NOTE: This story has been updated for clarity.
Guys living with a particularly vexatious personal problem should take heart, University of Virginia researchers want to study you.
Urologists are setting up a study that explores the use of low-intensity shockwave therapy as a way to treat erectile dysfunction and possibly repair the thwarted blood flow that causes it.
The focused sound waves stimulate the body to repair itself and could result in noninvasive treatments that permanently fix the problem, leaving patients free of both the side effects and costs of current drugs used to resolve erectile dysfunction.
“There have been some trials that suggest that soundwaves could be effective,” said Dr. Ryan Smith, of UVa Health’s Department of Urology. “We already use them to break up kidney stones and in other areas of medicine to stimulate the body to repair itself.”
The study is looking for a few good men between 30 and 80 years old who suffer from the condition. They can have baseline dysfunction or have the condition through prostate cancer treatments. Those men about to be treated for prostate cancer are also eligible.
It’s a blind trial. Some participants will receive fake treatments while others receive the real thing to help determine if the treatments work. Those who receive the placebo treatments may receive shockwave therapy for dysfunction after a one-month follow-up appointment.
“We want to see if this is a valid treatment, if there are other effects like pain and discomfort and how desirable it is as an alternative to drugs,” Smith said. “We want to take it to the next level and see if it is effective.”
Shockwave therapy uses non-invasive, pulsed sound waves. The waves cause ripples in the soft tissues, stimulate the body’s immune response to increase blood flow to the area and actually rebuild blood vessels.
The U.S. Food and Drug Administration has approved focused soundwaves for some musculoskeletal disorders. The National Institutes of Health have conducted numerous studies that show the soundwaves are effective for treating plantar fasciitis and tendonitis issues.
“When [shockwaves are] applied to an organ, the relatively weak, yet focused [waves] interact with the targeted deep tissues where they cause mechanical stress and microtrauma,” states a 2017 National Institutes of Health study conducted in Israel. “This induces a cascade of biological reactions that result in the release of angiogenic factors which in turn trigger neovascularization of the tissue with subsequent improvement of the blood supply.”
What that means, Smith said, is that the soundwaves get the body to react as if it was being stressed or injured.
"It stimulates a variety of responses including cellular growth factors which can induce new blood vessel growth, cell proliferation and tissue regeneration. This treatment hopes to promote the body's ability to heal damaged tissue," he said.
In this study, the waves will be aimed at the genitals. The focused impact should excite the body to respond, increasing blood flow through the vascular system in the penile tissue and resulting in strengthening of cell walls and repair of the blood vessels.
The study will require twice-weekly, 30-minute appointments for the first three weeks of the six-month study with follow-up appointments after the first, third and sixth months. The treatments are free to the participants.
According to the NIH, most treatment for erectile dysfunction involves pills and injections. In many cases, the drugs are expensive and not covered by insurance companies. They also don’t fix the problem at its base, but just touch the surface.
“These treatments are very effective and are reasonably safe with rare unwanted or adverse effects,” NIH researchers said. “However, they all share the same major drawback. They do not alter the underlying pathophysiology of the erectile mechanism.”
The drugs, researchers say, are a temporary solution.
“These treatments are usually taken on demand, prior to the sexual act, and their effect is essentially time limited,” the researchers said. “The evidence that its effect on the erectile tissue is long-lasting is very limited. Presently, only a small number of men can be offered treatment that would restore their spontaneous erectile function.”
Smith said the cause of dysfunction could be a precursor to a heart attack.
“If a guy develops erectile dysfunction, it could be that he’s building up plaque in the blood vessels, the same cardiovascular process that leads to heart attacks,” he said. “Often erectile dysfunction is the first harbinger, a biomarker of heart disease.”
An NIH study conducted by researchers at the University of Miami, Florida, warned that not all shockwaves are healing. Some, they say, just feel good.
“Currently, there are radial pressure wave generating devices that have been marketed for the treatment of erectile dysfunction,” the study states. “Radial pressure wave devices are designated [with the same] status given to personal massagers, which do not require regulatory approvals and can be used by anyone as no professional training is necessary to administer.”
The UVa study could result in finding a permanent repair.
“A lot of times patients have to pay for the drugs out of their own pocket and that can be expensive,” he said. “Besides the cost, dysfunction impacts everything from self-esteem to personal relationships. You can see how it impacts a patient’s mental health and self-image. This could make a big difference.”
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