ESWT ShockWave Therapy, or ESWT, has a long-standing history in the field of urology. Endorsed by both the American and European Urology Associations, this scientifically-backed treatment method is known for its safety, lacking significant side effects and complications. 

It’s particularly prevalent in the treatment of erectile dysfunction. Our extensive experience in administering this therapy to patients has yielded highly successful outcomes. In this article, We will discuss the application of ESWT ShockWave Therapy in treating erectile dysfunction and its role in other urological conditions.

What is The ESWT ShockWave therapy?

ESWT, or Extracorporeal Shock Wave Therapy, is a technique where low-intensity shock waves (known as Li-ESWT) are generated externally and then directed to a specific area of the body using a specialized applicator head. This method is  non-invasive, as the shock waves are applied from outside the body.

ESWT ShockWave Therapy for Urological Diseases

In urology, ESWT Shockwave Therapy (Extracorporeal Shock Wave Therapy) is extensively employed for the treatment of three specific conditions, supported by numerous studies in the medical literature attesting to its effectiveness. These conditions are:

1. Erectile Dysfunction
2. Peyronie’s Disease
3. Chronic Prostatitis

Each of these diseases has shown responsiveness to the therapeutic effects of ESWT Shockwave Therapy.

Advantages of ESWT ShockWave therapy

The use of ESWT ShockWave Therapy (Extracorporeal Shock Wave Therapy) in treating Erectile Dysfunction (ED), Peyronie’s Disease, and Chronic Prostatitis offers several significant advantages:

1. High Efficacy: ESWT boasts a high success rate in treating these conditions.
2. No Anesthesia Required: The treatment can be administered without the need for anesthesia.
3. Painless Treatment: Patients typically experience no pain during ESWT sessions.
4. No Side Effects: ESWT is known for its lack of significant side effects.
5. No Hospitalization Needed: The treatment can be performed on an outpatient basis, eliminating the need for hospital stays.
6. Cost-Effectiveness: Compared to other treatment methods, ESWT is relatively inexpensive.

When ESWT Shockwave Therapy should not be applied?

ESWT Shockwave Therapy (ESWT ShockWave Therapy), while generally safe, does have certain situations where its application, especially to the penis, should be avoided. These include:

1. Infection in the Treatment Area: ESWT should not be applied if there is an active infection in the area where the therapy is intended to be administered.
2. Open Wound in the Treatment Area: The presence of an open wound in the area to be treated is a contraindication for ESWT.
3. Presence of a Penile Prosthesis: Patients with a penile prosthesis should not undergo ESWT in the penile region.

The Cost of ESWT Therapy in Turkey?

The pricing for ESWT Shockwave Therapy (Extracorporeal Shock Wave Therapy) can fluctuate based on several factors, including the specific medical condition being treated, the number of therapy sessions required, and the qualifications and expertise of the practitioner administering it, but in general we can easily say that the cost in Turkey is around 40% to 70% less in most countries around the world.

Successful treatment outcomes are more likely when the therapy is conducted using appropriate devices. Moreover, the experience and skill of the healthcare professional, particularly a Urologist with a keen interest in this field, play a crucial role in the effectiveness of the treatment.

ESWT ShockWave Therapy For Erectile Dysfunction Treatment:

Extracorporeal ShockWave Therapy (ESWT) has shown effectiveness in the treatment of erectile dysfunction (ED). This noninvasive method involves applying shock waves to the penile shaft. 

A 2019 meta-analysis of randomized controlled trials revealed that ESWT can provide mild to moderate improvement in patients with ED of various causes, including vascular and neurogenic factors. 

This therapy is beneficial even for patients who did not respond to previous medical therapies. Moreover, ESWT does not report any negative effects, making it a promising option for ED treatment​​.

The most common causes of erectile dysfunction are:

The primary causes of erectile dysfunction (ED) are usually organic, stemming from underlying diseases, but psychological factors can also play a significant role.

