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Writer's pictureMichael Kaplan MD

What is LiESWL (low intensity extracorporeal shock wave therapy,) and can it really cure ED?

Updated: Sep 19, 2021

Urologists Pioneer Harnessing The Power Of Shockwaves


Anyone who has ever had a kidney stone will be happy to tell you how awful they are! They will bring the meanest, toughest guy to their knees screaming with anguish.

Let's take a trip back to the seventies. Bell bottoms were hot, lava lamps were a must, and hippies were everywhere!

But that's not all. If you had a kidney stone, you either passed it, or you could end up with a massive incision, complete with a week in the hospital.


All of that changed for the best when urologists started using the power of shock waves to break up kidney stones. The first machines were primitive by today's standards and were actually built by the Dornier Company in Germany. At the time, they were best known as a manufacturer of aircraft!


As you might suspect, the original machines looked like something you'd find in Dr. Frankenstein's laboratory. Patient's were lowered into a tub of water with a crane like apparatus.








While the machines were big, bulky, and very expensive, they revolutionized the treatment of kidney stones. Instead of spending a week in the hospital, patients could go home the same day, and return to work in a day or two.


Shock waves not only transformed the treatment of kidney stones, their thoughtful application has been a game changer in the treatment of a vast array of medical challenges. Best of all, the cost has come way down, and now, most modern instruments don't sound like a jackhammer or drum solo.


Shock Waves In Orthopedics


The orthopedists were the next to harness the power of shock waves. Instead of using the violent force of the waves, they harnessed the healing powers which actually stimulated regenerative forces which were brought on by attraction of stem cells to the areas that were treated. Shock waves were used to help heal bones, tendons, and soft tissue. The data was so good that the FDA eventually approved devices specifically for use in orthopedics.


Think Of Shock Waves Like Ocean Waves, Crashing And Then Heading Back To The Sea


Shock waves produce a sudden rise from ambient pressure to maximum pressure. That is the force that helps to break up kidney stones. But just as there is a sudden rise in pressure, there is a subsequent abrupt fall in pressure (the negative phase of the wave propagation.) Think of this negative phase like an ocean wave. After the wave crashes, all of the water returns back to the sea. This negative phase produces a phenomenon known as cavitation.


Cavitation results in the genesis of tiny bubbles. When these bubbles break up, they create small internal shock waves, which in turn engenders micro disruption of vascular tissues leading to revascularization. Ultimately, there is a release of local growth factors, and the recruitment of appropriate stem cells conducive to tissue healing. This is like a signal to the body's blood vessels.

How Shock Waves Produce Real Changes Inside Your Body


The signal that the tissue receives is thought to result in a chain of events that include:

1)Increased local NO production (Nitrogen oxide is a key actor in erections!)

2) Increases in platelet derived growth factor

3) Increased vascular endothelial growth factor (VEGF) (Important for growing new blood vessels.)

4) Recruitment of mesenchymal stem cells


How Shock Waves Can Help With Erectile Dysfunction


With further study it soon became apparent that low intensity shock waves could cure erectile dysfunction. In fact, low intensity shock waves have been used in Europe to treat erectile dysfunction for decades with great results. There is a panoply of causes for erectile dysfunction, but the most common cause is vascular insufficiency i.e. not enough blood getting to the penis.) Improving the blood flow dynamics will not fix every case of ED, but it will help a majority of patients. There have been over eighty published reports on the use of shock waves to treat erectile dysfunction with impressive results. Moreover even patients that are not completely impotent, but need a boost may benefit from treatment.













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