1. The “Fast” improvement

Both patients and providers are surprised when there is commonly improvement within days of the first treatment. We can’t grow blood vessels that quickly, so what is going on here?

Shock waves enhance Nitric Oxide by activating the enzyme that allow its creation, in both blood vessels and nerves.  This is similar to the mechanism by which the common ED medications work. Nitric Oxide mediates dilation of blood vessels, giving better inflow.  We therefore postulate that this increase in Nitric Oxide is the reason for the initial benefit of shock wave therapy.

2. The Longer Term Effects

Angiogenesis means “growth of new blood vessels”.  Shock wave treatments create the environment for angiogenesis by increasing levels of Vasoactive Endothelial growth factor (VEGF) and endothelial progenitor cells. This all leads to new smooth muscle, which is needed to line healthy vascular tissue, and that provides elasticity to the tissues. It is akin to rejuvenation, and physiotherapy for your penis.

3. Reduction of  Scar (fibrous) Tissue

Over time, the tissues of the penis become more heavily populated with the connective tissue that occurs in scars(collagen). And less populated with the more elastic smooth muscle. The penis can actually shrink over time from this fibrous tissue build up and loss of elasticity.

Shock Wave therapy has in studies been shown to improve the elasticity of the penis by increasing the elastic tissue, and reducing the relative amount of scar tissue.

From Sexual Medicine Reviews, 2021:

”…it is more than justified to speculate that Low intensity shock wave therapy might be an appropriate method to prevent or at least delay structural changes in the aging penis, (which results in) deterioration of erectile function or penile shrinking”

4. Nerve Recovery/ Regeneration

Studies have shown that after injury, shock wave regenerates the local nerves that feed the blood vessels of the penis, by a number of mechanisms, including increasing the number of cells that line nerves (Schwann cells) and that allow for good nerve function.

From Sexual Medicine Reviews , 2021:

“…results imply that shock wave can be successfully used for regenerative therapy even after tissue and functional damages have occurred after cavernous nerve injury in patients after Radial Prostatectomy”

Anxiety leads to higher “tone” which keeps the penis tight and prevents erections (sympathetic tone). Some men have more permanently elevated “tone, or are more prone to anxiety around sexual function. Shock Wave therapy alters the receptor profile in penis, lowering this sympathetic tone, and allowing for easier relaxation of the tissues of the penis, including the blood vessels.

From Sexual Medicine Reviews, 2021:

“…Shock Wave therapy may be able to decrease the sympathetic activity within the cavernous bodies and finally may facilitate erection in the so- called psychogenic ED patients with an increased sympathetic tone.”


At Ontario Men’s Health, we use Viasure technology from Cynosure, and Storz technology with SD-1 device, to harness the power of all the above mechanisms of action, and to achieve the best possible results for you.