Treatment Protocol for Erectile Dysfunction with Acoustic Radio Wave Therapy

Current Position of LiSWT in ED Treatment Algorithm

Standard first-line treatments for erectile dysfunction include FDA-approved oral PDE5 inhibitors, which should be offered with proper dosing instructions and titration before considering alternative therapies, as recommended by The Journal of Urology 2, 3
The European Association of Urology guidelines (2025) recommend that LiSWT may be used in men with mild vasculogenic ED (weak recommendation) 1
LiSWT is considered an innovative treatment modality that requires further large-scale, placebo-controlled studies for full clinical validation, according to European Urology 1

A thorough medical, sexual, and psychosocial history is essential, as stated by The Journal of Urology 4
Physical examination and selective laboratory testing should be completed, including morning total testosterone, as recommended by The Journal of Urology and European Urology 2, 1
ED may be a risk marker for underlying cardiovascular disease that requires evaluation, according to The Journal of Urology and Mayo Clinic Proceedings 2, 5

LiSWT may be more effective when combined with other treatments, such as PDE5 inhibitors, vacuum erection devices, or daily tadalafil, as suggested by European Urology 1
Psychosexual counseling should be considered to address psychological factors and improve treatment adherence, as recommended by The Journal of Urology and Praxis Medical Insights 2, 6
Treatment decisions should be made jointly by the physician, patient, and when possible, the partner, considering preferences, expectations, and the physician's judgment, according to The Journal of Urology 7