Focused Shockwave Therapy is a treatment that uses low-intensity extracorporeal shockwaves (LI-ESWT) directed precisely to targeted areas and depths — such as the penile base (crura) — to stimulate new blood vessel growth, repair tissue, and improve penile blood flow.
It is particularly suitable for men with mild to moderate erectile dysfunction (ED) caused by vascular issues (Vardi et al., J Sex Med 2010; Gruenwald et al., J Sex Med 2013).
How Focused Shockwave Works
- Precise deep targeting – Energy is concentrated at a specific depth (e.g., 3–5 cm) to reach key erectile tissues such as the penile crura, which play a critical role in trapping blood (EAU Guidelines on Erectile Dysfunction 2024).
- Stimulating new blood vessel growth (angiogenesis) – The shockwaves trigger the release of Vascular Endothelial Growth Factor (VEGF) and tissue-repair signals, promoting microvascular formation (Clavijo et al., Eur Urol 2017).
- Tissue repair – Activates cell repair pathways, reducing tissue degeneration and improving elasticity (Vardi et al., J Sex Med 2010).
- Minimizing surface side effects – Because peak energy is delivered deep inside the tissue, there is less risk of skin bruising or irritation (Fojecki et al., J Urol 2017).
Focused vs. Radial vs. Linear Shockwave
| Feature | Focused (our technology) | Radial | Linear |
| Wave depth | Precisely adjustable 1–6 cm | ~1–3 cm | 3–5 cm |
| Energy distribution | Concentrated focal point | 360° radial spread | Linear beam |
| Accuracy | High | Lower | Moderate |
| Suitable penile size | All sizes | Short–medium | Longer |
| Over-treatment risk | Low | Low | Potentially higher in short shafts |
Evidence-Based Treatment Protocols
Based on studies by Vardi et al. (2010) and Fojecki et al. (2017):
- Shots per session: 7,500–9,000, covering multiple positions along the shaft and base.
- Frequency: Twice per week × 3 weeks → 3-week break → Repeat for another 3 weeks.
- Total program: 12 sessions over 9–12 weeks.
- Energy level: 0.09–0.25 mJ/mm² (low-intensity), safe and non-destructive.
In the group with an EHS baseline of 2–3 (partial erection but insufficient for penetration):
- Approximately 60–70% were able to increase their EHS by at least 1 stage after completing the program.
- Most of those who improved from EHS 2 → 3 or EHS 3 → 4 underwent the full 12-session protocol (total ≥ 90,000 shots).
In Fojecki et al., J Urol 2017 (using Linear LI-ESWT), it was found that using fewer shots — e.g., 3,000–4,000 shots per session × 5 sessions — was generally insufficient to increase the EHS stage in patients with long-standing ED.
Hormones and Penile Tissue Restoration
Testosterone is not only important for libido but also for the maintenance and repair of penile structures:
- Stimulates nitric oxide (NO) production, promoting vasodilation and better blood flow (Mikhail, Am J Med 2006).
- Supports tissue structure maintenance and prevents atrophy (Shabsigh et al., World J Urol 1997; Castela et al., J Androl 2011).
- In men with low testosterone, restoring levels to the normal range can enhance responsiveness to shockwave therapy (Schardein et al., Androgens 2022).
Adjunct Treatments for Optimal Results
- Low-dose PDE5 inhibitors – e.g., Tadalafil (Cialis) 5 mg daily to maintain blood flow and support angiogenesis (Clavijo et al., Eur Urol 2017).
- PRP (Platelet-Rich Plasma) – Injected immediately after shockwave to boost repair and vascular regeneration (Gruenwald et al., J Sex Med 2013).
- Hormonal optimization – For patients with confirmed low testosterone to improve tissue repair and vascular health.
Outcomes from Research
- Approximately 60–70% of mild–moderate vasculogenic ED patients achieved an IIEF (International Index of Erectile Function) score improvement of ≥ 5 points, indicating a clinically significant restoration of erectile function (Vardi et al., J Sex Med 2010; Clavijo et al., Eur Urol 2017).
- Results typically last 6–12 months and can be prolonged with maintenance treatments or combined therapy.
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