Erectile dysfunction (ED) is one of the most common problems among men over 40. Most current first-line therapies are based on non-invasive treatments, such as PDE5 drugs (like the famous Viagra) or vacuum devices. Both these therapies require pro-activity before engaging in sexual activity, leading to loss of spontaneity and occasionally to less satisfying relationships. For these reasons, over the past decade a new concept of therapy has been developed: it involves a series of treatments whereby external energy is applied to penile tissues. The aim of these treatments is to restore spontaneous erectile function without the need for any pro-activity prior to sexual intercourse.
This article summarizes all the information about each of these technologies as well as the main differences between them.
Radio Frequency Technology
About the technology – radio waves are in fact the release of low frequency energy (1 MHz). Upon its release, this energy produces controlled heat which is harnessed for stimulating the production of a protein called collagen in the deep layers of various body tissues, including the penile erectile tissues. The role of collagen fibers is to provide the necessary firmness, tone and structure to these tissues. RF therapy is non-invasive and painless.
The aim of the treatment – to restore the biological penile erectile mechanism by using radio frequency to stimulate the production of new collagen fibers. The tunica albuginea is a penile tissue with a crucial role in the biological erectile mechanism. It is composed of numerous collagen fibers (giving it elasticity and rigidity) and it is crossed with veins responsible for draining the blood from the erectile bodies. During sexual stimulation, the elastic collagen fibers enable the tunica albuginea to stretch and compress the veins crossing it, so that blood cannot drain out through them from erectile bodies. In this manner, the tunica albuginea traps the blood in the erectile bodies during sexual activity and the erection is generated and maintained.
However, around the age of 35-40, when the cells produce less collagen in the tissues, the quantity and quality of collagen fibers in the tunica albuginea start to decline. The tissue loses its elasticity and rigidity and it cannot stretch and widen during sexual stimulation as before. Consequently, the tunica albuginea is unable to efficiently block blood leakage from the erectile bodies, and for this reason men usually start experiencing erectile dysfunction.
How is the treatment performed – The RF treatment is performed by using an innovative patented medical device, a first of its kind in the world, called Vertica. Vertica is designed for discrete self-use at home, and it does not require a doctor’s prescription. It creates radio waves (RF energy) that produce controlled heat which stimulates the growth of new collagen fibers in the deep layers of penile tissues, including the tunica albuginea. The new collagen fibers enables the tunica albuginea to effectively stretch so as to trap blood within the erectile bodies during sexual activity.
Treatment is performed by applying the Vertica device onto the external part of the penis. The device is likewise designed to induce collagen production in the internal part of the penis by heating the perineum area.
Treatment protocol – 3 treatments a week during the first month and about 2 treatments a week from the second week onwards (the duration of each treatment is approx.15-30 minutes). Vertica is a personal device to be retained by the patient for good. After achieving improvement in erection quality following preliminary use, the device may continue to be used as needed, for purposes of strengthening erectile tissues and maintaining the integrity of collagen fibers (just like a “gym” for the penis).
Treatment success rates – over 85%, as demonstrated by the world’s first pilot study of its kind, led by Prof.’ Ilan Gruenwald, of the neuro-urology clinic at Rambam hospital, Israel. The study assessed Vertica’s safety, efficacy and treatment satisfaction among men with mild to moderate erectile dysfunction. The results furthermore showed, that the improvement in erectile function has been maintained for an additional period of 6 months after treatment completion.
The added value –
- Penile RF treatment is a completely novel therapeutic concept, which is not based on timing a pill ingestion prior to sexual activity for improving short-term erectile function. Rather, the patient can use the device at any time, in the comfort of his home. Vertica is the only treatment in the world that works on restoring the natural erectile mechanism (i.e., locking the blood in the erectile bodies), so that the patient can enjoy spontaneous erections once again. Additionally, the improvement in erectile function is for the long run.
- Many patients report that already during the first weeks of using Vertica they start experiencing spontaneous nocturnal and morning erections.
Shockwave Technology
About the technology – This ED treatment is based on acoustic/shock waves device that emits gentle pulses. The pulses trigger micro-injuries to cell membranes which in turn induce the ingrowth of new blood vessels (neovascularization) and improve blood supply to penile tissues.
The aim of the treatment – similar to oral medications and most of the other ED treatments, shockwave therapy works on increasing blood flow to the penis. However, it will not help in cases where ED is caused due to degenerative changes in collagen fibers that result in leakage of blood from the erectile bodies during erection. Shockwave therapy may not be suitable for every ED patient and a qualified physician should first assess suitability and the projected success rates.
How is the treatment performed – this intimate treatment is performed in clinics by medical staff members, throughout a series of 6-12 treatments. Treatment is performed solely on the external part of the penis by placing the shockwave device directly on the organ. There are different types of devices with varying levels of effectiveness.
Treatment protocol – a series of 12 treatments consisting of 2 treatments a week during the first 3 weeks, a period of a 3-week break followed by 2 treatments per week during the next 3 weeks. The duration of each session is 15-20 minutes. Every couple of months a new series of treatments should be performed in order to maintain the desired effect.
Treatment success rates – approx.’ 65%-75%. However, a number clinical studies and meta-analyses have demonstrated inconclusive results regarding treatment effectiveness. Additionally, patients normally report a preliminary effect only after 3 months of treatment (if at all).
The added value – shockwave treatment allows the patient to get spontaneous erections, without timing the treatment prior to sexual activity. However, treatment takes place in specialized clinics, which requires scheduling appointments and thus the waiving of discreteness.
Summary of the differences between RF and shockwave therapies in treating ED
Radio Frequency (RF) | Shockwave (SW) | |
The technology | Low frequency radio waves (1 MHz) | Low intensity acoustic (shock) waves |
Mechanism of action | Thermal energy produces controlled heat which stimulates collagen synthesis in the tunica albuginea tissue (the erectile mechanism), enabling it to effectively lock the blood in the penis during erections. | Shockwaves trigger micro-injuries to cell membranes, which in turn induce the ingrowth of new blood vessels and improve the blood supply to penile tissues. |
Aim of the treatment | To restore the biological erectile mechanism so as to enable spontaneous erections | To improve blood flow to the penis and enable natural spontaneous erections |
How is the treatment performed? | By using Vertica – a home-use device, designed for self-use at the patient's convenience. | 2 treatments a week during the first 3 weeks, a 3-week break, and 2 treatments a week during the following 3 weeks. It's necessary to perform a series of treatments every couple of months to maintain the effect. |
Treatment protocol | 3 treatments during the first month and 2 treatments from the second month onwards. It's possible to continue using the device, as needed, for prevention and further strengthening the erectile mechanism (like a "gym" for the penis) | 2 treatments a week during the first 3 weeks, a 3-week break, and 2 treatments a week during the following 3 weeks. It's necessary to perform a series of treatments every couple of months to maintain the effect. |
Treatment success rates | - Over 85% - Patients report spontaneous nocturnal and morning erections already during the first weeks of treatment - The improvement in erectile function is maintained for at least 6 months after treatment completion, as demonstrated by the results of a clinical trial | -65%-75% - The effect is seen after about 3 months |
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