 40 years to 71% in older men. ED impacts negatively on sexual performance and quality of life (QoL). Low-intensity shockwave therapy (LiSWT) for ED is a regenerative therapy and contrary to other current therapeutic options which are mainly palliative, it restores the erectile mechanism enabling natural or spontaneous erections. LiSWT has found significant usefulness in the treatment of ED with potential to induce angiogenesis and dislodge plaques which will invariably improve blood flood to the penis leading to a lifelong solution to ED with marked improvement in sexual performance. Methodology: This is a prospective randomized study. All patients presenting to andrology clinic with erectile dysfunction were enrolled in the study. Informed consent was obtained. All patients were evaluated to identify the likely etiology and a proforma and standard abridged version of International Index of Erectile Function (IIEF-5) were administered. An Emshock and Smart Tecar 2 in 1 device was used to deliver low intensity shockwave to the penis at 5 different sites and treatment sustained twice a week for 3 weeks to complete a cycle before reassessment with IIEF-5 questionnaire. Data obtained were analyzed using Statistical Package for Social Sciences version 22.0. Results were represented in charts. P value of less than 0.005 was considered statistically significant. Results: Fifty four patients were enrolled in the study. The enrolled patients fell within the age ranges of 34 to 63 years. The identifiable etiology of ED were unknown in 22.22%, diabetes mellitus in 46.30%, hypertension in 18.52% and a combination of hypertension and diabetes in 13%. All patient enrolled for the study had varying degree of abnormal IIEF-5 score. Twelve patients (22.22%) had mild ED, eleven patients (20.37%) had mild to moderate ED, one patient (1.85%) had moderate ED and thirty patients (55.56%) had severe ED. All patients had varying significant improvement in erectile function and IIEF-5 score after the first treatment cycle. Eighteen patients (33.33%) achieved normal erection evidenced by progression to normal IIEF-5 while 36 patients (66.66%) achieved significant progress evidenced by improvement in IIEF-5 score. 4 patients had spontaneous erection that lasted more than 20 minutes during each treatment encounter. No patient had side effect and the patient satisfaction was one hundred percent. Conclusion: LiSWT remains revolutionary as a regenerative therapy for restoration to physiological erectile function possibly possessing unprecedented qualities that can rehabilitate erectile tissue. While results of several studies are variable, one thing that is found across many literatures is the low risk and lack of side effects of LiSWT. Its main benefit is the ability to support and potentially restore erectile function in men with ED without additional pharmacotherapy.

Published in Advances (Volume 6, Issue 4)
DOI 10.11648/j.advances.20250604.11
Page(s) 105-111
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Erectile Dysfunction, Low Intensity Shockwave Therapy, International Index of Erectile Function-5, Quality of Life

References
[1] Obiatuegwu K, Atim T, Magnus F et al. Quadmix Penile Injection: An Initial Urologist Experience. Int J Clin Urol. 2025; 9(1): 73-79.
[2] Morant S, Bloomfield G, Vat V et al. Increased Sexual Dysfunction in Men with Storage and Voiding Lower Urinary Tract Symptoms. J Sex. Med. 2009; 6(4): 1103-1110.
[3] Raymond C, Francois G and Culley C. Sexual Dysfunction and Lower Urinary Tract Symptoms Associated Benign Prostatic Hyperplasia. European Urol. 2005; 47(6): 824-837.
[4] Kenenna Obiatuegwu, Terkaa Atim, Sadiq Abu et al. Correlation between the Severity of Erectile Dysfunction and Prostate Size in Patients with Benign Prostatic Enlargement. Afr J Urol 27, 31 (2021),
[5] Solomon H, Evan JP, Nelson EB. Variations in low intensity shockwave treatment protocols for erectile dysfunction: A review of literature and guide to offering treatment. World J Mens Health. 2024; 42(2): 283-289.
[6] Sokolakis I, Hatzichristodoulou G. Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials. Int J Impot Res. 2019; 31: 177-94.
[7] ILan G, Boaz A, Noam DK, Yoram V. Shockwave treatment of erectile dysfunction. Ther Adv Urol. 2013; 5(2): 95-99.
[8] Janak Desai, Eric Huyghe, Gayle D Maffulli, Carmen Nussbaum-Krammer, Jessica Tittelmeier, Christoph Schmitz, Extracorporeal shock wave therapy for erectile dysfunction: rethinking study design, implementation, and analysis, British Medical Bulletin, Volume 154, Issue 1, June 2025, ldaf004,
[9] Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I. Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol 2010; 58: 243-248.
[10] Cheing GL, Chang H. Extracorporeal shock wave therapy. J Orthop Sports Phys Ther 2003; 33: 337-343.
[11] Katz JE, Clavijo RI, Rizk P, Ramasamy R. The basic physics of waves, soundwaves, and shockwaves for erectile dysfunction. Sex Med Rev 2020; 8: 100-105.
[12] 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: 593-606.
[13] Ogden JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy. Clin Orthop Relat Res 2001; 387: 8-17.
[14] Sokolakis I, Dimitriadis F, Teo P, Hatzichristodoulou G, Hatzichristou D, Giuliano F. The basic science behind low-intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic scoping review of pre-clinical studies. J Sex Med 2019; 16: 168-194.
[15] Capogrosso P, Frey A, Jensen C, Rastrelli G, Russo G, Torremade J et al. Low-intensity shock wave therapy in sexual medicine-clinical recommendations from the European Society of Sexual Medicine (ESSM). J Sex Med 2019; 16: 1490-1505.
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  • APA Style

