Research > Urology

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1. The Role of the Low-Intensity Extracorporeal Shockwave Therapy on Penile Rehabilitation After Radical Prostatectomy: A Randomized Clinical Trial
2. ​Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence - This study aimed to evaluate the therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence (SUI). The investigation was a single-arm, open-label, multicentre study conducted in Taiwan. 50 female patients with SUI received LiESWT-treated with 0.25 mJ/mm2 intensity, 3000 pulses, and 3 pulses/second, once weekly for 4-weeks (W4) and 8-weeks (W8). The pad test, uroflowmetry, life quality questionnaires, and 3-day urinary diary measurement were performed before and after LiESWT intervention. The results revealed that 8-week of LiESWT treatment meaningfully improved urine leakage (pad test), maximum flow rate, post-voided residual urine, average urine volume, functional bladder capacity, urinary frequency, urgency symptom, and nocturia, which also persisted to show significant improvements at 1-month follow up (F1). Moreover, bothersome questionnaires scores were significantly improved at W4, W8, and F1 as compared to the baseline (W0). These results indicated that 8 weeks of LiESWT attenuated SUI symptoms on physical activity, reduced bladder leaks and overactive bladder (OAB), implying that LiESWT brought significant improvement in the quality of life. (ClinicalTrials.gov number, NCT04059133).  More..
3. Erectile Dysfunction before and after results under ultrasound - PPT Slides. More..
4. Stem cells pose risk, offer promise  - Providing the therapy involves using an FDA cleared device with “genuine” shock waves, according to Irwin Goldstein, MD, a urologist who practices sexual medicine in San Diego and and is director of the nonprofit Institute for Sexual Medicine (SexualMed.org). “There are a lot of imitation non-shock wave acoustic sound waves that are being scammed and sold to patients who are desperate,” said Dr. Goldstein, who uses a device known as the UroGold 100. “Real shock wave therapy has been shown to activate endogenous stem cells. This specific device is FDA cleared now in the U.S. for increasing blood flow, connective tissue activation, and amelioration of pain, and the FDA has classified this device a non-significant risk (NSR) to humans.”  More..
5. Low Intensity Shock Wave Therapy: Regenerative Therapy for Erectile Dysfunction - (Dr Irwin Goldstein MD) Analogy to blood flow imparting physical forces – shear stress - onto endothelial cell to cause a biochemical response.  More.. 
6. The Basic Science Behind Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Scoping Review of Pre-Clinical Studies - Using Cochrane’s methodologic recommendations on scoping studies and systematic reviews, we conducted a systematic scoping review of the literature on experimental research regarding Li-ESWT for ED and
   other pathologic conditions. The initial systematic search was carried between January and November 2017, with
   2 additional searches in April and August 2018. All studies that applied shockwave treatment at an energy flux
   density >0.25 mJ/mm2 were excluded from the final analysis.  More.
7. In Situ Activation of Penile Progenitor Cells With Low-Intensity Extracorporeal Shockwave Therapy​ - Journal of Sexual Medicine (Guiting Lin MD PhD, Amanda B. Reed-Maldonado MD, Bohan Wang MD, Yung-chin Lee MD, Jun Zhou MD, Zhihua Lu MD, Guifang Wang MD, Lia Banie BS, Tom F. Lue MD) We previously reported that progenitor cells, or stem cells, exist within penile tissue. We hypothesized that acoustic wave stimulation by low-intensity extracorporeal shockwave therapy (Li-ESWT) would activate local stem or progenitor cells within the penis, producing regenerative effects.  More..
8. Comparative SWT Data to Evaluate Competing Technologies in the Treatment of Penile Connective Tissue for Improved Erectile Function.  (MTS Medical) - First comparative report for MTS/TRT UroGold, (unfocused shockwaves “SoftWaves” ) and Radial/Ballistic waves, (unfocused Storz D-Actor, aka “acoustic pressure pulse” (APP) for the treatment of Erectile Health. Introduction: In the USA, since 2007, approximately 400 shockwave therapy (SWT) or acoustic pressure pulse (APP) devices have been sold for the treatment of erectile dysfunction (ED) with over 250,000 patient treatments performed. The average fee for these treatments is $4000 (6 – 12 treatments per patient) and is most often performed by a non-urologist. Non-medical entrepreneurs are the typical purchaser/provider for this therapy in the USA. At least 90% of the devices sold in the USA are low cost radial shockwave devices (APP). As reported by physicians from the Mayo clinic at the 2018 ISSM conference in Lisbon, the average success rate is about 50% worldwide (Gainswave, the largest marketer of SWT for ED in the USA reports a much higher success rate) More..
