Electro Shock Wave Treatment (ESWT) for ED

ED1000 TreatmentA possible cure for Erectile Dysfunction.

Electro Shcokwave Treatment for ESWT for short has had a long history of use in medical treatment.

It was first used to break up kidney stones. Then it found its way into Sports Medicine where it was used to treat various sports injuries like tendinitis and ligament strains.

Most recently, ESWT has been used for the treatment of Erectile Dysfunction.

How does ESWT work for ED?

One of the causes of Erectile Dysfunction is the poor flow of blood into the penis caused by unhealthy blood vessels.

By shooting multiple low-intensity shockwaves into the penis, new and healthy blood vessels develop. This is known as neo-vascularization.

Who will benefit from ESWT?

Since this treatment is specific for blood vessel problems, only people with ED due to unhealthy blood vessels will benefit. These are usually old patients (40 to 70 years old) and may have chronic diseases such as Diabetes, High Blood Pressure or High Cholesterol.

If your ED is due to other factors such as stress or side effects of medicines, then you will not benefit from this treatment.

ESWT can potentially cure patients with mild to moderate ED. For patients with severe ED, it will make them respond better to ED medicines.

What is the success rate?

Studies have shown that 76% of patients will have an improvement in their IIEF score by more than 5 points. Another study showed that 21 out of 29 patients treated had an improvement of their Erection Hardness Score from 2 to > 3.

In very severe cases of ED where the patient could not get an erection even with medicines for their ED (i.e. PDE5 inhibitors), after the ESWT treatment, 72.4% of them were able to get an erection with their medicines.

Overall, it is fair to say more than 70% of people will benefit from this treatment. Of course 70% is not a 100% and this success rate has to be balanced against the cost of the treatment.

What is the procedure like?

You will first have to visit Our Doctors to determine if you are a candidate for ESWT or not.

During the treatment, a clear gel will be applied on your penis and the base of your penis (either side of the scrotum). The treatment probe is place against the skin.

The probe will then send low intensity shockwaves into the treatment area. There should be no pain at all during the procedure. Most patients do not feel anything at all. Some report that they feel a slight tingling.

You will require a total of 6 treatment sessions.

  1. 1 session everyday for 6 days OR
  2. 3 sessions per week for 2 weeks OR
  3. 2 sessions per week for 3 weeks

Each treatment session lasts 20 to 30 minutes. Most patients will start to experience an improvement 2 weeks after completion of the treatment.

Some patients will require a second round of 6 treatment sessions to be done 3 weeks after the first round.

Some patients will require medicines during the treatment process to improve the neo-vascularization of the penis.

Cost

Treatment costs $400 per session ($428 with GST).

Conclusion

ESWT presents an exciting new therapy option that has the potential to cure ED rather than having patients rely on tablets.

The only drawback is that currently is only works for mild to moderate ED caused by blood vessel problems.

This treatment will be available in our Andrology Centre at Novena Medical Center from October 2014.

advise


Need more advice?

To find out more about Penile Rash or other Men’s Health issues , please visit your doctor or visit Men’s Health Clinic.

Dr. Tan and Partners @Novena (Men’s Health Clinic)

Address:

10 Sinaran Drive,
#08-31, Novena Medical Centre
Singapore 307506

Telephone:
+65 6397 2095

Learn more about Andrology and Infection Centre at Novena Medical Center services.


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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

Find the profiles of our panel of doctors.

47 Comments

  1. Hi dr, i think i may have damage my penis by sleeping with the foresking retracted for so many times. Can this treatment could cure me?

    • I do not quite understand your question. However, I think the best thing for you to do is to see a doctor to get properly assessed. You are welcome to visit us at Novena Medical Center #08-31.

  2. P K UNIKRISHNAN

    Hi
    My Doctor advised me to go for ESWT since I have been identified having venous leak. I am 63 years old, have regular medication for BP CHOLESTEROL DIABETES.Also had an implant of a stent in 2011. I am a heavy smoker and drink only a daily basis. Should I stop this bad habit before I start ESWT treatment? Please help.

