It is still not clear what radial waves mechanism of action is for the treatment of erectile dysfunction. 12, 13, 14 Radial waves are low-pressure waves generated by the impact of two bodies, usually induced by pneumatic pressure, whereby they produce lower peak energy than shock waves. Shock waves have been used in medicine since the late 1970s and early 1980s and are defined as sound waves produced when waves propagate “through a medium at a speed faster than the speed of sound travels through that medium.” 11 In focused and linear versions, shock waves have been evaluated for treating erectile dysfunction in clinical studies and animal models, showing beneficial results in erectile tissue, including increased levels of nitric oxide synthase (NOS) of endothelial and nervous origin, increased production of endothelial growth factor, the local recruitment of stem cells and Schwann cells, and the appearance of long-term neovascularization. However, since 2010, shock waves have been evaluated as a new therapeutic option due to a large amount of evidence from cohort studies, controlled clinical trials, and meta-analysis 4, 5, 6, 7, 8, 9 suggesting that this type of wave generates benefits in some groups of patients with this disease and showing how the waves could act on the physiopathology of the dysfunction. 1, 2, 3 The treatment of erectile dysfunction typically focuses on obtaining an erection through pharmacological or even surgical mechanisms. Erectile dysfunction is a highly prevalent pathology in the entire male population, with a tendency to increase in the frequency of presentation as age increases.
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