Low-Intensity Shock Wave Therapy: A Revolutionary Approach to Erectile Dysfunction Treatment

Erectile dysfunction (ED) is a common condition that affects millions of men worldwide. While it can have a significant impact on a man’s quality of life, there have been numerous advancements in the field of sexual medicine to provide effective treatments. One such groundbreaking therapy is Low-Intensity Shock Wave Therapy (LI-SWT), which has gained prominence as a non-invasive, safe, and highly effective option for addressing ED. In this comprehensive guide, we will explore the science behind LI-SWT, its benefits, and its role in revolutionizing ED treatment.

Understanding Erectile Dysfunction

Erectile dysfunction, commonly referred to as impotence, is the persistent inability to achieve and maintain a satisfactory erection for sexual intercourse. It can result from a variety of physical and psychological factors, including:

  1. Vascular Issues: Reduced blood flow to the penile arteries.
  2. Nerve Damage: Impaired nerve signaling from conditions like diabetes.
  3. Psychological Factors: Stress, anxiety, or depression.
  4. Hormonal Imbalances: Low testosterone levels.
  5. Lifestyle Factors: Smoking, excessive alcohol consumption, or obesity.

While ED can affect men of all ages, it becomes more prevalent with age. Many men seek treatment options to regain their sexual confidence and overall well-being.

The Emergence of Low-Intensity Shock Wave Therapy

Low-Intensity Shock Wave Therapy is a cutting-edge treatment that has gained immense popularity in recent years. It was originally developed to treat musculoskeletal conditions, such as tennis elbow and plantar fasciitis, through the application of low-energy shock waves. Researchers soon discovered that LI-SWT had the potential to address the root causes of ED as well.

Extracorporeal shockwave therapy (ESWT) is an innovative, gentle therapy method that has already been successfully used for 25 years for soft tissue injuries in orthopedics. In ESWT, sound waves are directed in a focused manner into specific areas of the body in order to have a therapeutic effect in the target tissue.

Piezo shockwave technology has provided a breakthrough in the treatment erectile dysfunction, Peyronies disease and chronic pelvic pain syndrome by providing a non invasive, non pharmaceutical option. Our Piezo shockwave technology offers unique therapy source designs to meet the specific needs of the each-conditions.

For the treatment of Peyronies Disease, a therapy source that delivers a small, high energy therapeutic focus to treat the plaques is an ideal choice. For the treatment of chronic pelvic pain syndrome an elongated therapy focus is advantageous, taking into account the anatomy of the pelvic floor. The therapy source with the voluminous therapy focus in combination with the new optimised LSTC-ED therapy concept, allowed an improved application technique and therapy results.

All therapies are performed on an outpatient basis without anesthesia. It is painless and takes only a few minutes. The therapy head is positioned on the skin and then moved following the anatomical course of the target tissue.

Erectile Dysfunction (ED) – A matter of healthy blood vessels

Erections are caused by the complex interaction of blood vessels, the nervous system, hormones and muscles. During an erection, blood flow increases in the penis and results in increased venous compression. The erectile tissue and its blood supply therefore play an important role in erectile function. Reduced arterial inflow leads to reduced venous compression and thus to an insufficient erection. Arteriosclerosis is one of the most common causes of ED. Risk factors for ED include chronic nicotine abuse, diabetes mellitus, hypertension, elevated blood lipids, chronic kidney disease, etc.


The evolution of ESWT ED

“Linear Shockwave Tissue Coverage” – A unique therapy concept
for the treatment of Erectile Dysfunction

Supported scientifically, low-energy, focused shockwave therapy is defined as one of the “first-line” therapies by the European Association of Urology (EAU) Guidelines.


The use of point-focused shockwaves (Fig. 1) has shown good results in the treatment of vascular ED for some time.

Further development of piezo shockwave therapy source technology has created a new version with a linear, voluminous therapy focal zone. This innovation in therapy delivery has resulted in the breakthrough, optimized therapy approach LSTC-ED. This technology and application technique has decisively improved results.

The linearly focusing shockwave now makes it possible to treat the entire course of the corpus cavernosum quickly and comprehensively. The therapy source is applied at right angles to the corpora cavernosa (Fig. 2). It is guided longitudinally along the penis (corpora cavernosa (Fig. 3)) and the perineum (crura penis (Fig. 4)). This guarantees maximum and homogeneous energy application in the target tissue.

Treatment with the LSTC-ED technique and the PiezoWave²

We have taken the greatest possible care in researching and clinically refining this procedure. We are dedicated to providing evidence based therapies.

A prospective, multicentre placebo-controlled study (*) of 75 patients showed significant improvement in IIEF-5 score and successful treatment in 81% of patients after one month of treatment. Functional improvement was demonstrated 6 months after treatment, demonstrating the long-term effect of LSTC-ED treatment.

