Abstract
Current treatments for erectile dysfunction (ED) such as phosphodiesterase type 5 inhibitors (PDE5Is) and intracavernosal injections (ICI) therapy, such a symptom therapy used as on demanded before sexual intercourse, the clinical efficacy reached to 80%, with mild side effects, however, such a symptom therapy could not restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, include corpus cavernosum smooth muscle and endothelial dysfunction, and neuropathy. Although the mechanisms remain to be further investigated its underlying mechanisms may involve recruiting endogenous mesenchymal stem cells. Recently, device of low-intensity pulsed ultrasound (LIPUS) has been developed and animal study had been proven to have effects of improving erectile function and restoring pathological changes in penile tissue in STZ-induced diabetic ED, however, it is needed to perform clinical study. LESWT & LIPUS could be novel therapy for treating ED with restore pathological changes in the penis in the near future. However, further extensive evidence-based basic and clinical studies are needed.