ED’s effects extend beyond the physical, often leading to emotional and psychological distress. Many men with ED experience feelings of embarrassment, low self-esteem, and reduced confidence, which can strain relationships and diminish overall quality of life.

Addressing and managing ED is crucial not only for restoring sexual function but also for improving emotional well-being and interpersonal relationships.

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What Is Erectile Dysfunction (ED)

Erectile dysfunction (ED) is a medical condition characterised by the persistent inability to achieve or maintain an erection sufficient for sexual activity. While occasional difficulties with erections are common and can occur for a variety of reasons, consistent problems may signal an underlying medical issue or other contributing factors.

An Overview Of Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal Shockwave Therapy (ESWT) is a non-invasive medical procedure that uses acoustic waves, known as shockwaves, to promote vascular regeneration and enhance blood flow in the penis. The therapy aims to address the root cause of ED by stimulating the growth of new blood vessels, a process termed angiogenesis.

Distinct from other ED treatments, ESWT does not rely on medications or surgical interventions. While treatments like phosphodiesterase type 5 inhibitors (commonly known as PDE5 inhibitors) provide temporary relief by enhancing the effect of nitric oxide and improving blood flow, ESWT offers a therapeutic approach targeting the underlying vascular insufficiency associated with ED.

Mechanism of Action

Extracorporeal Shockwave Therapy (ESWT) operates through the application of low-intensity acoustic waves to the penile tissue. These waves induce mechanical stress, leading to a series of biological reactions within the cells.

  • Microtrauma and Inflammatory Response: The acoustic waves produce controlled microtrauma in the tissue. This initiates an inflammatory response, calling upon the body’s intrinsic repair mechanisms.
  • Stimulating Angiogenesis: One key result of this response is the release of vascular endothelial growth factor (VEGF) and other healing growth factors. VEGF, in particular, plays a pivotal role in the process of angiogenesis, which is the formation of new blood vessels from pre-existing vessels.
  • Enhancing Blood Flow: As new blood vessels form, blood flow to the penile tissue is enhanced. This improved vascularisation addresses the vascular insufficiency that is often at the core of erectile dysfunction.

Benefits of ESWT for ED

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    Non-invasive Nature of the Treatment

    ESWT stands out as a treatment option that requires no incisions, medications, or implants. This reduces the associated risks and recovery time seen with surgical interventions, offering patients a safer alternative with minimal discomfort.

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    Duration of the Effects

    After completing the recommended sessions, many patients report sustained improvements in their erectile function. These effects can last for months, depending on individual factors, reducing the need for continuous treatments or medications.

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    Improved Vascular Health

    Beyond its immediate effects on erectile function, ESWT contributes to the overall vascular health of the penile tissue. By promoting angiogenesis, the treatment ensures a better, more consistent blood flow to the area, potentially benefiting other aspects of penile health and responsiveness.

Procedure Details

Duration and Frequency

ESWT sessions for ED typically last about 15 to 20 minutes. The total number of sessions required varies, but a common regimen is 6 to 12 sessions, spread out over several weeks. It’s often recommended that patients undergo two sessions per week, but this can be tailored according to individual needs and response to the therapy.

What to Expect During the Treatment Session

The patient is positioned comfortably, and the targeted area is usually numbed with a local anaesthetic to reduce discomfort. The shockwave applicator is then placed against the skin over the treatment area. Patients may feel a tingling sensation or a light tapping against the skin as the shockwaves are delivered. The procedure is generally well-tolerated, and patients can return to their normal activities immediately after the session.

Potential Side Effects and Risks

Common Side Effects

  • Mild pain or discomfort during the procedure
  • Redness or swelling at the treatment site
  • Minor bruising

Rare but Serious Complications

  • Hematoma or severe bruising
  • Infection at the treatment site
  • Adverse reactions affecting penile sensation or function

Contraindications for the Treatment

  • Patients with bleeding disorders or taking anticoagulant medications
  • Presence of malignant tumours in the treatment area
  • Patients with pacemakers or other implanted electronic devices
  • Active infections in the treatment region

Alternative Treatments for ED


  • Phosphodiesterase type 5 (PDE5) inhibitors: Include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). They enhance the effects of nitric oxide, a natural chemical the body produces that relaxes muscles in the penis, increasing blood flow.
  • Alprostadil: Can be injected directly into the penis or inserted as a pellet through the urethra, leading to an erection.
  • Testosterone replacement: Prescribed for men with low testosterone levels.

Penile Implants

  • Inflatable devices: A pump implanted in the scrotum allows the man to inflate or deflate the implant.
  • Semi-rigid rods: These are firm and can be bent into an erect or non-erect position.

Vacuum Erection Devices

A tube is placed over the penis, and then the pump is used to draw air out of the tube, creating a vacuum. This causes blood to be drawn into the penile tissues and leads to an erection. Once erect, a ring is placed at the base of the penis to maintain the erection.

Get an Accurate Diagnosis & Proper Treatment
for Your Urological Conditions


Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

Our Clinic Locations

Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

3 Mount Elizabeth, #11-16 Medical Centre, Singapore 228510

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

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    Frequently Asked Questions

    What is the success rate of ESWT for ED?

    ESWT has shown positive outcomes in many clinical trials with success rates varying based on the severity of ED. On average, around 70% of patients report improved erectile function after treatment.

    How long do the effects of ESWT last?

    The effects of ESWT can last anywhere from 6 months to 2 years. Duration varies depending on individual factors, including the severity of ED and underlying vascular health.

    Are there any immediate side effects post-treatment?

    Most patients experience minimal side effects. Some may experience mild pain or bruising at the treatment site, but these effects are temporary.

    How does ESWT compare to traditional ED medications?

    ESWT aims to treat the underlying cause of ED by promoting vascular health and improving blood flow, whereas traditional ED medications temporarily increase blood flow. While both can be effective, ESWT offers a potential long-term solution without the need for ongoing medication.

    Is ESWT painful?

    The procedure may cause mild discomfort, but it’s generally well-tolerated. Some clinics use a numbing cream to reduce any potential pain.

    Are there any long-term risks associated with ESWT for ED?

    Current research suggests ESWT is safe with no significant long-term risks. However, as with any medical procedure, it’s important to discuss potential risks with a qualified healthcare provider.