Low-intensity shock wave therapy for ED appears to be most suited for men who have mild erectile dysfunction and who are either responsive or nonresponsive to PDE-5 inhibitors, according to Dr. Ramasamy.
“Men who have not tried Cialis and Viagra respond very well, and men who have tried and failed Cialis and Viagra, who have received shock waves, appear to go back to respond to PDE-5 inhibitors,” he said. “I don’t think it’s appropriate for the man with severe diabetes, severe venous insufficiency, or men who have had previous pelvic surgeries, such as radical prostatectomy or radical cystectomy.”
Dr. Goldstein said he agrees that it’s doubtful shock wave therapy will rescue men in the severe group.
“But, if we follow this over time, we might allow people to never become severe,” Dr. Goldstein said.
The next big advance in ED treatment?
If the FDA approves shock wave therapy for ED, Dr. Goldstein said he thinks all urology practices will offer the treatment.
Using the device and performing the treatment requires little in the way of a skill set. Nurses can deliver the treatment. But everyone in the room needs to wear heavy-duty ear protection because the sound from the device can be loud and physically damaging, especially to those administering low-intensity shock wave therapy, Dr. Goldstein said.
The only disposable required to use the technology is ultrasound gel, which when rubbed on the penis helps to transmit the shock waves, according to Dr. Sloane.
“The point is, this will become a pretty widespread treatment of aging men. Most people will have pretty good erectile function until age 40, 45, 50. Then, after age 40 or 45, you have a direct falling,” Dr. Goldstein said. “So if you can change the slope a tiny bit, make it less steep with just getting your penis shocked, would you do that? When this comes out and it’s shown to be efficacious, I will be one of the people getting shock wave therapy.”
Dr. Burnett is an investigator for Medispec. Dr. Ramasamy is an investigator for Direx. Dr. Goldstein is a consultant to and researcher for Dornier; researcher for Tissue Genesis; a member of the speakers’ bureau for Coloplast, Dornier, and Mist Pharmaceuticals; and provides writing support for Pfizer.
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