Focused Shockwave Therapy
(Li-ESWT)
Low-intensity focused acoustic waves directed at penile tissue. No medication, no surgery. A treatment with careful scientific support, applied with precision.
How does focused shockwave work?
The erectile tissue (corpus cavernosum) works like a sponge, threaded with roughly one million tiny blood vessels. During an erection, those vessels fill with blood. As you age, vessels are gradually lost and the sponge fills less effectively. Shockwave therapy stimulates the formation of new blood vessels, restoring the network so the tissue can fill optimally again.
Neovascularisation
Formation of new blood vessels in the treated tissue, structurally improving blood flow.
Angiogenesis
Stimulation of growth factors (VEGF) that promote the development of vascular networks.
NO pathway activation
Activation of the nitric oxide pathway, essential for vasodilation and erectile function.
Stem cell activation
Mobilisation of endogenous stem cells to the treated area for tissue regeneration.
Fibrosis reduction
Breakdown of fibrotic (hardened) tissue that restricts blood flow and elasticity.
Your pathway in detail
A standardised protocol based on available clinical evidence. Every session is performed under the responsibility of the specialist.
Equipment: Storz Medical Duolith SD1 T-Top "ultra"
We work exclusively with the Storz Duolith SD1 T-Top, the device used in the majority of clinical studies. Medically certified, focused, and proven in urological practice. Not a generic consumer device.
When can you expect results?
Regenerative therapy does not work like a pill. The body needs time to form new vascular tissue. This is the expected progression.
What the evidence says
We always distinguish between what we know, what we suspect, and where the evidence is still insufficient.
Cochrane Systematic Review 2025: 21 randomised controlled trials with a total of 1,357 patients. IIEF improvement of 3 to 5.25 points.
Recognised as a treatment option by the EAU (2024). 7+ meta-analyses confirm significant improvement. Long-term data beyond 12 months are limited.
- How much improvement can I expect?On average 3 to 5.25 points on the IIEF scale. For the individual patient, this can mean the difference between "it doesn't work" and "it works again". In well-selected patients, we see that the majority experience noticeable improvement.
- How strong is the scientific evidence?More than seven international meta-analyses show significant improvement in erectile function. The European Association of Urology (EAU) recognises LI-ESWT as a treatment option for vasculogenic ED. The evidence is growing, but long-term data beyond 12 months are not yet available.
- Is this a proven therapy?It is a therapy with growing scientific support: recognised by the EAU, backed by multiple meta-analyses, and applied daily in urological clinics worldwide. Not every man responds equally strongly. That is why we measure individually and advise based on your own response.
Focused vs. radial
Not all shockwave is the same. The difference between focused and radial equipment is clinically relevant.
Who is shockwave most suitable for?
Shockwave therapy does not work equally well for everyone. The outcome strongly depends on the cause and severity of your symptoms.
Best indication IIEF 11-17
Vasculogenic erectile symptoms, moderate severity. This is the group for which the most evidence is available. The chance of clinically relevant improvement is greatest here.
Good indication IIEF 17-21
Mild erectile symptoms. Men in this group often notice subtle but valuable improvements: more spontaneous erections, less dependence on medication.
Limited indication IIEF <11
Severe erectile symptoms. The evidence for this group is limited. A combination therapy or alternative treatment may be more appropriate. We discuss this at the intake.
Prostate application NEW
Shockwave can also be targeted at the prostate for chronic prostate inflammation. In that case, it is combined with our prostate treatment for optimal effect.
Side effects and risks
Shockwave therapy is a non-invasive treatment with a favourable safety profile. No serious side effects have been reported in the clinical literature.