Shockwave for Erectile Dysfunction

 

Erectile dysfunction describes a condition where an erection is either not possible or not sufficient for the desired task of sexual activity. 

 

One of the main drivers causing erectile dysfunction is poor vascular blood flow and patients who respond well or fair to PDE5i medication are shown to have the best outcome.  Patients who are non-responders have shown to improve and become good responders to PDE5i medication following Focus Shockwave .   

At Core Body Clinic we also use Focus ShockWave in the treatment of Pelvic Pain in both men and women, and we are currently using in Hard Flaccid syndrome and erectile function after Prostatectomy.

You can find out more by calling or emailing the clinic or booking online

How does Shock wave help Erectile Dysfunction?

While medication like PDE5 inhibitors provide a solution to erectile dysfunction, they do not change the underlying pathophysiology of loss in vascular supply and reduced nitric oxide release.  Focus shockwave has angiogenic properties and delivers electro shock impulses into the target tissue stimulating healing through the process of angiogenesis.  New blood vessels are formed and the release of nitric oxide is enhanced dialating blood vessles and increasing cell permeability.  The overall effect increases and enhances perfusion and thus provides a longer standing change in erectile tissue physiology and therefore enahnced erectile function. 

Research has shown that these changes achieve better and even spontaneous erectile function, where this might have been unachieveable.  Some patients experience pain during an erection and ShockWave therapy can help by modulating the release of substance P, a powerful peripheral nerve neurotransmitter responsible for the reduction of pain.

 

 

Research has demonstrated that Focus ShockWave therapy can lead to a significant improvement in erectile function and has been shown to improve the International Index of Erectile Function which lasts at least 9 months .  A systematic review (pooling of lots of randomised controlled trials) with a cohort of over 800 patients treated for erectile dysfunction using focus shockwave therapy found that the treatment was indeed highly effective, safe and led to significant improvements in erectile function. Further reading can be found here.

 

How many sessions are required?

It is necessary to repeat the sessions for at least 6 weeks and in a consistent weekly manner.  In some instances it is necessary to repeat 2 sessions a week.

6 to 8 sessions are needed in most cases.  This can last for up to 18 months with a repeat course recommended after this time. 

 

Is it safe?

Shock Wave therapy is very safe provided it is delivered by trained practitioners.  Some patients experience a little ache like pain during the treatment that can last for 24 to 48 hours afterwards. 

 

Is this the only treatment I need?

Erectile dysfunction can have many causes that interact to cause ED.  Therefore, having a holistic approach to treatment is key in ensuring you get the best out of the Shock wave therapy. Other treatments may include:

  • Pelvic floor exercises to release your pelvic floor

  • Specialised Breathing and relaxation work.  Relaxation through breathing has been found to be hugely beneficial for all types of conditions.

  • Re-education of the  pelvic floor, hip and abdominal musculature

  • General exercise

 

 

more reading.........

How does an erection happen?

An erection occurs when we become aroused and messages from the brain signal the penile muscles (Corpus Carvernosa) to relax.  Blood enters the erectile tissue (Corpus Carvenosa) via the pudendal artery and inflates the penis.  The Tunica Albugenia then contracts to trap the blood in the penis and keep it in an erect state.

The erectile tissue  of the Corpus Carvenosa and Corpus spongiosum are under autonomic control are extensions of the pelvic muscles of the skeletal and consciously controlled Bulbospongiosus and Ischiocarvenosus.  It must be noted that these are different. 

 

What Causes Erectile Dysfunction?

There are many causes of erectile dysfunction and finding out the likely cause is a good starting point in getting the right treatment.  This is a list of possible causes:

  • Problems affecting the flow of blood to your penis

  • Conditions of the nervous system, which is made up of your brain, nerves and spinal cord

  • Changes or disease causing change in hormone levels

  • Physical structure problems in the penis

  • Diabetes

  • Smoking

  • Psychological and emotional well-being

  • Intra-pelvic pain syndromes like Chronic Pelvic pain

  • Hard Flaccid or HF

  • Post surgical injury to nerves and muscular tissue (Prostatectomy / TURPS)

  • Cycling

We could always recommend you see your GP 1st to rule out any other co-morbid factors.

 

To find out more

Please email the clinic or call. 

Ask for Adrian Wagstaff to call you back. 

If you are confident you require Shock wave then simply book online using the online services.

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Shockwave Therapy

What Is Shockwave Therapy?

Extracorporeal shockwave therapy uses high-powered sound waves to stimulate the healing of chronically injured tissues like tendons or over the painful joints of osetoarthritis.  We also use shockwave for vascular erectile dysfunction and it has also found application in pelvic pain. Shockwave therapy has been used in medicine for over 20 years and has a large body of evidence proving its effectiveness having been adapted from lithotripsy treatment that is still used today as a treatment to break down kidney stones.

This is only available at our Mumbles and Swansea Clinics. 

Shockwave therapy is very different from ultrasound therapy and can mechanically stimulate tissues deep within the body unlike other types of sound wave therapies. 

 

 

 

 

There are TWO types of shockwave therapy.  Radial and Focus.......At Core Body Clinic, we use FOCUS shockwave and there is a good reason why: 

 

 

How does shockwave therapy work?

Shockwave therapy works through a variety of biological mechanisms. The powerful sound waves created by the therapy have been shown to cause a cellular level vibration within injured tissues that have a number of beneficial effects from mechanical stimultion to regenerative effects in tissues (Focus only):

Key effects: 

Increase of cell wall permeability

Stimulation of Microcirculation (Blood, Lymph)

Release of Substance P Neurotransmitter responsible for pain modulation.