    Kenenna, O., Felix, M., Terkaa, A., Ernest, A. (2025). Low Intensity Shockwave Therapy for Erectile Dysfunction: Keeping Hope Alive. Advances, 6(4), 105-111. https://doi.org/10.11648/j.advances.20250604.11

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    Kenenna, O.; Felix, M.; Terkaa, A.; Ernest, A. Low Intensity Shockwave Therapy for Erectile Dysfunction: Keeping Hope Alive. Advances. 2025, 6(4), 105-111. doi: 10.11648/j.advances.20250604.11

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    AMA Style

    Kenenna O, Felix M, Terkaa A, Ernest A. Low Intensity Shockwave Therapy for Erectile Dysfunction: Keeping Hope Alive. Advances. 2025;6(4):105-111. doi: 10.11648/j.advances.20250604.11

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  • @article{10.11648/j.advances.20250604.11,
      author = {Obiatuegwu Kenenna and Magnus Felix and Atim Terkaa and Aniede Ernest},
      title = {Low Intensity Shockwave Therapy for Erectile Dysfunction: Keeping Hope Alive
    },
      journal = {Advances},
      volume = {6},
      number = {4},
      pages = {105-111},
      doi = {10.11648/j.advances.20250604.11},
      url = {https://doi.org/10.11648/j.advances.20250604.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.advances.20250604.11},
      abstract = {Introduction: Erectile dysfunction (ED) is defined as persistent inability to achieve and sustain an erection sufficient for satisfactory sexual performance. The prevalence of ED increases with aging from 9% in men younger than 40 years to 71% in older men. ED impacts negatively on sexual performance and quality of life (QoL). Low-intensity shockwave therapy (LiSWT) for ED is a regenerative therapy and contrary to other current therapeutic options which are mainly palliative, it restores the erectile mechanism enabling natural or spontaneous erections. LiSWT has found significant usefulness in the treatment of ED with potential to induce angiogenesis and dislodge plaques which will invariably improve blood flood to the penis leading to a lifelong solution to ED with marked improvement in sexual performance. Methodology: This is a prospective randomized study. All patients presenting to andrology clinic with erectile dysfunction were enrolled in the study. Informed consent was obtained. All patients were evaluated to identify the likely etiology and a proforma and standard abridged version of International Index of Erectile Function (IIEF-5) were administered. An Emshock and Smart Tecar 2 in 1 device was used to deliver low intensity shockwave to the penis at 5 different sites and treatment sustained twice a week for 3 weeks to complete a cycle before reassessment with IIEF-5 questionnaire. Data obtained were analyzed using Statistical Package for Social Sciences version 22.0. Results were represented in charts. P value of less than 0.005 was considered statistically significant. Results: Fifty four patients were enrolled in the study. The enrolled patients fell within the age ranges of 34 to 63 years. The identifiable etiology of ED were unknown in 22.22%, diabetes mellitus in 46.30%, hypertension in 18.52% and a combination of hypertension and diabetes in 13%. All patient enrolled for the study had varying degree of abnormal IIEF-5 score. Twelve patients (22.22%) had mild ED, eleven patients (20.37%) had mild to moderate ED, one patient (1.85%) had moderate ED and thirty patients (55.56%) had severe ED. All patients had varying significant improvement in erectile function and IIEF-5 score after the first treatment cycle. Eighteen patients (33.33%) achieved normal erection evidenced by progression to normal IIEF-5 while 36 patients (66.66%) achieved significant progress evidenced by improvement in IIEF-5 score. 4 patients had spontaneous erection that lasted more than 20 minutes during each treatment encounter. No patient had side effect and the patient satisfaction was one hundred percent. Conclusion: LiSWT remains revolutionary as a regenerative therapy for restoration to physiological erectile function possibly possessing unprecedented qualities that can rehabilitate erectile tissue. While results of several studies are variable, one thing that is found across many literatures is the low risk and lack of side effects of LiSWT. Its main benefit is the ability to support and potentially restore erectile function in men with ED without additional pharmacotherapy.
    },
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Low Intensity Shockwave Therapy for Erectile Dysfunction: Keeping Hope Alive
    
