Use of Eswt Therapy in Urology

In recent years, there have been many clinical studies on the use of ESWT therapy in urology. With increasing knowledge and experience, the use of this treatment in daily practice is increasing. In the current treatment of some problems that impair male sexual health, such as erectile dysfunction, chronic prostatitis and Peyronie's disease, ESWT has the safety/effectiveness and cost ratios to be recommended in the guidelines.

Shock wave therapy, also known as ESWT, is a treatment method that is applied by creating high-pressure sound waves outside the body and then focusing on the desired area. European urology guidelines recommend a phased treatment scheme for the treatment of erectile dysfunction in men. In addition to the PDE5i drugs that we have recommended to patients for this problem for many years, ESWT has also found its place among the first-line treatment options. The main reason for this is the high success rates achieved with the right patient selection.

In this treatment for erectile dysfunction, it is applied to different points of the penis to support the formation of new vessels and to provide permanent improvement in impotence. The treatment consists of a total of 6-8 sessions, each lasting approximately 20 minutes. After the application, the patient can continue his daily life. This method has no known serious side effects.

In addition, the main advantages of ESWT therapy are:

- Low-intensity application is preferred so that the treatment can be applied at an effective dose rather than at a level where patients do not feel pain. It does not require hospitalization during the treatment period, it is an outpatient method.

- It is not a surgical method, it does not require anesthesia.

- If the problem recurs, it can be applied again.

In addition, whether the underlying cause of erectile dysfunction is vascular, neural or psychogenic factors; ESWT treatment emerges as a viable option in all cases.

Although it is widely used in men with erectile dysfunction, it has been observed that ESWT application has significantly positive effects on the quality of life in patients with chronic prostatitis (chronic prostatitis). Chronic prostatitis is a disease that is resistant to drugs, difficult to treat, and disrupts patient comfort. This can cause pain in the groin, anus and penis area, as well as burning during urination or ejaculation. Especially in symptomatic periods, 6 sessions of ESWT application provide approximately 70% relief in patients.

Finally, the benefits of ESWT can be mentioned in Peyronie's disease, which is an acquired connective tissue disease of the penis. Peyronie's disease is characterized by the development of inelastic fibrous plaques on the penis. Patients usually have penile pain, penile curvature and erectile dysfunction, which impair quality of life and sexual satisfaction. Many different methods are tried in the treatment. ESWT has also started to take place in the treatment by causing direct damage to the plaque or causing neovascularization (new vessel formation). ESWT performed in 20-minute sessions a week, varying between 6-12 weeks, shows a decrease in penile pain scores, curvature and plaque sizes in Peyronie's disease. This provides a significant increase in the quality of life of patients.

In summary, when we accept that "there is not much to be done" in some cases where we tried different treatment methods maybe 20 years ago, we can now apply the ESWT treatment, which is a method we know to be effective, to our face. patients. We can emphasize that this method should be tried especially in the first-line treatment options of erectile dysfunction.