You used more shocks and more energy than I did when I lost my progress.  And I lost all my progress in one session that overdid it.

I checked a shockwave education site and according to the site 3 bar is equivalent to 120mj.

https://www.shockwavetherapy.education/index.php/theory/types-of-shockwave

My suggestion would be to dial back both the energy level and number of shocks.  Most of the published studies of SW for ED used 1500 shocks per session total - 300 shocks in five locations.  4000 shocks per session was the most I saw when I reviewed the abstracts of published studies.

1 bar is twice the energy level I am currently using.  1 bar should be okay, but you should get a result with even less than that.

I hope this round turns out better for you!
 

Last edited by Yobro (9/29/2019 11:00 pm)

Thanks, Yobro and Dick for your replies and suggestions. You have given me a lot to consider!

Looking over your comments and also the settings others seem to be using, I think you are quite correct. I need to back off the energy setting and the number of shocks I am using.

My machine is a pneumatic type, rather than the electromagnetic models most seem to be, so my excuse is that I got a little confused between Bars, Mj and Mj/mm2. Of course, it is always easy to assume that more is better, so I fell into that trap, too.

My SW machine has a built-in ED setting, which suggests:

1000-1500 shocks per area
4-8 sessions of treatment
5-7 day intervals

It doesn’t suggest frequency or energy settings, but the range of available settings is:

500 - 5000 shocks
Frequency 1-21 Hz
Energy 1 - 8 Bar


My lowest energy setting is 1 Bar (90 Mj) so I guess that is what I should use. I have been using 15 Hz for the frequency setting, but see that others seem to go for a lower setting, so maybe I should reduce this to 10 Hz and see how that goes.

My approach so far has been to apply shocks to top, bottom and each side of the shaft, and to left and right crura. I use ultrasound gel and a condom over the treatment head, (15mm convex) and move the head along each area to try to distribute the shocks evenly. Do you think that maintaining the same application pattern, but reducing the number of shocks from 1000 per area (6000 total) to maybe 300-400 (1800-2400 total) would be about right?

During the first round of treatment, I couldn’t really feel much effect during or after treatment, though I would have expected to feel a little sore afterwards. Do you think that is normal?

Dick - regarding my ED diagnosis I have seen two doctors and a urologist, who confirm moderate to severe ED, but without going on to investigate the actual cause. Bear in mind that I am in the UK, where we have a fine but woefully underfunded National Health Service. They tend to go as far as confirming the ED to be of physical origin, after which their only option seems to be pills.

Because the doctors and consultants are under so much financial pressure, it is next to impossible to get them to go further into investigations like this. Basically, if it is not immediately life-threatening, they expect you to live with it.

I did have some surgery in my groin area several decades ago, and I strongly suspect that vascular damage as a consequence of the surgery, plus advancing years may be to blame for my ED. Much of what I have read about venous leakage sounds a lot like my experience of the problem. I have partial success with PDE5 inhibitors, but they don’t always work for me, and my erections have an unfortunate habit of vanishing just when I need them! I do get morning wood sometimes, but it doesn’t last long.

This is why I’m trying the shockwave approach, in the hope of at least improving my erectile function as much as is possible.

Thank you again for your input and recommendations. I welcome any other advice you may have, especially regarding a more realistic and effective treatment program.

Badger

Thanks for your additional comments and advice, Yobro. I'll give it a try at the lower energy settings and at a lower shock count per session. I will probably drop the frequency a bit too - with the lower shock count it won't take any longer per treatment.

I guess we are all feeling our way through these various treatment options, which makes this board extremely valuable to everyone. Like you, I am dismayed at just how inconsistent the protocols are when you start reading up on how the professionals do it. They all seem to have their own approach, and the clinical trials, such as they are, seem equally inconsistent. I am amazed that there is simply nothing definitive on the efficacy of ED shockwave therapy yet. The clinics seem to be doing their own thing and seem more than a little guarded about the details of what exactly it is that they are doing.

I'm also working on my general health. I've upped my exercise (walking and cycling mainly) and try to eat well and get as much sleep as I can. I have done this for a few years in the hope of raising my testosterone to a decent level. I was badly hypogonadal, and I've been on TRT for a couple of years now. I now care that I have ED, whereas a few years ago I felt so bad that I couldn't care less. TRT has helped my general health and wellbeing a lot, but has not done anything to help the ED.

Like you, I'm convinced that my ED is multi-factoral, and I've been trying to nail the specifics for several years. I'm pretty certain that mine is not psychological in origin, though suffering from ED does bring psychological pressures.

Your comments about your stubbornness made me smile - it pretty much exactly describes my own determination over the past few years (and yes, I get the same sort of comments about stubbornness from my long-suffering SO).

This is a journey that we would all prefer not to have to be on, but nobody wants to accept defeat, so we all keep going. I've tried pumps and all the gizmos that looked like they might help, plus any number of pills and supplements, and none of it has worked for me. Shockwave therapy is the first strategy I have encountered that claims to work on the cause of ED, rather than trying to mitigate the symptoms, so I'm definitely going to keep trying.

Fingers crossed!

 

Thanks for your suggestion, maomao, but as I understand it, shockwave treatment works by causing micro tears in the tissue, which then encourages healing and the formation of new blood vessels. This neovascularisation process is supposed to take 2 or 3 weeks from what I have read, with continuing improvements for some weeks after that.

That said, I see that you have had some improvement quite soon after treatment, and I have read elsewhere that some men claim significant beneficial effects after just one or two sessions. I guess we are all different, and probably respond differently based on the nature of our specific ED cause.

Others have commented that their ED actually got WORSE right after treatment, but that it improves once the course of treatment and a healing period is complete. The problem is, of course, that if nothing happens in a couple of days, or a couple of weeks or a month or more, does this mean you are still in the ‘healing’ phase, or simply that it didn’t work?

In my case, I can’t discern any improvement a month on from my first course of treatment (and I have been ‘testing’ the results) so I’m interpreting that as a fail. It looks like I may have been using way too much energy and applying too many shocks during my first round of treatment, so may have done more harm than good. Yobro and Dick have both suggested that I should proceed at a lower level, so I’m now planning to back off and apply fewer shocks at lower energy to see if this is a better approach.

Thanks, and good luck with your continued treatment.