Using shockwave therapy starts first with having the correct technology.
Understanding Focused vs. Radial is most important.
But it's clear that technique also plays a critical role in determining success in treatment.
You can't just hold the wand on the plaque for Peyronies Disease - you have to go at it from different angles, targeting different areas, etc.
Like anything - there are crafty and advanced techniques for sending shockwaves to the right place (at the right frequency, correct EFD, etc.), correct numbers of shocks, frequency per week/month, etc..
Does anyone have any ESWT techniques that they are willing to share?
Be they for ED, Peyronies Disease, CPPS?
Thanks!
Let me get this straight:
You are running an ESWT clinic and ask some guys in a forum about the proper technique on how to use it?
I don't operate the equipment - I have an MD who is a vascular surgeon who is great at it.
But like any practice - there are the experiences of others which we cannot discount.
We don't know it all.
We've treated hundreds upon hundreds of men and spoken to thousands.
There is no perfect solution. Sharing information is how we can all improve.
How would you use the feedback though , you can't really risk to try something just because someone here suggested it...
FocusWavesClinic, so you came here to this forum saying that all the guys that are using your incredible machines got better, now you are asking random guys with no Medical degrees for advise on how to use the Waves?, Do you really have a clinic or you are just a sellsman?
Quote from: projectpd on January 14, 2023, 10:44:46 AM
How would you use the feedback though , you can't really risk to try something just because someone here suggested it...
Medicine is a practice.
Shockwave technology is continuing to expand and there is both an art and a science to it.
And thus if we want to be forever students of the human body and to continue to increase our knowledge about medical technology, it behooves us to always seek to improve our skills by practicing what we do.
Wouldn't you agree?
I have no idea who is on this forum.
Could be 100 guys with ED/Peyronies Disease - Could be some clinic owners - could be some Pharma reps - could be some pervs - could be some shockwave technicians.
That's why I'm asking.
Quote from: Bud luck on January 14, 2023, 11:06:17 AM
FocusWavesClinic, so you came here to this forum saying that all the guys that are using your incredible machines got better, now you are asking random guys with no Medical degrees for advise on how to use the Waves?, Do you really have a clinic or you are just a sellsman?
Is this really what you took away from my posts?
Did I ever say 'all the guys got better'?
Cmon dude - I know you are frustrated with things but you aren't thinking clearly by making these comments.
I'm not asking YOU how to use shockwave.
I'm asking anyone out there who has experience administering them if they are willing to share and discuss technique and openly discuss this evolving technology.
Quote from: FocusWaveClinic on January 14, 2023, 03:44:27 PM
Medicine is a practice.
Shockwave technology is continuing to expand and there is both an art and a science to it.
And thus if we want to be forever students of the human body and to continue to increase our knowledge about medical technology, it behooves us to always seek to improve our skills by practicing what we do.
Wouldn't you agree?
No, it's not clear how one can risk "practising" to improve your skills. What is your take on the study (20) in your 2nd reference, that said,
Penile deviation was not reduced by ESWT (P=0.66) but worsened in 20/50 (40%) and 12/49 (24.5%) patients of the ESWT and placebo-group, respectively (P=0.133). Plaque size reduction was not different between the two groups (P=0.33). Additional, plaque size increased in five patients (10.9%) of the ESWT group only.
Quote from: FocusWaveClinic on January 14, 2023, 03:44:27 PM
I have no idea who is on this forum.
That's why I'm asking.
that was why *I* was asking
If these studies prove that ETSW are not helping anyone and made it worse to some, why are there still clinics all over the world promoting the Shockwaves for penis fibrosis?, why nobody is holding accountable for lying and damaging we sufferers of this awful disease?I got damaged twice and they all denied any wrong doing, so many lies on the Medical business.
Quote from: FocusWaveClinic on January 14, 2023, 03:55:08 PM
I'm asking anyone out there who has experience administering them if they are willing to share and discuss technique and openly discuss this evolving technology.
There is no magic technique to it I guess.
I suggest you refer to the manufacturer of your device who should offer training for this
Maybe, find out the details of the technique used in that study ( Hatzichristodoulou 2013) and make sure not to use anything too similar. E.g. What was the focal point depth and maximum energy flux. Was the device focused only in the plaque or could other areas have been included.
Peyronies is I think, thought to possibly result from a pathological inflammatory cascade, yet the proposed mechanism of ESWT is thought to involve inflammation and i believe ED patients are supposed to avoid anti inflammatories such as NSAIDs . What advice would you propose... what was the advice for the Hatzichristodolou study.
You referred to, radiative ESWT negatively, but the Gainswave content describe it as safer than focused. Presumably focused by definition could direct higher energy into a healthy area and so have more potential for damage. how do you address this?
Quote from: projectpd on January 15, 2023, 12:53:43 PM
Peyronies is I think, thought to possibly result from a pathological inflammatory cascade, yet the proposed mechanism of ESWT is thought to involve inflammation and i believe Erectile Dysfunction patients are supposed to avoid anti inflammatories such as NSAIDs .
ProjectPD, I feel like from previous penile injuries I have healed better and faster when not taking NSAIDS but interestingly Dr. Trost says there is weak evidence for their us. So who really knows. But they have been shown to have a depressant effect on wound healing while simultaneously decreasing the granulocytic inflammatory reaction. So the trade off is to decrease inflammation but slow wound healing.