9. Treatment of stress urinary incontinence with low-intensity extracorporeal shock wave therapy in a vaginal balloon dilation
   induced rat model - To investigate the outcomes and mechanisms of low-intensity extracorporeal shock wave
   therapy (Li-ESWT) on stress urinary incontinence (SUI) in a vaginal balloon dilation (VBD) rat model.  More..
10. Effectiveness of shock wave therapy: implementation of a soft wide focus applicator in patients with erectile dysfunction - (MTS-Science) - Low-intensity extracorporeal shock wave therapy (LI-ESWT) is of great clinical interest for the treatment of erectile dysfunction (ED), chronic pelvic pain (CPP) and Peyronie’s disease. Extensive research in animal and human studies showed that the beneficial effect of LI-ESWT is due to its angiogenic properties. It is thought to stimulate neovascularization by inducing the expression of regeneration- and growth-related factors, like for example eNOS, VEGF and PCNA although the precise underlying mechanisms are not entirely clear yet. Thereby LI-ESWT can increase penile blood flow and endothelial function and represents a new, sustainable therapeutic strategy to restore erectile function, independent of, or supporting the conventional palliative medication.  More..
11. First Report for Unfocused Low Intensity SoftWave® Therapy (uESWT ) for Nocturia and Erectile Dysfunction (ED) - (IRB study at Georgia Urology, Atlanta, USA) - Since 2007 at least 250.000 ED patients have been treated with shock wave therapy (SWT). The majority of them treated with radial / ballistic SWT devices by non-urologists (Source: TRT)  Power Point
12. Low Intensity Shock Wave Treatment for Erectile Dysfunction-How Long Does the Effect Last? - PubMed (Urology Department, Sheba Medical Center, Ramat-Gan, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.) We studied the long-term efficacy of penile low intensity shock wave treatment 2 years after an initially successful outcome. More..
13. Case Series of Weekly Low Intensity Shock Wave Therapy for Erectile Dysfunction - (MTS Science) - Low Intensity Shock Wave (LiSW) has emerged as a therapy for vasculogenic erectile dysfunction (ED). Mechanism may be related to angiogenesis, release of growth factors and/or recruitment of stem cells. Several sham controlled studies have shown improvement in peak arterial velocity and efficacy in the 60-65% range depending on the definition. The initial protocol of twice weekly treatments for 3 weeks with a rest period and repeat has remained the standard, although this can be very inconvenient for patients. We wished to study the efficacy and safety of LiSW using a modified protocol of 4 weekly treatments.  More.
14. Pilot Trial, First Report Worldwide for Unfocused SoftWave® Therapy (uESWT) for the Treatment of Testicles to Improve Testicular Size and Function - (Georgia Urology, Atlanta, USA. 2018) Testosterone in males is produced in the testicles. With aging testosterone levels are reduced, and this is associated with the loss of libido and erectile dysfunction More..
15. Efficacy of extracorporeal shock wave therapy (ESWT) for males chronic pelvic pain syndrome: A phase III, randomized, double blind controlled with placebo study - (MTS-Science) - Chronic Prostatitis/ Chronic Pelvic Pain Syndrome (CP/CPPS) according to NIH is genitourinary pain or discomfort lasting 3 or more months with undetectable uropathogenic bacteria. More..
16. Complementary effect of L-citrulline supplementation on SparkWave™ therapy-induced angiogenesis and regeneration - (MTS-Science) - SparkWave™ therapy (SW™T) is a modern day non-invasive treatment option for a wide range of pathological conditions, including ischemic heart disease, vasculogenic erectile dysfunction (ED), wound healing or traumatized bones. It induces angiogenesis and improves hemodynamics, thereby promoting tissue healing and neovascularization in the affected areas which is highly necessary to guarantee rapid healing. The angiogenic and regenerative effect of SW™T is based on the activation of stem cells and growth factors like eNOS, VEGF and PCNA, leading to tissue restoration and nerve generation  More..
