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Physician Resource

UVA Urologist Addressing Key Unknowns About Shockwave Therapy for ED

At a Glance:

Ryan Smith, MD, is overseeing a clinical trial testing low-intensity shockwave therapy for erectile dysfunction to determine:

  • Optimal treatment protocol
  • Which patients will most likely benefit

Unlike other treatment options for erectile dysfunction (ED), all of which are palliative in nature, LiSWT is unique in its ability to restore the erectile mechanism and enable spontaneous erections for men with vasculogenic ED.

The FDA has already approved the technology to promote wound healing in musculoskeletal disorders. Not yet FDA-approved for ED treatment, key questions remain. UVA Health urologist Ryan Smith, MD, is overseeing a clinical trial to help answer those questions: “What remains largely unknown are the patients most likely to benefit, the safety, durability, and optimal treatment protocols,” Smith says.

Penile Rehabilitation Post-Prostate Cancer Treatment

Many participants join the UVA Health trial following prostate cancer treatment.

This UVA-initiated trial is a key piece of an extensive undertaking by UVA Urology to run one of the nation’s leading prostate cancer programs. “This trial speaks to our emphasis on cancer survivorship and quality of life. Some are proposing this could be a means to penile rehabilitation after prostate cancer treatment,” Smith says.

He adds, “Current treatments for ED don’t address the underlying disease process. The hope is that shockwave therapy could be potentially restorative, at least to some degree. It’s important for men to understand, however, that it’s not the fountain of youth. But if we can provide some benefit without medication or an invasive procedure, then that has the potential to change a lot of men’s lives.”

May Become Standard of Care for Vasculogenic ED

With angiogenetic properties, LiSWT is used in the management of chronic wounds, peripheral neuropathy, and in cardiac neovascularization. Studies over the past decade, confirm that LiSWT “generates a significant clinical improvement of erectile function and a significant improvement in penile hemodynamics without any adverse effects” and “may create a new standard of care for men with vasculogenic ED,” write the authors of a review in the journal Therapeutic Advances in Urology.

Who is Eligible to Participate in UVA Urology-Led Trial for ED?

A person can qualify for the trial if they are:

  • Aged 30-80 and currently suffering from ED
  • Finished with prostate cancer treatment and has ED
  • Planning to undergo treatment for prostate cancer and either has or is at risk for ED

What Can Trial Participants Expect?

Participants will be randomly assigned to either a group that receives shockwave therapy or a control group. Those in the control group will have the opportunity to receive shockwave therapy after the 1-month follow-up appointment.

Shockwave therapy is administered using a wand that creates non-invasive, pulsed sound waves. For those receiving therapy as part of the UVA clinical trial, shockwaves will be delivered to the penis tissue twice a week for three weeks. Patients will have follow-up visits in 1-,3-, and 6-month intervals.

The trial is still open but temporarily paused to new patients as statisticians complete an initial analysis and to allow clinicians to complete follow-up and current treatments for enrolled patients. 

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