You can find an overview of all studies here

How LI-SWT Works

LI-SWT uses acoustic waves to stimulate the growth of new blood vessels and improve blood flow in the penile region. The therapy involves the following steps:

  1. Assessment: A healthcare provider evaluates the patient’s medical history, conducts a physical examination, and may perform diagnostic tests like ultrasound to determine the severity and underlying causes of ED.
  2. Treatment Session: During an LI-SWT session, a device delivers low-energy shock waves to specific areas of the penis. These shock waves help stimulate the release of growth factors and increase the production of nitric oxide, a key molecule involved in the erection process.
  3. Results: Over a series of sessions, typically administered over several weeks, patients often experience improved erectile function, increased penile blood flow, and enhanced overall sexual performance.

Benefits of LI-SWT for Erectile Dysfunction

Low-Intensity Shock Wave Therapy offers several advantages as a treatment for ED:

  1. Non-Invasive: Unlike surgical options, LI-SWT is non-invasive, meaning there is no need for incisions, anesthesia, or recovery time.
  2. Safety: LI-SWT is considered a safe and well-tolerated treatment with minimal side effects, such as mild discomfort or bruising at the treatment site.
  3. Long-lasting Results: Many patients report sustained improvement in erectile function, often lasting up to two years or more after completing the treatment protocol.
  4. Improved Quality of Life: LI-SWT not only addresses the physical aspects of ED but can also alleviate the psychological and emotional distress associated with the condition.

Is LI-SWT Right for You?

While LI-SWT has shown remarkable promise in treating ED, it may not be suitable for everyone. It is essential to consult with a qualified healthcare provider who can assess your individual case and recommend the most appropriate treatment approach. Factors such as the underlying cause of ED, your overall health, and medical history will all play a role in determining whether LI-SWT is a viable option for you.



Low-Intensity Shock Wave Therapy represents a revolutionary breakthrough in the field of erectile dysfunction treatment. It offers a safe, non-invasive, and effective solution for men seeking to regain their sexual confidence and improve their overall quality of life. If you or a loved one is dealing with ED, consider discussing LI-SWT with Siam Clinic Phuket to explore this promising treatment option. With advancements in medical technology, there is newfound hope for men facing this common condition, allowing them to enjoy fulfilling and satisfying sexual relationships once more.

FAQ : General questions about shockwave therapy:

How do extracorporeal shockwaves work?

The mechanical energy of the shockwaves is generated extracorporeally (=outside the body) and transferred in a focused manner into the diseased target tissue. There, the mechanical stimulus is converted into positive, therapeutic acting biochemical signals that help the body to repair altered tissue and initiate tissue regeneration.

What are contraindications of ESWT?

In principle, ESWT has few contraindications.
The instructions for use of the ESWT systems contain the stated contraindications. The contraindication for use included in the instructions for Richard Wolf’s therapy sources are as follows:

  • Active tumour disease (especially in the prostate or pelvic area)
  • Penile prostheses
  • Coagulation disorders (prior clarification of the coagulation status may be necessary)
  • Hypogonadism
  • Taking blood-thinning medication
  • etc.

The decision to utilize shockwave therapy despite any contraindications that may be present is at the sole discretion of the attending physician.

Is the treatment painful?

The treatment is based on the “bio-feedback” provided by the patient to the clinician applying the therapy. The intensity of a treatment is individually adjusted according to the patient. Particularly in the treatment of CPPS, patients report a “feeling of well-being” because they feel that the cause of their pain is being addressed.

How long does a treatment take?

Depending on the disease and the patient, the number of pulses can vary and usually lasts only a few minutes.

What do I have to pay attention to during the treatment?

Especially in the treatment of CBSS/CPPS, the patient’s cooperation is essential for long-term therapy success. Exercises for the pelvic floor muscles, dealing with stress and learning relaxation techniques are the first steps a patient can take to positively influence the course of treatment.

Questions about erectile dysfunction treatment:

Who is shockwave therapy for erectile dysfunction suitable for?

As with all other treatment options, shock wave therapy is not an option for everyone. There is a simple reason for this: the causes of erectile dysfunction are varied – and a careful diagnosis is important to achieving the goal of the therapy. In principle, shockwave therapy is indicated for vascular erectile dysfunction (see also contraindications). Shockwave therapy can also be a good option if drug therapy is not an option because of possible side effects.

What are the disadvantages of other treatment options compared to ESWT?

Current treatments for erectile dysfunction (e.g. PDE-5 inhibitors, injections (SKAT), vacuum pumps…) have the following problems and disadvantages compared to ESWT:

  • Side effects
  • Only symptoms are treated
  • costly
  • lack of sexual spontaneity
  • dwindling self-esteem
  • psychological distress

How many treatments are necessary?

Of course, every patient and his or her course of disease is different. Number of treatments depends on previous illnesses, concomitant diseases, duration and severity and are therefore difficult to make. On average, patients need 4-8 treatments.

Is the treatment painful?

No. The treatment and regulation of the intensity is done in constant communication with the practitioner. If something becomes uncomfortable, the intensity can be adjusted immediately.

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