Forget What You Think You Know
Erectile Dysfunction (ED) is defined as the inability to attain or sustain an erection. It is also not solely a condition of the elderly. According to a 2017 study, 33% of men over the age of 40 have experienced ED. At 60, that number grows to 68% and by age 70 the figure is around 82%.1 Put simply, ED is a big problem that no one is talking about.
The primary symptom that contributes to ED is restricted blood flow to the penis; the underlying causes of that can be numerous. Cardiovascular or hormone issues, the build-up of scar tissue and/or nerve interference are some of the most common physical causes. While many patients rely on medications, some have turned to more invasive techniques and others are suffering in silence.
Shockwaves and Urology
Shockwaves have been a commonly used medical treatment for urological conditions since the 1970’s. Originating in Europe as lithotripsy, shockwaves were used to break down kidney stones before they were ever used for pelvic health or musculoskeletal treatments.
Shockwave therapy for ED is not painful. Because focal shockwaves are used for most of the treatment, it is remarkably effective at stimulating profound cellular change without causing any pain or damage to healthy tissues.
Shockwaves stimulate new blood vessel growth and the removal of any scar tissue that has developed. Although it can take some time for this to occur, results are rapid in comparison to most therapies. Many clients notice results after 2 sessions and have significant if not complete improvement after 6 sessions. As an added benefit, clients receiving ED treatment often report improvements in prostate health, incontinence and overall sexual performance.
Results That Speak for Themselves
In 2014, a study was published that concluded shockwave therapy was a tolerable, clinically effective treatment for men with severe ED.2 The following year, another study showed that shockwave was an effective long-term treatment of ED, since the majority of subjects could have intercourse without medication at 6 months post-treatment.1 In 2016, a systematic review of 7 different clinical trials supported the previous finding, as subjects treated with shockwave had maintained >60% improvement months after their treatments had ended.4
Interestingly, the same study noted that shockwave therapy had considerable potential for those patients who had failed medical and pharmaceutical therapy. No negative side effects were reported and 80% of patients would recommend the treatment to their friends.4
The Common Causes
There are many potential causes of ED, which is what makes it so remarkably frustrating and complex. For some, the condition crept into their lives insidiously until, one day, they realized it was a real problem.
Perhaps it is the diabetic struggling with cardiovascular restrictions or the man with scar tissue from an intercourse injury. For others, a devastating work injury or surgical slip left their sex life changed in an instant. Then there are those who have absolutely nothing wrong physically…and yet something is still wrong. We have seen it all.
The Not So Common Causes
The epidemiologist in us loves a good problem to solve. Our holistic approach, with careful consideration of the kinetic chain, enables us to see connections between injuries that others may not. A great example is the 30-year-old man who comes for ED treatment of relatively recent onset. After choice questioning and careful consideration of his case, the therapist determines that this could be related to his fall off a roof last spring, in which he hurt his back and remained on bed rest for several weeks. The timeline adds up and the nerve paths involved further support the therapist’s reasoning. Before treating the pelvic area, the low
back is the focus. In many cases, the source is correctly identified, and symptoms disappear without the need for ED treatment. Who would have thought?!
Reclaim Your Spontaneity
One of the most common concerns our new clients voice is that they have lost the ‘magic’. When the passionate moment can progress naturally, it is a beautiful thing. Having to take a warm-up break to pop a pill can kill the moment faster than parents showing up on prom night.
Then you have those who suffer with complete erectile dysfunction – even the meds don’t help. The psychological ramifications of this scenario are profound and can cause great stress both physically and emotionally – for both partners. When the love doesn’t die, why should the libido?
After a shockwave therapy for ed, pelvic health protocol, results improve over the following 3 months, even after treatments have stopped. The best moments are when our clients tell us that the spontaneity has returned.
Shockwaves Treat More Than ED
Studies have shown shockwave therapy is also an effective treatment for Induratio Penis Plastica (Peyronie’s Disease)6, which is a bend in the penis due to the accumulation of scar tissue. Although it was deemed to be “moderately effective” during clinical trials, it was associated with higher patient satisfaction rates.6
Shockwave has also proven to be effective over pharmaceuticals for clients suffering from Chronic Pelvic Pain Syndrome (CPPS).7 Most reported satisfaction due to easy and inexpensive application with no side effects.
We’re Here to Help (even if it is for some free education and a referral)
Clients experiencing ED as a result of nerve damage will not typically see the same results as clients experiencing vasculogenic ED (due to scar tissue or vascular problems); however, we always recommend coming in for a consult if you are unsure. A severed nerve, such as what can occur during a prostatectomy or injury, can be very difficult to treat; however, nerves that are blocked as the result of muscle tension or scar tissue can be corrected.
