Alessandro Boffini1, Carlo Molinari1, Marco Gaffi1, Caterina Gulia1, Claudio Anceschi1
  • 1 Ospedale San Camillo, U.O.C. Urologia (Roma)


The purpose of this study is to define the feasybility and efficacy of LI-SWT in the treatment of erectile disfunction in 158 pts with ED.

Materials and Methods

We enrolled , between 2015 april and 2016 december, 158 pts suffering of erectile disfunction.
110 pts (Group A) had vasculogenic impotence (82 arteriogenic and 28 with venous leak). 48 pts (Group B) had ED subsequent to NSRP (both robotic and laparoscopic). 110 pts with pure vasculogenic ED were treated with 4 weeks course of LISWT for a total amount of 16000 SW in 4 different sites(cavernosal bodies and crura) with a frequency of 180 shock waves / min and an energy flow density of 0.09 mj/cm2. 48 pts with ED after NSRP had a 6 weeks course of LI-ESWT for a total amount of 18000 SW with same frequency and energy in 2 different sites (only corpora cavernosa). All patients were treated at the same time with PDE5 inhibitors and Tribulus Terrestris Plus Arginine for 2 mnths. The positive response means sexual performance improvement (PDE5 responder can suspend the medication & PDE5 not responder became responder) based on IIEF5 test and EHS.


The A Group presented a positive response in 77 pts (70 %). The IIEF5 score improved in mean 5 points; EHS score passed from 2 to 4. The B Group had a positive response in 20 pts (48%). In this case IIEF5 had a mean improvement of 9 points;EHS score passed from 1 to 3.


LI-SWT showed in many sudies the capacity to create a new angiogenesis of the corporal bodies through the increase of local VEGF, that stimulates local stem cells to create new vessels.


The PDE5 medication don't treat the cause of ED. The LI-ESWT directly works on the corporal vascular system, stimulating the new angiogenesis, that improve the blood flow to restart the erection.


Hatzichristou D, d’Anzeo G, Porst H, et al. Tadalafil 5 mg once daily
for the treatment of erectile dysfunction during a 6-month observational
study (EDATE): impact of patient characteristics and
comorbidities. BMC Urol 2015;15:111.

Frey A, Sonksen J, Fode M. Low-intensity extracorporeal shockwave
therapy in the treatment of postprostatectomy erectile dysfunction:
a pilot study. Scand J Urol 2016;50:123–7.

Zhihua Lu , Guiting Lin , Amanda Reed-Maldonado, Chunxi Wang, Yung-Chin Lee , Tom F. Lue
Low-intensity Extracorporeal Shock Wave Treatment Improves
Erectile Function: A Systematic Review and Meta-analysis
EUROPEAN UROLOGY 71 (2017) 223–233