Shockwaves

The doctor. Luis Rodríguez Vela is a urologist and belongs to Top Doctors, the select circle of top-level doctors in Spain. As an expert in shock waves, he will explain the details of his treatment.

Shock waves are a very novel treatment to treat patients with erectile dysfunction. In this sense, in the guidelines of the European Association of Urology, in its update of 2013, it is indicated that with this treatment of shock waves a very positive effect is exerted for patients with vascular erectile dysfunction. Its medical use begins in the 80s when high-energy shock waves are described for the fragmentation of kidney stones. They have been evolving, later they have been using medium energy for trauma processes and currently low energy shock waves are used to treat patients with erectile dysfunction and patients with Peyronie's disease.

Currently, shock waves are used in multiple trauma processes that occur with pain, are used for their magnificent anti-inflammatory and analgesic effect. They are also used in rehabilitation, in processes with contractures, with pains, trigger points, and have a very beneficial effect to eliminate pain. At the level of urology, these low energy shock waves are used to treat patients with erectile dysfunction because these shock waves have an effect of facilitating the formation of blood vessels, angiogenesis. New blood vessels are formed, the blood flow to the erectile tissue increases and this provides a better erection and better function of the endotherium. In addition, in patients with Peyronie's disease, which is a type of penile curvature, these shock waves have a very positive, very beneficial effect on fibrosis, the healing of erectile tissue, improving it and also improving erection.

In patients with erectile dysfunction, shock wave treatment is performed in 5 sessions. One session is applied every week and in each session we employ 3600 shock waves. It is important to apply these low energy shock waves throughout the length of the erectile tissue. We start with the cavernous bodies that form the pendulum penis and then apply it to the perineal part of said cavernous bodies. As these low energy shock waves do not cause pain, no local anesthesia is necessary and when they finish, each session lasts around 30 minutes, the patient goes quietly to his home. On the other hand, in patients with Peyronie's disease, we apply 4 sessions and also 3,600 shock waves directly on the plaque to improve the erection and to decrease the degree of fibrosis caused by the en- curvation.

The treatment with shock waves, as I have said, increases vascularization. The most positive effects of shock waves are observed after 4 weeks after finishing the treatment. We mentioned the patients 1 month after aca-bar and it is frankly comforting to see how when finishing the treatment, patients who have come to us because they have erectile dysfunction and need pills, they no longer need the medication and can have a satisfactory relationship and it is also frankly it is comforting to see how patients with severe erectile dysfunction, who come because they have not responded with any type of medication, after treatment with shock waves do respond to these pills and can have a satisfactory relationship. Finally, indicate that these low energy shock waves do not produce pain or any type of adverse effect.