Low Intensity Pulsed Ultrasound (LIPUS) for Erectile Dysfunction
Low Intensity Pulsed Ultrasound (LIPUS) is a new painless, non-invasive treatment for erectile dysfunction.
Most erectile dysfunction treatments such as tablets (Viagra), penile injections, and penile vacuum pump therapy require use of the medication or device on each occasion prior to sexual activity. LIPUS is different in that the beneficial effect is persistent following treatment, which may mean an improvement in sexual spontaneity is possible.
How does it work?
There are two theories about how sound waves work to treat erectile dysfunction. One is that they directly stimulate the growth of new blood vessels leading to improved erectile function, the other is that they recruit stem cells, which help with growth of new penile vascular tissue.
Who is it appropriate for?
LIPUS is most effective in men with mild to moderate erectile dysfunction with a vascular cause for the dysfunction rather than a neurogenic (nerve injury) cause. Risk factors for vascular injury are high blood pressure, diabetes, high cholesterol, smoking and ageing. Nerve damage can be due to spinal cord injury, prostate surgery or other pelvic surgery.
What does Treatment Involve?
Soundwaves are applied to different treatment zones on the penis and the perineum using a small hand held probe (Storz Duolith SD1 ultra). The treatment is painless so anaesthesia or other pain relieving medications are not needed. There are few side effects aside from mild skin redness. A course of treatment involves six fifteen-minute sessions in the clinic – two sessions per week for three weeks.
What effect might it have?
An improvement in erection quality occurs in most men. Erection hardness and duration of erection may improve. This may mean that men who had previously required oral tablets such as Viagra to generate an erection may not need to use medication or require a lower dose. Some men with more severe dysfunction requiring injection therapy may be able to transition onto oral treatments. The duration of benefit is uncertain – studies suggest that the benefit lasts at least six months. The treatment may be repeated.
What else can be done to help recover erections?
There are several lifestyle measures that can be adopted to improve erectile function. These include daily exercise, keeping weight in a healthy range, avoiding smoking and excessive alcohol, getting adequate sleep and ensuring that blood pressure, cholesterol and testosterone have been checked and are in the healthy range. Some medications for blood pressure (B-Blockers) or prostate enlargement (Finasteride or Dutasteride) may inhibit erections. Sometimes these medications may be able to be substituted for alternatives without this side effect.
How can treatment be arranged?
Bookings are made through Urology Care Wellington by calling 04 920 0162
Our Urology nurse will contact you to arrange an appointment where you will fill in a health questionnaire, have weight and blood pressure measured and treatment planned.
What is the follow-up?
A questionnaire on erectile function is sent out three months following treatment & our Nurse will speak to you on the telephone four months following treatment.
Journal of Sexual Medicine 2017; 14:27-35
In this systematic review and meta-analysis published in 2017, researchers analysed the use of low-intensity extracorporeal shock wave therapy in seven randomized controlled trials, with a total of 602 patients. They found among men with an average age of 60.7 years and an average follow-up of 19.8 weeks that the International Index of Erectile Function score significantly improved an average 6.40 points from baseline in men receiving shock wave treatment, compared to an average 1.65 points in those receiving sham therapy.