Focused shockwave therapy for erectile dysfunction
Erectile dysfunction is common, treatable, and rarely talked about. Around half of men between 40 and 70 experience it at some point, and most never raise it with a clinician. At Pelvix we offer focused shockwave therapy (LiESWT) as a non-invasive, drug-free treatment for erectile dysfunction of vascular origin and ED following prostate surgery. The treatment is delivered in our private clinic by a specialist pelvic health physiotherapist. No GP referral is needed.
What is focused shockwave therapy for ED?
Focused shockwave therapy uses low-intensity acoustic pulses to stimulate the formation of new blood vessels and improve blood flow to the penile tissue. Better blood flow tends to mean firmer, more reliable erections. A handheld probe is applied to the shaft of the penis and the perineum. Sessions are short — usually around 20 minutes — with no need for anaesthetic, no needles, no medication and no recovery time. Most men return to normal activity straight away.
We use the Storz Medical Duolith® SD1 T-TOP ultra — a research-grade focused shockwave platform built specifically for urological use. Focused shockwave is the device class used in the published clinical evidence, and it is meaningfully different from the cheaper “radial” pressure-wave devices marketed for similar purposes.
Who is it suitable for?
Focused shockwave is most likely to help if you have:
- Mild to moderate vascular (blood-flow related) ED
- ED following prostate surgery
- ED that responds only partially to PDE5 inhibitors (Viagra, Cialis) and you would like to reduce or stop relying on them
- ED related to pelvic pain
- Peyronie’s disease — primarily to address pain and curvature
It is less suitable for ED that is primarily psychological, hormonal or neurological in origin, or for severe ED where surgical options are being considered. Read more about ED in this blog post
Part of the first appointment is working out whether shockwave is the right starting point for you — or whether something else (pelvic floor rehabilitation, lifestyle changes, onward referral) would be more appropriate.
What does the evidence show?
Focused shockwave therapy is the only non-invasive ED treatment currently included in the European Association of Urology 2025 guideline. A 2024 Bayesian network meta-analysis of 1,272 men found a mean improvement of around 4.9 points on the standard erectile-function questionnaire (IIEF) when using the focused energy density our protocol delivers. Improvements typically emerge gradually over six to twelve weeks and last in the order of six to twelve months. Some men experience substantial improvement, some experience modest improvement, and some do not respond. We will be honest with you about what we are seeing as the course progresses.
What happens at your first appointment?
During your first appointment, we will:
- Take a full history — medical, sexual, lifestyle, medications
- Discuss your goals openly and without judgement
- Carry out a physical assessment, which may include an examination of the pelvic floor where it is clinically relevant — only with your full consent
- Talk through whether focused shockwave is the right option, what realistic outcomes look like, and the proposed treatment plan
- If you agree that shockwave is the right plan, begin the first treatment in the same appointment
You will not be asked to commit to a full course of treatment in the room. We are happy for you to go away and think about it.
How many sessions will I need?
The standard protocol is six sessions, delivered once or twice per week over three to six weeks. Each follow-up session takes around 20 minutes. Some men need 12 sessions, particularly those with other health issues, i.e diabetes. We review progress part-way through the course and again at three months post-treatment. Some men benefit from a top-up session at six or twelve months — we discuss that on an individual basis rather than selling it up front.
What does it cost?
New assessment (includes shockwave if agreed)
£230
Follow-up session
£168
Course of six (1 new assessment + 5 follow-ups)
£1,025
Can shockwave be combined with other treatments?
Yes — and often this is the most effective approach. Focused shockwave can be combined with:
- PDE5 inhibitors (Viagra, Cialis) — you do not need to stop these during treatment
- Pelvic floor physiotherapy — particularly relevant after prostate surgery
- Lifestyle changes — cardiovascular health, sleep, weight, alcohol, smoking
- Psychosexual support — we can recommend trusted practitioners locally
ED is rarely caused by a single factor. Addressing the contributing factors alongside shockwave usually produces better results than shockwave alone.
Does it hurt?
Most men describe focused shockwave as a tapping sensation that is mildly uncomfortable rather than painful. The energy level is adjusted to your tolerance and we build up gradually. No anaesthetic is needed.
Is it safe?
Focused shockwave therapy has an excellent safety record. The published trials report no serious adverse events. Minor short-lived effects (mild bruising, transient skin redness) are uncommon.
How soon will I notice a difference?
Most men notice changes between four and twelve weeks after starting treatment. Effects can continue to develop for several months after the final session.
Will I need to take Viagra forever afterwards?
Not necessarily. Many men reduce or stop PDE5 inhibitors after a course of shockwave. Some continue to use them occasionally. We will help you find what works for you.
Is it covered by private medical insurance?
At present most UK private insurers do not reimburse shockwave for ED, as it is still classed as an emerging therapy. We are happy to provide itemised invoices for you to submit, but we recommend assuming this will be self-funded.
Is the appointment fully confidential?
Yes. We are bound by the HCPC and CSP codes of professional conduct. Your records are kept securely and nothing about your visit is shared with your GP unless you ask us to write to them.
Do I need a GP referral?
No. You can self-refer.
Let’s talk it through, when you’re ready
If you would like to talk it through first, the free 15-minute introductory call is the easiest place to start. No commitment, no pressure. If you would rather go straight to a consultation, you can book online.