Should Low-intensity Extracorporeal Shockwave Therapy Be the First-line Erectile Dysfunction Treatment for Nonresponders to Phosphodiesterase Type 5 Inhibition?

Some trials have shown an overall benefit of low-intensity extracorporeal shockwave therapy (LI-ESWT) for erectile dysfunction, while others have been unable to find differences between LI-ESWT and sham treatment. In the absence of definitive evidence, patients should only be offered LI-ESWT in an investigational setting or on an off-label basis with a thorough understanding of the risks and benefits.