Also, the guy asking patients how to do ESWT is 2nd funniest thread after the cabbage leaf thread lol
Quote from: projectpd on January 14, 2023, 07:39:22 PM
No, it's not clear how one can risk "practising" to improve your skills. What is your take on the study (20) in your 2nd reference, that said,
Penile deviation was not reduced by ESWT (P=0.66) but worsened in 20/50 (40%) and 12/49 (24.5%) patients of the ESWT and placebo-group, respectively (P=0.133). Plaque size reduction was not different between the two groups (P=0.33). Additional, plaque size increased in five patients (10.9%) of the ESWT group only.that was why *I* was asking
sorry can you link the study?
I think he refers to this study:
https://pubmed.ncbi.nlm.nih.gov/23898925/ (https://pubmed.ncbi.nlm.nih.gov/23898925/)
QuoteConclusions: Despite some potential benefit of ESWT in regard to pain reduction, it should be emphasized that pain usually resolves spontaneously with time. Given this and the fact that deviation may worsen with ESWT, this treatment cannot be recommended.
I saw Dr. Hatzichristodoulou in person, he has done a lot of Peyronie's research and may be the most experienced Peyronie's surgeon in Germany/Europe. He is skeptical about eswt, but it is not all black and white. It didn't help me though...
I already referred exactly to the study linked in his own references , if he has no clue about what he's posted or has no interest it, it does no good for us to provide the link.
Interesting Blex, did you get the impression he was skeptical from before his study or after it ?
FocusWavesClinic came to the forum saying that his waves were making men with penis fibrosis better, then he changed his mind and said that some men get better, then he is asking for advice to random guys on the forum on how to use the ESWT, then.....
yep ;-)
Haha Idk about ESWT but I think I'll add FocusWave clinic on things NOT to try.
Quote from: projectpd on January 15, 2023, 12:53:43 PM
Maybe, find out the details of the technique used in that study ( Hatzichristodoulou 2013) and make sure not to use anything too similar. E.g. What was the focal point depth and maximum energy flux. Was the device focused only in the plaque or could other areas have been included.
Peyronies is I think, thought to possibly result from a pathological inflammatory cascade, yet the proposed mechanism of ESWT is thought to involve inflammation and i believe Erectile Dysfunction patients are supposed to avoid anti inflammatories such as NSAIDs . What advice would you propose... what was the advice for the Hatzichristodolou study.
You referred to, radiative ESWT negatively, but the Gainswave content describe it as safer than focused. Presumably focused by definition could direct higher energy into a healthy area and so have more potential for damage. how do you address this?
Radial or acoustic waves aren't BAD - they just aren't very useful for sexual dysfunction conditions. Plus they are painful and require numbing creams for a majority of patients (this is what I've heard from other clinics using these devices to treat ED and Peyronies Disease).
That's because radial cannot achieve the depths required to create the neovascularization required, or the power required to safely break up plaque/scar tissue.
This is the mistake that most men make - they don't do the research to realize that these cheap devices are mostly ineffective in treating ED/Peyronies Disease.
Even focused, while generally painless and side effect free, is not a guarantee that it will improve your condition.
I have zero experience in hearing patients getting worse post treatment. Perhaps unchanged, but not worse.
I think there is always risk to damage healthy areas with poor technique but as the treatment itself if regenerative, it seems highly unlikely.
Quote from: projectpd on January 17, 2023, 05:42:46 PM
I already referred exactly to the study linked in his own references , if he has no clue about what he's posted or has no interest it, it does no good for us to provide the link.
I didn't link this study.
Probably not enough shocks - only 2,000 per treatment. This is about half of what we use in our clinic per treatment.
Quote from: Trapper on January 15, 2023, 01:40:57 PM
ProjectPD, I feel like from previous penile injuries I have healed better and faster when not taking NSAIDS but interestingly Dr. Trost says there is weak evidence for their us. So who really knows. But they have been shown to have a depressant effect on wound healing while simultaneously decreasing the granulocytic inflammatory reaction. So the trade off is to decrease inflammation but slow wound healing.
Also, the guy asking patients how to do ESWT is 2nd funniest thread after the cabbage leaf thread lol
LOL - I'm not asking how to do it.
You do realize that medical professionals share information, technique, strategy, etc.
I guess these forums don't have any such professionals...
Quote from: projectpd on January 17, 2023, 05:51:39 PM
Interesting Blex, did you get the impression he was skeptical from before his study or after it ?
I honestly can't comment much on this. Had an appointment for 30 mins and we mostly talked about surgery.
But it should be noted that he did a meta-analysis in 2019 about ESWT for ED Treatment with following positive result:
QuoteIn conclusion, the present meta-analysis provided results showing that LI-ESWT significantly improves erectile function in patients with vasculogenic ED.
So it seems he does not think ESWT is damaging per se. So always remember to take single studies with a grain of salt, this goes in either direction.
Quote from: FocusWaveClinic on January 19, 2023, 08:11:45 PM
LOL - I'm not asking how to do it.
You do realize that medical professionals share information, technique, strategy, etc.
I guess these forums don't have any such professionals...
I wish you and especially your patients all the success in the world.
But to be honest, your demeanor does not inspire confidence.
Quote from: blex on January 20, 2023, 08:53:37 AM
I wish you and especially your patients all the success in the world.
But to be honest, your demeanor does not inspire confidence.
All I want is to help. Honestly.
My demeanor has been clear - I'm not pushing some magic beans here - and I'm ok with being attacked by frustrated guys - I can handle it. I talk with hundreds of them every month.
Continuing this topic is not going anywhere and I think points on EWST have been made. I am going to lock this topic from further posting and any further contacts can be made through personal messages.