    AU  - Obiatuegwu Kenenna
    AU  - Magnus Felix
    AU  - Atim Terkaa
    AU  - Aniede Ernest
    Y1  - 2025/10/30
    PY  - 2025
    N1  - https://doi.org/10.11648/j.advances.20250604.11
    DO  - 10.11648/j.advances.20250604.11
    T2  - Advances
    JF  - Advances
    JO  - Advances
    SP  - 105
    EP  - 111
    PB  - Science Publishing Group
    SN  - 2994-7200
    UR  - https://doi.org/10.11648/j.advances.20250604.11
    AB  - Introduction: Erectile dysfunction (ED) is defined as persistent inability to achieve and sustain an erection sufficient for satisfactory sexual performance. The prevalence of ED increases with aging from 9% in men younger than 40 years to 71% in older men. ED impacts negatively on sexual performance and quality of life (QoL). Low-intensity shockwave therapy (LiSWT) for ED is a regenerative therapy and contrary to other current therapeutic options which are mainly palliative, it restores the erectile mechanism enabling natural or spontaneous erections. LiSWT has found significant usefulness in the treatment of ED with potential to induce angiogenesis and dislodge plaques which will invariably improve blood flood to the penis leading to a lifelong solution to ED with marked improvement in sexual performance. Methodology: This is a prospective randomized study. All patients presenting to andrology clinic with erectile dysfunction were enrolled in the study. Informed consent was obtained. All patients were evaluated to identify the likely etiology and a proforma and standard abridged version of International Index of Erectile Function (IIEF-5) were administered. An Emshock and Smart Tecar 2 in 1 device was used to deliver low intensity shockwave to the penis at 5 different sites and treatment sustained twice a week for 3 weeks to complete a cycle before reassessment with IIEF-5 questionnaire. Data obtained were analyzed using Statistical Package for Social Sciences version 22.0. Results were represented in charts. P value of less than 0.005 was considered statistically significant. Results: Fifty four patients were enrolled in the study. The enrolled patients fell within the age ranges of 34 to 63 years. The identifiable etiology of ED were unknown in 22.22%, diabetes mellitus in 46.30%, hypertension in 18.52% and a combination of hypertension and diabetes in 13%. All patient enrolled for the study had varying degree of abnormal IIEF-5 score. Twelve patients (22.22%) had mild ED, eleven patients (20.37%) had mild to moderate ED, one patient (1.85%) had moderate ED and thirty patients (55.56%) had severe ED. All patients had varying significant improvement in erectile function and IIEF-5 score after the first treatment cycle. Eighteen patients (33.33%) achieved normal erection evidenced by progression to normal IIEF-5 while 36 patients (66.66%) achieved significant progress evidenced by improvement in IIEF-5 score. 4 patients had spontaneous erection that lasted more than 20 minutes during each treatment encounter. No patient had side effect and the patient satisfaction was one hundred percent. Conclusion: LiSWT remains revolutionary as a regenerative therapy for restoration to physiological erectile function possibly possessing unprecedented qualities that can rehabilitate erectile tissue. While results of several studies are variable, one thing that is found across many literatures is the low risk and lack of side effects of LiSWT. Its main benefit is the ability to support and potentially restore erectile function in men with ED without additional pharmacotherapy.
    
    VL  - 6
    IS  - 4
    ER  - 

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