The most common organic causes include cardiovascular diseases, diabetes (particularly chronic and poorly controlled cases), obesity, a sedentary lifestyle, heavy smoking, excessive alcohol consumption, and high blood pressure.

ED can also emerge as a side effect of certain medications, such as those for cholesterol, blood pressure, and psychiatric conditions.

Hormonal imbalances, neurological diseases, and surgeries like radical prostatectomy (for prostate cancer) and radical cystectomy (for bladder cancer) are additional contributors. Psychological factors are also important considerations in the onset of ED.

ESWT Therapy, How Does it Work?

The effectiveness of ESWT Shockwave Therapy (Extracorporeal Shock Wave Therapy) for penile treatment is backed by numerous studies, which show that it:

1. Encourages the formation of new capillaries in the penile tissue.
2. Enhances the function of existing penile capillaries.
3. Stimulates the activation of stem cells.
4. Aids in nerve regeneration and healing.
5. Reduces inflammation.
6. Decreases the formation of free radicals, thereby reducing oxidative stress.
7. Helps in the remodeling of erectile tissue.

These mechanisms collectively contribute to the improvement of erectile function.

ESWT Therapy Sessions for ED Treatment

The application of ESWT (Extracorporeal Shock Wave Therapy) for erectile dysfunction typically involves 3-6 sessions, based on the patient’s specific condition.

For more effective results, the therapy is often repeated after 4-6 months. The usual frequency is twice a week. Each session lasts about 10-15 minutes, during which up to 1500 shock waves are administered to different areas of the penile tissue. 

This targeted approach aims to improve erectile function by stimulating the penile tissue and enhancing blood flow.

It’s very important to note that ESWT Shockwave Therapy is known to be an effective solution for miner to moderate cases of ED, and in most moderate cases we prefer to use ESWT as a supportive treatment along with PRP or Stem cells

Optimizing ESWT Therapy Outcomes

ESWT Therapy treatment for erectile dysfunction has an average effectiveness of about 60-80%, with higher efficacy in younger patients and those with mild to moderate vascular-related erection issues. 

To enhance the outcomes of ESWT Therapy, several factors should be considered:

1. Overweight patients should aim to reach their ideal weight.
2. Diabetic individuals need to control their blood sugar levels and follow an appropriate diet.
3. Engaging in a regular exercise program.
4. Managing high blood pressure effectively.
5. Stopping the use of alcohol and tobacco.
6. Addressing any drug habits.
7. Treating underlying psychological problems.

Chronic prostatitis and ESWT Shockwave Therapy

Chronic prostatitis, a chronic inflammatory condition of the prostate, often presents with urinary issues, groin and anal pain, sexual dysfunctions like erectile problems and premature ejaculation, and psychological issues. 

In treating chronic prostatitis with ESWT (Extracorporeal Shock Wave Therapy), patients typically undergo 4-6 sessions, either once or twice a week. 

Each session involves the application of 3000 shock waves to the perineum (the area between the scrotum and anus) while the patient is in a supine position.

ESWT Therapy and P-shot Merging

Merging Extracorporeal Shock Wave Therapy (ESWT) with Platelet-Rich Plasma (PRP) therapy, commonly known as the P-Shot, is an innovative approach in the treatment of Erectile Dysfunction (ED). This combination aims to utilize the benefits of both treatments to enhance effectiveness. Here’s an overview:

Extracorporeal Shock Wave Therapy (ESWT):

ESWT is a non-invasive treatment that uses shock waves to improve blood flow and promote the regeneration of blood vessels in the penis. It’s known for its role in breaking down plaque in blood vessels, stimulating angiogenesis (the formation of new blood vessels), and rejuvenating erectile tissue.

Platelet-Rich Plasma (PRP) Therapy (P-Shot):

The P-Shot involves injecting PRP, derived from the patient’s own blood, into the penis. PRP is rich in growth factors that stimulate tissue repair and regeneration. This therapy is believed to enhance blood flow and erectile function by promoting the healing and growth of new tissue.