    • You have multiple factors causing your ED. Diabetes, High Blood Pressure, High Cholesterol and smoking all contribute to ED. Your medicines used to control Diabetes, High Blood Pressure, High Cholesterol also contribute to ED. To top it all off you also have venous leak! If you want to solve your ED you have to stop smoking, stop drinking, get your Diabetes, High Blood Pressure, High Cholesterol under good control. You will also need ESWT and very likely also need tablets for your ED. You may even need penile injections.

  3. Max Z

    I have a venous leak and went through a 6 session ESWT. I did not use Cialis during the sessions. The doctor did not tell me about that. I waited a lot and after the treatment there were 3-4 weeks when I felt good and got proper erections with sildenafil. But then the effect vanished in a few weeks. The nurse that gave the treatment told me that some men had taken 6+2 treatments and the last two were 2-3 months after the first 6. What do you think about this?

    • drtan

      Out of professional courtesy I should not be commenting on your Doctor’s advice and treatment. As far as I know, there is no strict guideline on ESWT for venous leak. The treatment guideline for ESWT for ED in general is 6 sessions followed by a break of 3 weeks followed by another 6 sessions. You should go back to your attending Doctor for more advice.

  4. Reddy p

    I’m 27yrs old and am diagnosed with an arteriogenic ED( penile doppler showed mild reduction in systolic blood velocities). Am I a good candidate for ESWT? Once done, how long will this be effective.

    • drtan

      Wow. I am so sorry to hear that. You are very very young to have arteriogenic ED. Yes you are a very good candidate for ESWT. Effectiveness usually lasts a year after 6 sessions. Following which we do 1 to 2 sessions per year to maintain. I have personally found that the benefits last longer in younger patients.

  5. Dear Doctor

    I have ED problem. I use to lead a very active sex life until I had a heart bypass operation in 2013. At times I may experience mild erection which last a short while and it went limp. I am age 72 and need help.
    what would a penile implant cost and what are the risks in my case
    Thanks and regards
    KC Fong

    • Apologies. We do not place penile implants. You are welcome to see us for a discussion of your ED and recommendation of treatment options. If you are keen on an implant, we can refer you to the appropriate surgeon. The risks of placing an implant are similar to the risk of other surgeries. There is a risk of bleeding, infection, implant failure and there is also a risk of anesthesia. The surgeon and anesthetist will have to analyze your fitness for surgery before deciding to do it for you or not. You have had a heart bypass surgery so that might be a complicating factor. Furthermore, you may be on blood thinners like Aspirin which may also further complicate matters for the surgery.

      You may first want to consider other options like tablets, penile injections, shock wave treatment and vacuum pumps.

  6. Tan Bee Lam

    Hi Doctor,

    I am an old man age 63 and have been suffering from ED for many years since my fifties. I am unable to get erections at all unless I take Viagra or Cialis pill. Even then it is not a very hard erection.

    I am wondering if this new treatment ESWT is effective and will cure my ED.

    However, from what I gathered for this treatment to be administered, the penis need to be in a semi solid state long enough so that the shockwave could be applied to the shaft of the penis.

    But my penis is always in the flaccid state which is less 2in in length, so will it suitable for ESWT treatment?

    Thanks

    • Let me start with the caveat that I have not seen you and therefore the information here should not be taken as medical advice.

      From what you have told me I really do not think ESWT can permanently cure your ED. What it CAN do for you is improve your reaction to Viagra or Cialis.
      In other words, after going through the ESWT therapy, you will still need Viagra or Cialis but will get a good hard erection when you take them.

      You do not need to be erect when undergoing ESWT. That said, very often, to get the most out of the ESWT therapy, we encourage patients to be on daily 5mg of Cialis while undergoing ESWT.

  7. HI DOCTOR
    NICE TO MEET YOU,I THINK I HAD BEEN SUFFERING ED FOR A LONG TIME NOW.THE PROBLEM IS THAT BEFORE THERE WAS NO ERECTION BUT NOW THERE IS AFTER TAKING SOME TREATMENT.CURRENTLY,IT WILL STOP OR GO DOWN MID WAY WHEN I’M HAVING INTERCOURSE.I ALSO FOUND OUT THAT MY SEMEN IS WATERY.IS THERE ANY SOLUTION TO THIS PROBLEM AND CAN YOU HELP?….THANKS

  8. Hi Doctors,

    I have some erection problems. I can maintain a very hard erection for a long time. It become semi hard after 7 – 8 mins and I will go soft when I am in some positions.

