Introduction
Erectile dysfunction (ED) and chronic
prostatitis/chronic pelvic pain syndrome (CP/CPPS) are among the most common
urological conditions in men. According to epidemiological studies, more than
50% of Taiwanese men aged 40–70 experience varying degrees of erectile
difficulties. The prevalence of chronic prostatitis has been reported at 5–8%,
often causing recurrent pain in the lower abdomen or perineum, along with
urinary symptoms and reduced sexual quality of life.
In addition to conventional medications,
low-intensity extracorporeal shockwave therapy (Li-ESWT) has gained increasing
attention in recent years, offering new treatment possibilities for both ED and
chronic prostatitis.
I.
Erectile Dysfunction and Chronic Prostatitis
Common
causes of erectile dysfunction
● Cardiovascular
disease (arteriosclerosis leading to insufficient penile blood flow)
● Endocrine
disorders (e.g., diabetes, low testosterone)
●
Psychological
stress and anxiety
● Prostate-related
conditions
Symptoms
of chronic prostatitis
●
Recurrent
pelvic or perineal pain
● Urinary
frequency, urgency, or difficulty voiding
●
Painful
ejaculation or decreased libido
● Persistent
psychological stress and impaired quality of life
II.
Limitations of Conventional Treatments
Common treatments for erectile dysfunction
● PDE5
inhibitors (e.g., sildenafil, tadalafil)
●
Vacuum
erection devices
● Penile
injection therapy or prosthesis implantation
Although medications can improve erections, some
men cannot use them long-term due to side effects (such as headache, flushing,
low blood pressure) or underlying cardiovascular conditions.
Common
treatments for chronic prostatitis
● Antibiotics
(when infection is suspected)
● Anti-inflammatory
or pain medications
● Alpha-blockers
to improve urination
●
Heat
therapy or physical therapy
● Psychological
support and lifestyle modification
Because the causes of chronic prostatitis are
complex, treatment results are often temporary, and relapse is common.
III.
Mechanism of Shockwave Therapy
Shockwave therapy applies low-intensity acoustic
waves to the penis or surrounding prostate tissue, leading to multiple
biological effects:
● Angiogenesis:
Promotes new blood vessel growth, improving local circulation.
● Nerve
regeneration: Stimulates repair factors, enhancing nerve function.
● Anti-inflammatory
action: Reduces chronic inflammation and alleviates pain.
● Tissue
activation: Improves metabolism and supports recovery of affected areas.
Thus, shockwave therapy not only relieves
symptoms but also targets the underlying pathology by improving circulation and
reducing inflammation.
IV.
Application of Shockwave Therapy in Erectile Dysfunction
Clinical studies have shown that patients
undergoing shockwave therapy demonstrate significant improvements in erectile
rigidity and International Index of Erectile Function (IIEF) scores. It is
especially beneficial for men who respond poorly to oral medications or are
unable to take them.
Treatment
protocol
● A
linear probe is applied to the corpora cavernosa and penile crura.
● One
to two sessions per week, typically 6–12 sessions total.
● Each
session lasts about 15–20 minutes.
Key
features
● No
anesthesia required; patients can resume daily activities immediately.
● Enhances
penile blood flow and restores natural erectile function.
● Results
vary; men with severe vascular disease or diabetes may see less improvement.
V.
Application of Shockwave Therapy in Chronic Prostatitis
In patients with chronic prostatitis, shockwave
therapy has been shown to provide:
● Pain
relief: Significant reduction in pelvic and perineal discomfort.
● Urinary
improvement: Reduced frequency, urgency, and residual urine sensation.
● Better
sexual quality of life: Less ejaculatory pain and reduced anxiety.
Treatment
protocol
● A
focused probe is applied to the perineum and pelvic region.
● Each
session lasts 15–20 minutes, with 6–12 sessions recommended.
This offers a safe and sustainable option for
patients who experience recurrent symptoms or limited response to medications.
VI.
Possible Side Effects and Precautions
Shockwave therapy is generally safe, with only
minor and temporary side effects such as:
●
Local
redness or soreness
●
Mild
numbness
● Rare,
short-term increase in pain that resolves within hours
Not recommended
for:
●
Patients
with prostate cancer
● Individuals
with bleeding or clotting disorders
VII.
Clinical Role of Shockwave Therapy
Shockwave therapy is not a replacement for
medication but rather an alternative option. It is particularly suitable for:
● ED
patients with limited drug efficacy or significant side effects
● Chronic
prostatitis patients with recurrent or drug-resistant symptoms
● Men
suffering from both conditions who wish to improve erectile function and pelvic
pain simultaneously
VIII.
Conclusion and Recommendations
With its non-invasive, safe, and quick-recovery
charteristics, shockwave therapy is increasingly adopted in clinical urology.
For men with erectile dysfunction or chronic prostatitis, it provides a
promising pathway that combines safety with long-term benefit.
Recommendations
for men:
● Seek
medical evaluation if you have persistent pelvic pain or erectile difficulties.
● Consult
your urologist to determine if shockwave therapy is appropriate.
Combine
treatment with lifestyle measures such as regular exercise, healthy diet, and
stress management for optimal results.