Combining ESWT and the P-Shot:

The rationale behind combining these therapies is to harness the mechanical stimulation of ESWT with the regenerative capabilities of PRP. ESWT can enhance the effects of PRP by increasing blood flow and making the tissue more receptive to the growth factors. Conversely, the healing properties of PRP may complement the therapeutic effects of ESWT.

Research and Evidence:

While promising, this combined approach is relatively new, and more research is needed to fully understand its efficacy and long-term outcomes. Early studies and clinical experiences suggest positive results, but it’s crucial for patients to consult with healthcare professionals for personalized advice.

Patient Considerations:

As with any medical treatment, patient-specific factors such as the underlying cause of ED, general health, and previous treatments must be considered. A thorough medical evaluation and consultation with Istanbul Urology Clinic or a healthcare provider specializing in sexual health are essential before opting for this combined therapy.

This integrated approach represents an exciting frontier in ED treatment, offering a potential synergistic effect that might yield better outcomes for patients struggling with erectile dysfunction.

ESWT’s Impact on Chronic Prostatitis

In chronic prostatitis, ESWT Therapy aids in recovery through various mechanisms:

1. Reducing muscle contraction, thus alleviating pelvic muscle spasms and groin pain.
2. Impacting pain receptors to decrease pain.
3. Affecting nerve conduction to block nerve impulse flow, thereby eliminating pain.
4. Regenerating nerve damage.
5. Healing inflammation.
6. Regulating hypersensitization.
7. Reducing oxidative stress in prostate tissue.
8. Preventing the increase of mast cells in prostate tissue and reducing their destruction.

These actions collectively contribute to the alleviation of symptoms associated with chronic prostatitis.

Recovery Criteria Post-ESWT Therapy

In chronic prostatitis cases treated with ESWT Therapy, patients often observe significant improvements in their symptoms. These improvements include:

1. Reduction or alleviation of pain.
2. Betterment of urinary complaints.
3. Correction of premature ejaculation.
4. Improvement in psychological issues.
5. Enhanced overall quality of life.

These positive changes contribute to a more comfortable and healthier daily living experience for patients suffering from chronic prostatitis.

ESWT Therapy for Peyronie’s Disease Treatment

Peyronie’s disease is a condition where the penis develops hard and stiff areas due to calcification. This happens in a part called the tunica albuginea, especially in an area crucial for erections. It can cause pain, bending of the penis, and sometimes trouble getting or maintaining an erection.

There are two stages of Peyronie’s disease: acute and chronic. The acute phase, lasting 1 to 18 months, involves pain and inflammation. Medication can be used during this phase to ease pain and reduce inflammation.

In the chronic stage, the disease stabilizes, and pain usually goes away. Treatment at this point often involves surgery to fix the curved penis. If there’s also trouble with erections, a procedure to insert a penile prosthesis may be considered. However, there isn’t a guaranteed drug treatment for Peyronie’s disease.

However, in cases when it’s advanced  cases or Peyronie’s disease must be treated with a surgery to remove it or by doing a penile implant surgery to fix multiple problems all together. 

When ESWT Therapy is applied to treat Peyronie’s disease, it can lead to various beneficial outcomes:

1. Pain associated with the disease can decrease or completely disappear.
2. Plaques might shrink or even fully resolve in some cases, halting the progression of the disease for some patients.
3. There can be a partial improvement in the curvature of the penis.
4. If erectile dysfunction is present alongside Peyronie’s disease, ESWT may help in correcting this issue as well.

Takeaway:

In summary, ESWT Therapy (Extracorporeal Shock Wave Therapy) is an effective treatment for erectile dysfunction in men. Additionally, it is beneficial in treating Peyronie’s disease and chronic prostatitis. ESWT can yield positive results in these conditions when applied to suitable patients and under the right indications.