    I have did the IIEF questionnaire. I am all right. I am wondering do I have ED? or is it other erection issues?

    Can the ESWT help my erection?

    Hope to hear from you soon.

  9. Hi,

    I had been suffering ED for quite some time. My prob is when I m in lying position, my erection is not a problem. But once I stand up, the erection goes off straight.

    Tats caused frustrations where I cant have sex when I m trying to insert it.

    I suspect it’s my blood vessel prob. However, do u have the necessary equipment to check on blood vessel? Or necessary equipment to check on the causes? Will the cost b vr high?

    • Dr Justin Sim

      If you are young then most ED is psychological in nature. Particularly if you can get an erection lying down. If it was a blood vessel problem you would also experience it lying down. We don’t have penis blood vessel checks available but we can certainly still investigate for you. If it really is a blood vessel problem we can use our machine to increase your blood vessels but this can be up to $400 per session and you may need several sessions. I would advise you come and speak to us first.

  10. Hi Dr Tan, I’m only in my mid twenties, so will this treatment still be suitable for me? But I’m not sure of the cause too.. One more thing, how much is the total cost for the 6 session package now? Thanks.

    • ED in your mid-twenties is usually caused by a venous leak or chromosomal abnormalities. You should see a doctor and get properly diagnosed first. ESWT may be able to help with mild cases of venous leak ED. Total cost of 6 sessions is $2568 (with GST)

  11. nicholas thang

    i am from China,i have an ed with venous leak, i wanna try this treatment of ESWT to singapore,but i have a poor enlish,i am afraid of getting difficulty in contact with the doctors,could I talk with the doctor there in Chinese?is the name of hospital Novena medical center?

    • 你好。我是陈医师。ESWT可能能够帮助静脉漏引起的勃起功能障碍。当然最有效的治疗方法还是静脉硬化治疗。我本身在我们Novena Medical Center的诊所看诊。很欢迎你来跟我讨论哪个治疗方法比较适合你。请发电子邮件给 doctor@drtanandpartners.com 我们会帮你约看诊时间。

      • nicholas thang

        谢谢您的回复,陈医生。请问静脉硬化是怎样的一种治疗方法?是开刀做手术吗?是不是类似于静脉结扎?如果是,那么是不是也会容易复发啊?有效期一般有多久?我现在吃cialis还是有点效果的,只是不如以前正常时的效果那么好,坐着勃起还可以,站起来的话勃起就不好了,难以维持。如果用eswt治疗效果会好点吗?我们国内没有这样的治疗方法。

        • 对。静脉硬化治疗的确需要动小手术找出阴茎背深静脉然后把药直接打进去。这一种治疗方法有70%的成功率。大多数比较年轻的人会选择试ESWT先。

          • nicholas thang

            如果eswt有效果的话,这种效果是永久的吗?会不会过段时间就恢复原状了?

          • eswt的效果不是永久的。eswt会改善动脉血流。但是,过了一段时间动脉一定再回到原来的状态。大多数的患者会一年做一次或两次eswt来保持效果。只是初一次做eswt才需要6次。

          • Nicholas thang

            不好意思,陈医生,您所说的“只是初一次做eswt才需要6次”这句话我不太明白。这句话的意思是说,第一次做eswt需要做6个session,如果一年后又恢复原状了,需要进行第二次eswt的话,那么可能需要做更多的session是吗?比如7个session或者8个session,甚至再多点?

          • 对不起。我的华语水平不高害你乱了。初一次eswt需要6个sessions。一年后只需要1到2个sessions.

          • Nicholas

            陈医生,我还是那个静脉漏患者,不好意思还有一个问题想问一下,您之前说如果ESWT的治疗效果不好的话,还可以进行静脉硬化治疗,我想问下,你们医院可以进行静脉硬化手术吗?另外,我在网上搜索了一下,发现静脉硬化的治愈率却是挺高,但是也无法避免静脉侧枝循环的再次建立,也就是依旧会复发,如果复发了,这个手术可以再做第二次吗?

