Enf. Renato Gonçalves

Specialized Exams

Enf. Francisco Martins

Specialized Exams

Low-intensity shock wave therapy  
In erectile dysfunction

HPA Magazine 21 // 2024

“This has never happened to me before!"
This can be seen as one of the most common responses given to the awkward situation in which a man is haunted by the "ghost" of erectile dysfunction. More than a misfortune, impotence involves cultural values related to the expectations of sexual behaviors for both men and women.
Only at the end of this century did pharmacological solutions begin to emerge, such as Viagra®, Uprima®, Cialis®, and Levitra®, which became crucial in combating erectile dysfunction. However, while solving the "x" of the issue, these medications affected the practices of both young and old individuals.
From these "side effects," more and more cases have emerged, proving that the inability to complete intimate relations results in fear, decreased self-confidence, loss of self-esteem, and depression. The instant power of the remedy, in some cases, tends to distance affection and concern for health in achieving an "enviable" sexual performance.

Demystifying the "ghost"...
An epidemiological study conducted in Portugal observed that the overall prevalence of any type of sexual dysfunction reached 23.9% of the male population between 18 and 75 years old. Of these, about 13% showed some degree of erectile capacity loss.
As erectile dysfunction is a very common condition, it is necessary to look at this condition from the perspective of normalizing and resolving the problem, like any other ailment, and never as a reason for exclusion and discrimination.
According to the 4th International Consultation on Sexual Medicine, held in 2015, erectile dysfunction is defined as "the constant or recurrent inability to obtain or maintain a penile erection capable of achieving sexual satisfaction."
Previously considered a psychological disease, nowadays, this pathology is recognized as a result of both biological and psychological factors, sociocultural influences, pathological conditions, and also as a possible consequence of the use of certain therapies and recreational drugs.
One of the causes of erectile dysfunction is Peyronie's disease, which manifests as the development of scar tissue inside the penis, resulting in curved and often painful erections, causing erectile dysfunction.
The cause of Peyronie's disease is not completely known; however, there are some factors that increase the risk of developing scar tissue around the penis, such as biological, pathological factors, or, most frequently, some trauma to the penis from a sexual act.

The treatment...
The introduction of low-intensity shock wave treatment has brought great hope for resolving erectile dysfunction and Peyronie's disease.
This new and innovative treatment aims to restore the erectile mechanism so that men have the possibility of having erections without the need for medication, even allowing the cure of this dysfunction.
Thus, considering these results, low-intensity shock wave treatment is considered in the guidelines of the European Association of Urology as a first-line therapy in the treatment of erectile dysfunction.
How does the treatment work?
Low-intensity shock waves are sound waves that promote local microtraumas, leading to the creation of new blood vessels as a consequence of these microtraumas. These promote the supply of proteins in that area, stimulating the formation of new blood vessels (neovascularization) from the preexisting capillary network, thus improving erection and penile rigidity.
Shock wave therapy restores spontaneous erections, recovers erectile tissue in the cavernous bodies, and does not interact with other medications.
The results of the treatment are achieved gradually, where the patient's trust in healthcare professionals and the effectiveness of the treatment are essential. Patience, resilience, adherence to treatments, and a commitment to follow all therapeutic indications proposed by the doctor and nurse are crucial for the results and success of this intervention.
We share the opinions of some patients who have successfully completed the treatment regarding the treatment and the team that accompanied them:
"I am 70 years old and was diagnosed with Peyronie's disease. I underwent low-intensity shock wave treatment. I had 10 sessions with Nurse Renato Gonçalves at HPA, and the result exceeded my expectations."
"I just completed a 5-session shock wave treatment, and I felt an improvement after the 3rd treatment. At this moment, I feel normal like when I was young. Nurses Renato and Francisco are excellent people; they know how to talk to patients and make them feel at ease. I was satisfied with the treatment and undoubtedly recommend it."
"I am 46 years old, suffer from erectile dysfunction, and underwent treatment with Nurses Renato and Francisco, which worked perfectly. It is a treatment that does not cause pain. I was very well treated, and the various processes throughout the treatment were explained to me."
In summary, sexuality is a central aspect of human life, being a relevant parameter in assessing the quality of life. 
Erectile dysfunction and Peyronie's disease are directly linked to sexuality, which can have a negative effect on overall health, as the inability to complete intimate relations results in fear, decreased self-confidence, loss of self-esteem, and depression.
We can affirm that this treatment is undoubtedly the best solution for a problem that affects more than 150 million men worldwide, where often the main difficulty is taking the first step to undergo treatment. Low-intensity shock wave therapy for erectile dysfunction is performed at the HPA Saúde Group, at the Hospital de Gambelas. Treatment can be scheduled through the email examesespeciaishpaf@grupohpa.com or by calling +351 967 178 009 (weekdays from 9h00m to 18h00m).
After scheduling, a consultation is conducted with the referring urologist, who evaluates the patient and prescribes the indicated treatment. 
This is done weekly, and each session lasts 30 to 40 minutes. It is non-invasive, painless, and does not require any preparation, sedation, or anesthesia.