If your ED is believed to have origins outside of our scope of practice, we refer to a handful of trusted, qualified professionals including urologists, general physicians, osteopaths, chiropractors and registered psychologists specializing in sex therapy. We respect our limits and would never treat someone if we know what we are doing is unhelpful. Building a strong relationship of trust with our clients is a company core value. Most importantly, before proceeding with a treatment plan, we are honest about realistic results, so your expectations are completely fulfilled throughout the course of your treatment.
“Hard” Questions
At Remedial Wellness, we are always here to answer your questions in a professional manner. To us, this is so normal that it is just another body part. These are some of the questions we often receive at Remedial Wellness that can be a tough ask:
⦁ What happens in the treatment room?
We have invested in your comfort. State of the art equipment and devices designed with professionalism in mind keep you feeling like you are walking into any other physio appointment.
The therapist will use shockwave devices to treat the area of the pelvic floor, the perineum, the shaft of the penis, and any other pelvic areas deemed relevant.
Appointments are approximately 45 minutes in duration.
⦁ Is it possible that I will get an erection during treatment?
Although it is not common, it has happened. We consider this a good response as it is ultimately the desired result. No need for embarrassment;
we are health professionals and human beings.
⦁ How many treatments will I need?
We recommend 6. Pelvic Health treatment plans also have a differentiated treatment schedule that spans 5 weeks.
Some clients find 6 treatments is enough. Others, such as heavy smokers or those with diabetes, need more than 6 or may need more frequent ‘tune-up’ sessions over time.
⦁ What is the cost?
Each Pelvic Health treatment costs $250 and is performed by an experienced Registered Physiotherapist.
Your treatment may be claimable through your extended health benefits plan under physiotherapy benefits. In most cases, direct-billing is also possible.
⦁ How many people have you treated for ED?
Since we started treating Pelvic Health conditions in 2015, we have treated a multitude of clients from all over North America. In the last 6 months, we have accepted 21 new clients for pelvic health treatment plans and have performed 64 treatments in that time.
⦁ Can I still have sex while I’m receiving treatments?
Please do. It is encouraged in order to gauge the subjective effectiveness of treatment. This is a non-invasive procedure with no down time. You will experience little to no discomfort throughout the course of your treatment plan.
⦁ Can I book an appointment without having to discuss my case with anyone but the therapist?
Absolutely. Discretion and professionalism are top priorities within our clinic. We also understand that this conversation can be extremely difficult for some clients.
If you would prefer, you can request a call back from the physiotherapist directly. This may take a bit more time to secure your booking but will enable you to speak with your therapist directly before deciding if this treatment is right for you.
Pelvic Health treatments are always bookable, even for new clients.
Summary
Shockwave therapy has gained traction in the last 5 years as an effective, non-invasive approach to treating erectile dysfunction, Peyronie’s disease, chronic pelvic pain syndrome, and incontinence.
Considering the invasiveness of some alternative treatments and surgery, and the unpredictability of medications, it is no surprise that men are turning to shockwave therapy for a restorative, long-term solution.
With no negative side effects, convenient ‘lunch-break’ treatments and a relatively rapid recovery rate, client satisfaction is exceptionally high.
Citations:
1) Çayan S, Kendirci M, Yaman Ö, et al. Prevalence of erectile dysfunction in men over 40 years of age in Turkey: Results from the Turkish Society of Andrology Male Sexual Health Study Group. Turk J Urol. 2017;43(2):122-129.
2) Anne B. Olsen, Marie Persiani, Sidsel Boie, Milad Hanna & Lars Lund (2015) Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study, Scandinavian Journal of Urology, 49:4, 329-333, DOI: 10.3109/21681805.2014.984326
3) Yee, C., Chan, E. S., Hou, S. S., & Ng, C. (2014). Extracorporeal shockwave therapy in the treatment of erectile dysfunction: A prospective, randomized, double-blinded, placebo controlled study. International Journal of Urology, 21(10), 1041-1045. doi:10.1111/iju.12506
4) Sokolakis, I., & Hatzichristodoulou, G. (2016). Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: A systematic review and meta-analysis of randomised controlled trials. International Journal of Impotence Research. doi:10.1038/s41443-019-0117-z
5) Chung, E. and Cartmill, R. (2015), Low‐intensity extracorporeal shockwave therapy for treating ED. BJU Int, 115: 46-49. doi:⦁ 10.1111/bju.13035
6) Chung E. Peyronie’s disease and low intensity shock wave therapy: Clinical outcomes and patient satisfaction rate in an open-label single arm prospective study in Australian men. Korean J Urol. 2015;56(11):775-80.
7) Meijlink, J. M. (2017). The Changing Role of Organized Patient Support for the Chronic Pelvic Pain Patient. Urological and Gynaecological Chronic Pelvic Pain, 15-24. doi:10.1007/978-3-319-48464-8_2