Penile Shock Wave & Alternative ED Therapies
There is now so much marketing surrounding Penile Shock Wave Therapy coming from cash-only clinics advertised on the radio, in newsprint, and on the Internet that every Urologist must be prepared to answer questions about these therapies, what the literature tells us about their efficacies and if they are worth the very high cost associated with them, particularly when they are gotten from stand-alone clinics which are most commonly the source of the advertisements.
The concept behind the original shock wave therapy was sound. Since erectile dysfunction is usually a result of decreased blood flow to the penis, it was thought that if we could break up tiny calcifications in penile arteries, just like we do with kidney stones, that may open arteries up and allow for more blood flow. Also, lab research with ultrasonic shockwaves showed that tissue trauma from this energy source could create new blood vessels in the injured tissue. In theory, this sounds very promising, and the initial studies done over ten years ago suggested that this may help patients to some degree in the distinct subgroup of patients who already have success with pills. However, the studies never really advanced beyond that, and there have been few if any, further high-quality, placebo-controlled trials on the subject since. Patients are sold these treatments largely on hope and not actual data, and the cost can be well above $6000 to the patient in standalone men’s health clinics as insurance does not cover such treatments.
Penile shock wave treatments can be offered to a patient with erectile dysfunction very responsibly if they are fully informed of their borderline efficacy, it is offered to only the subgroup where it has any appreciable chance of working and where the patient can afford ultimately to lose this amount of money without creating undue hardship. Several urologists offer it this way, often for closer to $3000 total.
Other even less established alternative treatments for erectile dysfunction include injections of stem cells or platelet-rich plasma. At best, these therapies can be considered experimental at this time. Studies are being performed here, but none have shown definitive evidence of efficacy. These treatments hope to regenerate healthy vascularized erectile tissue. They are expensive and currently are not recommended by Urologic Surgeons of Washington.
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