The combination of low-intensity shockwave therapy (SWT) and leukocyte-poor platelet-rich plasma (PRP), supplemented with short-term daily Cialis, is a safe and effective treatment that improves erectile function in men with mild to moderate erectile dysfunction.

Patients aged 30–60 years with mild to moderate ED were enrolled. All participants received six weekly treatment sessions. Each SWT session delivered 3,000 shocks distributed as follows: 1,000 shocks to the left penile corpus, 1,000 to the right penile corpus, 500 to the left penile perineal crus, and 500 to the right penile perineal crus. In addition, patients were prescribed Cialis 5 mg daily throughout the treatment period and discontinued the medication at therapy completion. PRP was prepared using Regen Lab technology; during the first session immediately after SWT and the final (6th) session, 6 cc of leukocyte-poor PRP (3 cc per side) was injected distally following a 10-minute tourniquet application at the penile base. Patients were followed for a median of 3.5 months, with the primary outcome measured as change in the International Index of Erectile Function (IIEF) score.

Initial results indicate an improvement in IIEF scores from baseline, with the combination therapy demonstrating a positive trend in erectile function. Importantly, no adverse effects were observed—specifically, there were no declines in erectile function, nor were there any instances of new scarring or plaque formation.

The combination of focused SWT and leukocyte-poor PRP appears to be a safe and effective treatment option for men with mild to moderate ED. However, the long-term durability of the therapeutic effect remains unknown and requires further investigation.

The combined use of SWT and leukocyte-poor PRP, supplemented with short-term daily Cialis, appears to be a safe therapeutic option that can enhance erectile function in patients with mild to moderate ED. These promising initial findings warrant further investigation in larger, controlled studies to validate efficacy and long-term outcomes.

Giezen, R.B., Chung, E. & Ramasamy, R. Individualised shockwave therapy for erectile dysfunction: importance of establishing precise therapeutic range. Int J Impot Res (2025). https://doi.org/10.1038/s41443-025-01028-3
Mason, Matthew M., et al. “Low-Intensity Extracorporeal Shockwave Therapy for Diabetic Men with Erectile Dysfunction: A Systematic Scoping Review.” Andrology, vol. 11, no. 2, 8 June 2022, pp. 270–281, https://doi.org/10.1111/andr.13197. Accessed 31 Mar. 2023.