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Low-intensity shockwave therapy for erectile dysfunction.

Onuralp Ergun1,2, Kwangmin Kim3, Myung Ha Kim4

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|July 14, 2025
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Low-intensity shockwave therapy (LiSWT) may offer a small benefit for erectile dysfunction, but the clinical importance is uncertain. This treatment shows potential for long-term improvement with minimal adverse events.

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Area of Science:

  • Urology
  • Regenerative Medicine
  • Sexual Health

Background:

  • Erectile dysfunction (ED) affects numerous men globally.
  • Low-intensity shockwave therapy (LiSWT) is an emerging treatment for ED.
  • Existing systematic reviews lack rigorous methodology and focus on patient-important outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of LiSWT for ED compared to sham treatment.
  • To assess critical outcomes including erectile function, treatment discontinuation, and adverse events.
  • To analyze patient-important outcomes such as satisfaction and quality of life.

Main Methods:

  • A comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searches conducted across major databases (Cochrane Library, MEDLINE, Embase, Scopus) and trial registries.
  • Included 21 RCTs with 1357 participants, assessing outcomes in short and long term.

Main Results:

  • LiSWT showed a small, potentially not clinically important, short-term improvement in erectile function (IIEF-EF score).
  • Long-term erectile function may improve, but evidence certainty is low.
  • No significant difference in treatment discontinuation or adverse events compared to sham.
  • Penile rigidity may improve short-term and long-term, but clinical significance is questionable.

Conclusions:

  • LiSWT may offer a modest benefit for erectile function in men with ED.
  • The clinical importance of observed improvements remains uncertain.
  • Low certainty of evidence necessitates cautious interpretation due to study limitations and potential bias.