          • 我们的诊所没有提供手术服务。你可以跟泌尿科医师讨论这个问题。

  12. Yes it is possible.
    We can do:
    1. 6 sessions every day for 6 days
    2. 6 sessions one every 2 days for 12 days

  13. Jakarta

    Hi Doctor,

    I am from Jakarta, I will be travelling to Singapore next week. I would like to make an appointment for Electro Shockwave Treatment. I am currently under medication for impotency.

    • Hi, sure thing. The Electro Shockwave Treatment is available at our Novena clinic. Kindly call +65-63972095 to make an appointment.

  14. Vincent

    Hi Dr Tan
    How are you. I would like to ask if the success rate of this treatment is also dependent on the doctor carrying out the treatment. I am asking because I notice that Pro Lim from Gleneagles charges $3600 for the entire course. It is quite different from what your clinic charges. May I know why are there such differences.
    My second question is pertaining to frequency. I read that in other countries , the recmended number is treatments is 12. However in sg, all the clinics do the treatments in block of 6. In your experience should 12 be more of an accurate figure for this treatment to succeed? Thank you for your time in answering my question.

    • drtan

      Prof Lim and I both have our own set of patients and report similar experiences. We often discuss our experiences at conferences. I really cannot comment on the price difference.

      As for the number of sessions required, you brought up a good point. The recommended number of sessions by most guidelines and by the manufacturer of the machine I use (ED1000) is 6 over 3 weeks. Then wait 3 weeks and another 6 IF required. My personal experience is there is definitely an additional benefit from 12 sessions but not a lot more than 6. In other words, patients experience the most benefits from the first 6 sessions. So the question is whether or not it is worth it to pay for another 6 sessions for less benefit. People who require 12 sessions are usually people with vascular risk factors like Diabetes. What I sometimes advise my patient (without vascular risk factors) is to spread out the next 6 sessions over 3 to 6 months. I find that they still get the benefits and it provides longer term improvement.

  15. Hi Doctor,

    I am back to my country and I am very happy for the results. Thank you very much.

    If there is a chance of you visiting my country, please let me know. I can show you around.

  16. Hi Dr,

    I am 55 male from Bandung West Java. I am currently on oral medication for this problem. I would like to try this treatment matter.

    I am going Singapore to visit my daughter and her family next month. I will be staying in Singapore for 2 – 3 weeks.

    I will just like to know the how long will this session be.

    • ESWT Treatment for ED requires 6 sessions over 3 weeks. Each session lasts about 20 minutes and is painless. I have had patients who squeezed the 6 sessions into 2 weeks and had similar benefits.

  17. Anonymous

    Thank you for your recommendation and after the treatments my performance has improved gradually.

  18. Lim Weng Chiew

    ESWT is for those with blood vessels problem only? But how do I know if the cause of my ED is due to blood vessels problems or not.

    Can I try this treatment regardless of whether it is due to blood vessels problem or not because this is the only treatment that can cure ED if I am not mistaken.

    From what I heard, it is very expensive, just a few sessions of treatment will cost thousands of dollars, is that true?

    • ESWT works by inducing the penis to make new healthy blood vessels. A process called angiogenesis. So it works well for patients who suffer from mild to moderate ED with a vasculogenic cause. It also works for patients who do not respond to PDE5I’s. If your ED is not caused by blood vessel issues, it is highly unlikely this treatment is going to make any difference. You are certainly welcome to try it but you might be wasting your money. We charge $500 per treatment session. One treatment course is 6 sessions over 3 weeks which comes up to $3000.

      • Random11889

        Does venous leakage get cured by shockwave therapy? I am sure I have a venous leakage and would like to know if it counts as a vasculogenic disease which can be cured by shockwave therapy.

        • That is a very good question. ESWT does NOT cure venous leakage. Venous leakage is fixed by surgery or inserting a coil into the vein to reduce outflow. However, you can use ESWT to improve the inflow and in some situations, this may be good enough to overcome the venous leakage. That is assuming you have some arterial compromise in the first place.

          • random

            What kind of surgery fixes venous leakage? And what are their success rates?

          • drtan

            You can tie off the veins or insert a coil into them. You need to check with a surgeon who does these surgeries. I do not do them.

          • when you said “However, you can use ESWT to improve the inflow and in some situations, this may be good enough to overcome the venous leakage”

            do treated similar experience? if yes what is the result?

          • Patients have reported satisfactory results so far.

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