17. Penile low intensity shock wave therapy for PDE5i non-responders suffering from vasculogenic Erectile Dysfunction since 2 to 10 years: A prospective, randomized, placebo-controlled study - (MTS Science) - Several animal and human studies have evaluated the role of low-intensity extracorporeal shockwave therapy (LIST) in the management of multiple disorders such as chronic wounds, peripheral neuropathy and cardiac ischemic disease. LIST was reported to trigger a chain of events that releases angiogenic factors, recruits endothelial progenitor cells, induces neovascularization and enhances blood flow in treated areas. Recently, some studies with contradictory results have assessed the efficacy and safety of this therapy on patients suffering erectile dysfunction.  More..
18. Clinical evidence of SparkWave™ therapy in the treatment of erectile dysfunction - (MTS-Science 2016) Urogenital indications such as painful penile angulation, erection problems and / or chronic pain in the pelvic region frequently lead to a reduced quality of life for affected patients. Besides the actual symptoms the indications often have a negative impact on sexuality and partnership.  More..
19. Spark Wave® Therapy Ameliorates Urinary Incontinence - (MTS-Science April 14th, 2019) Stress urinary incontinence (SUI) is the involuntary leakage of urine during activities such as coughing, sneezing, lifting, laughing or exercises. SUI is estimated to affect at least 10 – 20 % of women and poses a significant health problem.  More..
20. Low–Energy Shockwave Therapy Improves Ischemic Kidney Microcirculation - National Institutes of Health (Xin Zhang, James D. Krier, Carolina Amador Carrascal, James F. Greenleaf, Behzad Ebrahimi, Ahmad F. Hedayat, Stephen C. Textor, Amir Lerman, and Lilach O. Lerman 2016​) - Microvascular rarefaction distal to renal artery stenosis is linked to renal dysfunction and poor outcomes. Low–energy shockwave therapy stimulates angiogenesis, but the effect on the kidney microvasculature is unknown. We hypothesized that low–energy shockwave therapy would restore the microcirculation and alleviate renal dysfunction in renovascular disease.  More..​
21. Pilot Trial, First Report Worldwide for Li-SWT (unfocused SoftWaves) For the Treatment of Testicles to Improve Testicular Size and Function. - (Tissue Regeneration Technologies) - A four patient pilot trial was conducted in 2018 including four (4) subjects with an average age of 62 (range 57 – 71).  All subjects reported typical symptoms of low testosterone. More..
22. Comprehensive Urology to Utilize New Shockwave Therapy Device: PulseWave - (PRESS RELEASE PR Newswire 2018) Comprehensive Urology Medical Group, one of the nation's leading urological practices, announces the addition of a new low intensity shockwave therapy device (LISWT), PulseWave, to their offerings. More..​
23. Alternative Treatment for Erectile Dysfunction with the Urogold 100™ - (MTS Science 
    Published on Jun 21, 2016) The improvement of Erectile Dysfunction through the treatment with the urogold100® has been shown in scientific studies as Spark Waves® promote the generation of new blood vessels by the release of angiogenic growth factors. More..
24. Urological Times Cover - Scroll to Page 18 - 19 - (Urological Times) It’s hard to argue against an erectile dysfunction treatment that is potentially disease modifying, is noninvasive, and seems to do no harm. The treatment, low-intensity shock wave therapy, has yet to earn the FDA’s approval but is widely used in other countries. More..
25. Cleveland Clinic - Low Intensity Shockwaves In Urology - (Cleveland Clinic Daniel Shoskes, MD) - As urologists, we have decades of experience with extracorporeal shockwave lithotripsy for breaking apart stones within the body. Today, a related and emerging technology, low-intensity shockwave therapy (LiSWT), is being explored for several other urological applications. More..
26. Erectile Dysfunction and the Shocking Truth: Is Shockwave Therapy Effective - (American Urological Association 2017) - American Urological Association. Dr. Tom Lue addressing erectile dysfunction during debate. More..​​
27. Effects of Low-Energy Shockwave Therapy on the Erectile Function and Tissue of a Diabetic Rat Model - Introduction—Low-energy shockwave therapy (LESWT) has been shown to improve erectile function in patients suffering from diabetes mellitus (DM)-associated erectile dysfunction (ED). However, the underlying mechanism remains unknown.  More..
28. Treatment Chronic Pelvic Pain Syndrome CPPS Shockwave Therapy - Media 
29. Review of the Current Status of Low Intensity Extracorporeal Shockwave Therapy (Li-ESWT) in Erectile Dysfunction (ED),
    Peyronie's Disease (PD), and Sexual Rehabilitation After Radical Prostatectomy With Special Focus on Technical Aspects of the
    Different Marketed ESWT Devices Including Personal Experiences in 350 Patients - More.