News — April 6, 2022 – As increasing numbers of men seek treatment for erectile dysfunction (ED), many clinics are marketing non-FDA approved Shockwave Therapy (SWT) intervention – with wide variations in techniques, provider costs and referrals, based on an analysis of Urology practice®an official journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

“Shockwave therapy, as a restorative therapy for erectile dysfunction, is performed mostly by non-urologists and is not standardized,” reports the study by James Weinberger, MD, MBA, Sriram V. Eleswarapu , MD, PhD, and colleagues from the David Geffen School of Medicine at UCLA. “This study highlights concerning trends in major metropolitan markets, given the substantial financial impact for patients and inconsistent referrals between providers.

Variable costs and protocols for “experimental” ED treatment

Shockwave therapy is marketed directly to consumers to the growing number of men suffering from sexual dysfunction due to erectile dysfunction. In this treatment, targeted sound waves are used with the aim of improving blood flow and increasing erectile function.

Drs. Weinberger, Eleswarapu and colleagues analyzed information from 140 clinics advertising SWT for the treatment of erectile dysfunction in eight major US cities. Using a “secret shopper” approach, researchers made phone calls to gather information about the credentials and training of providers performing SWT, as well as prices, duration, and protocols of SWT treatments. .

Only 25% of clinics offering SWT were urologists – specialists in the treatment of male reproductive problems. Other specialists performing SWT treatments included dermatologists, chiropractors, and obstetricians/gynecologists. Non-physicians, such as physician assistants or nurse practitioners, performed SWT in 13% of clinics.

Based on information from 99 clinics, the average price per SWT treatment was approximately $490, with a total price of $3,400 for a full treatment. Prices varied widely for clinics in different metropolitan areas.

The most commonly recommended number of SWT treatments was six. However, there was no standardized approach for the SWT treatment of erectile dysfunction. “[T]The number of shocks per session, the type of device used, and the frequency settings varied considerably,” the researchers write.

There is growing interest in SWT and other regenerative therapies that seek to “cure” erectile dysfunction, rather than just treating it. Although some preliminary data supports this line of research, there is a lack of high-quality evidence supporting the widespread use of SWT (or other treatments like protein-rich plasma or stem cell injections) for the treatment of erectile dysfunction.

In the absence of clinical trials demonstrating its long-term effectiveness, SWT has not been approved by the FDA for the treatment of erectile dysfunction and is not covered by insurance. In its guidelines for the treatment of erectile dysfunction, the AAU designates SWT as an “experimental” treatment that should be limited to research trials.

“Our results show that real-world practice does not adhere to these recommendations,” said Drs. Weinberger, Eleswarapu and his colleagues write. They believe that patients exploring treatment for erectile dysfunction “should be evaluated by urologists who are equipped to perform a formal men’s health assessment and provide a data-driven, patient-centered discussion of treatment options” .

Click here to read “Shockwave Therapy for Erectile Dysfunction: Marketing and Practice Trends in Major United States Metropolitan Areas”.

DOI: 10.1097/UPJ.0000000000000299

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On Urology practice

An official journal of the American Urological Association (AUA), Urology practice focuses on clinical trends, challenges and practical applications in the four areas of business, health policy, specialty and patient care. Information that can be used in daily practice will be provided to the urological community via peer-reviewed clinical practice articles (including best practices, reviews, clinical guidelines, selected clinical trials, editorials and books white papers), “research letters” (short original studies with an important clinical message), the affairs of urology practice, health policy issues in urology, education and training in urology, as well as content for members of the urology care team.

About the American Urological Association

Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is one of the leading advocates for the specialty of urology and has more than 23,000 members worldwide. The AAU is a leading urological association, providing invaluable support to the urological community in pursuit of its mission to foster the highest standards of urological care through education, research and formulation of health care policy. health. To learn more about the AAU, visit: www.auanet.org

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