When you read the words, "Shock treatment may improve erectile dysfunction," your mind may go many places. Maybe you imagine a tiny defibrillator, custom-made for limp dicks. Maybe it has little paddles that you hold with your index finger and thumb, rubbing them together as you yell, "Clear!" and zap a boner into existence.
Some of you may imagine that. Others may imagine a shock collar for a penis.
But in reality, the shock treatment for ED recently profiled in European Urology doesn't use electricity, but rather vibration. Low-intensity shock wave treatment (LIST) is the newest development in man's age-old quest for boners, and it uses sound waves to actually grow new blood vessels in the penis. "The vibrations create changes in the tissue [of the penis]," says Dr. Natan Bar-Chama, the director of male reproductive medicine and surgery at New York's Mount Sinai Hospital. "It makes new vascular tissue, a process called neovascularization."
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"Erectile dysfunction has multiple causes," says Bar-Chama. "The main culprits have to do with changes that occur in the muscle and vascular system in the penis: cardiovascular disease, diabetes, high cholesterol, smoking, and hypertension can all cause it." An erection is basically a water balloon filled with blood instead of water. Blood fills the corpora cavernosa (the two spongy tissue sections running along either side of the penis), causing the penis to stand hard and proud. If the blood vessels that connect to the corpora cavernosa are damaged or impaired, blood can't fill the corpora, leaving a half-filled balloon. By creating new blood vessels, LIST creates a new, healthier path for blood to flow into the penis.
How do sound waves create blood vessels? It's doing exercise, essentially. When you work out, you're actually causing tiny tears in your muscle tissue. The muscles then heal and become even stronger. A 2014 study proposed that LIST shock waves cause microtrauma in the corpora cavernosa. This prompts new vascular tissue to grow, increasing blood flow to the penis. "You're addressing the physiological cause, not just treating the symptoms," says Bar-Chama. "No other ED treatment does that."
Phosphodiesterase 5 inhibitors (PDE5i)—pills like Viagra, Cialis, and Levitra—are still the most common form of treatment for ED. "The pills are widely used, extremely safe, and effective," says Bar-Chama. "However, 40 to 50 percent of men stop using the medication, either because of lack of efficacy or side effects." PDE5i are vasodilators, meaning they temporarily dilate the dysfunctional old blood vessels. What they can't do is create healthy, virile new blood vessels. Because of this, LIST may be more effective at what the 2014 study called "spontaneous erections" than the Viagras of the world. A study conducted earlier this year shows that LIST may also help men respond to PDE5i pills, allowing for erections both planned and spontaneous.
"Erectile dysfunction is a spectrum, like most diseases, ranging from mild to moderate to severe," says Bar-Chama. Medication is still most effective in mild to moderate ED, but shock wave treatment may actually be able to prevent ED from moving to its most severe stage.
Shock wave treatment has many applications. High-intensity shock wave therapy is the most common treatment used to break up kidney stones, according to the National Kidney Foundation. "It's also used with patients with burns," says Bar-Chama. The same treatment that brings us boners can treat burnt scar tissue.