It is a powerful vasodilator, causing considerable hypotension

Cavitation Release of nitric oxide (increased cell metabolism, neoangogenesis, anti-inflammatory effect)

Stimulation of growth factors

 

 

 

 

 

 

 

 

When Should You Consider Shockwave Therapy?

Shockwave can be used at varying points of the injury cycle and like all injuries we tend to leave things until its not got better.  While it is not a panacea and should be used as part of a clinical rehab and treatment plan, it is known to have particular application in the following conditions: 

  • Plantar Fasciitis
  • Tendinopathies like Achilles Tendinopathy 
  • Bone and Stress Fractures
  • Delayed bone-non unions/bone healing
  • Acute injuries
  • Knee & Joint arthritis / Medial Knee OA
  • Osteitis Pubis -Groin Pain
  • Haglunds Deformity
  • Insertional Achilles Pain
  • Tibialis Posterior Tendon Syndrome/ankle sprain
  • Morton Neuroma
  • Medial Tibial Stress Syndrome / Shin Splints
  • Tib Post/ Peroneal Tendons
  • Avascular Necrosis of Hip
  • Trigger Finger
  • Carpal Tunnel Syndrome
  • Chronic Pelvic Pain
  • Coccydynia
  • Myofascial Pain
  • Urological indications (ED) Male Impotence or Erectile dysfunction.Dysfunction / Chronic Pelvic Pain / Peryonie’s
  • Wound Healing and other dermatological and aesthetic indications

 

Can Shockwave help with Erectile Dysfunction?

Yes. Piezo electric sound stimulation can help in up to 80% of cases in vasular erectile dysfunction**.  Making Shockwave a good choice for erectile problems.  This, combined with our Mens Health Program at Core Body Clinic is the best chance we can offer men with erectile problems. 

 

What are the success rates of shockwave therapy?

Shockwave therapy has been shown to provide a 80-90% success rate in reducing chronic tendinitis pain within 12 weeks of starting treatment.

 

 

What are the contra-indications?

  • Shockwave Therapy can not be used:
  • If you are pregnant
  • Over open growth plates
  • Over the lungs
  • Over major blood vessels
  • Over infected areas
  • If you have had a recent steroid injection
  • If you are on anti-coagulant medication
  • If you have an active cancer

 

 

Is shockwave therapy safe?

Yes. Shockwave therapy is extremely safe having been used on millions of patients around the world with virtually no negative side effects. Recent NICE guidelines recommend the use of shockwave therapy and emphasise the safety of the therapy.

 

Side-effects include:

  • A temporary reddening of the area treated
  • A temporary increase in pain fro 24 hours after treatment
  • Mild to moderate pain during treatment
  • Low level bruising if the treated area

 

What to expect during Shockwave therapy treatment?

Prior to engaging in shockwave therapy your diagnosis will need to be confirmed by a diagnostic ultrasound scan. This is to ensure you are a good candidate for the therapy and to optimise results.

Once diagnosis has been confirmed your therapist will apply the shockwaves to the injured tissue. Typically this will correlate with some tender areas located around your injury. The treatment is non-invasive so no needles are used. There is also no need for local anaesthetic. The treatments itself lasts no longer than 8-10 minutes. During the treatment you should expect to feel some mild to moderate discomfort, this is required in order to achieve maximum benefits. The energy levels applied during treatment can be adapted to suit each individual patient.

 

 

 

What Do I need to do after treatment?

One of the main advantages of shockwave therapy is there are no major restrictions on patients after treatments. It is recommended that heavy impact activity is restricted for 24 hours after treatment but patients will be fine to drive and return to work after treatments.

Many athletes and elite sports teams use shockwave therapy over injections to manage injuries as it allows them to continue training and playing throughout the season.

 

Do I need to do any other treatments with Shockwave therapy?

Yes. In order to maximally benefit from shockwave therapy it must be combined with a specific stretching or strengthening home exercise programme. The exercises required will be demonstrated and progressed by your therapist during each session.

 

When will I notice improvements?

Most people will notice an almost instant decrease in pain after treatment. This will be a temporary decrease as the tissue has been desensitised. Over time the pain relief becomes more permanent. Typically most people notice a significant improvement in symptoms 3-6 weeks after their first session. The optimal results of shockwave therapy are realised at 12 weeks after the first treatment.

 

How many treatments will I need?

Every patient will require a minimum dose of 3 treatments performed at weekly intervals. After the 3rd treatment patients will be reviewed at 6 weeks to assess response to treatment – at that point a decision on further treatment can be made. If an injury has been present for a long-time then a further 3 treatments may be required. Typically patients do not require more than 6 sessions.

For shockwave in erectile dysfunction patients and pelvic pain, the delivery of treatment is longer and the number of sessions is higher with 6 to 8 sessions more typical. 

 

What device do CoreBodyClinic use?

At Core Body Clinics we only use the highest-grade medical shockwave therapy equipment. The devices used are the original Swiss made shockwave therapy machines as used in the NICE guideline recommendation trials.  We use the Storz Duolith Focus Shockwave system.

PLEASE CALL TO BOOK AN APPOINTMENT. 

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3844425/

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674007/

 

https://www.nice.org.uk/Guidance/IPG571

 

https://www.nice.org.uk/Guidance/IPG311

 

https://www.nice.org.uk/Guidance/IPG313

 

https://www.ncbi.nlm.nih.gov/pubmed/26612525

 

https://www.ncbi.nlm.nih.gov/pubmed/19088057

 

https://www.ncbi.nlm.nih.gov/pubmed/25940060

 

https://www.ncbi.nlm.nih.gov/pubmed/28650749

 

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