Low intensity shock waves in urological problems

Low intensity shock waves in urological problems

by | Sep 7, 2018

Dr. Juan C. Gonzalez and Alejandro Lira, are now at the forefront of our urolgy program A Better Man by JLPrado Surgical Center.

In the different stages of our lives, marked by age, some pathologies are manifested. In the case of men, perhaps the most significant are urological ones, and can be registered after the age of 30; premature ejaculation, infertility, prostate cancer, enlarged prostate, and erectile dysfunction (usually, after 40 years) are some of these pathologies.

In the decade of 30 years of age, the enlargement of the prostate (benign hyperplasia) can happen asymptomatically until it becomes more serious. Equally, for those of 30 to 40 years of age, the most common urological disease is infertility and after this age it is erectile dysfunction, a condition that derives from other organic disorders such as diabetes, hypertension, arteriosclerosis and/or ischemic heart disease.

In the urology program A Better Me by JLPrado Surgical Center, a solution is given to all the pathologies of this specialty that range from functional to kidney, prostate, and bladder cancer, kidney stones in the bladder, outpatient surgery, circumcision and vasectomy, all that is the urinary tract of men as well as women and the genital tract of men.

There are groups of patients with erectile dysfunction whose causes are very variable. Organic alteration, diabetes, cholesterol and/or high triglycerides, cardiovascular or hormonal problems such as decrease in testosterone, causes that give rise to problems of dysfunction.

There is another group of patients, also numerous, who do not suffer from any of these conditions. However, their sexual function is not normal or satisfactory.

In these cases, the physical condition, the psychic, nutritional, emotional or socioeconomic aspect may be an influence. Unhealthy eating habits, bad sleeping habits, lack of exercise, and stress from work and/or a relationship may also be factors at play.

There are also other patients with these pathologies but whose origins are combined, that is, between the organic and the psychological.

We started looking for new cutting-edge alternatives available in the market and that’s how we started—through a device manufactured in Israel called Renova, and produced by the company Tairex, pioneers in shock waves.

In urology, high-intensity shock waves for the destruction of intrarenal liters have been in use for about 50 years, but only until a few years ago medium intensity shock waves were used to help patients with orthopedic problems (tendonitis) that helped reduce inflammation.

Later, when they also began to apply this type of wave with transducers in cardiological problems, they realized that they favored the formation of new arteries and blood vessels in those who had suffered a heart attack, thereby improving their vascularity and their condition.

And it was in this way that the company decided to transplant the technology into urology, where a transducer is used at the level of the body of the penis and at the bottom of it, in the perineum, to produce this same reaction of angiogenesis (formation of new blood vessels), small capillaries, which have the singularity of improving the oxygenation of the corpus cavernosum to strengthen erectile function—the same objective, of course, of oral medication.

The difference between what we intend to offer and the medications is that they improve blood flow at the time they are ingested, but when the reaction passes, the dysfunction returns. In the case of the Renova machine, it is intended to leave a treatment which will, if not cure, improve the dysfunction to a greater degree.

There are statistics that indicate that 30% of men over 40 years of age register changes in the firmness of the erection and this makes it possibly not an important dysfunction but it affects their quality of life.

It is important to take into account that the population is very varied, there are those with 46 years of age who have a mild dysfunction and suddenly there are also those of over 70 years—there are no homogeneous groups.

The candidate to treat with the machine is the one who presents some improvement with any of the other existing therapies. If with the medicinal treatment there is an erection, the patients are more likely to respond to the machine.

For a patient who has no reaction to medicine and in 10 years or less has not had any results with any other treatment, he will not respond to the machine either. There is no full guarantee that if you deal with the machine there will be a full reaction.

The treatment is applied 4 times, once a week, although there have been those who have made an important advance in their problem since the second time. The treatment has no contraindications and is not painful, with many saying they do not feel anything.

After treatment there is no bleeding, bruising or inflammation. It is a safe procedure, even in patients with a pacemaker. There are no contraindications.

Regarding the cost of the treatment, it is relatively expensive, depending on the patient’s stay and his preferences, but it is not more expensive than some other options, such as the implantation of stem cells or the placement of a prosthesis in the penis, which may be the last option to alleviate severe cases, but it is 5 times more expensive than that of our shock wave machine.

When it comes to implants, there is no turning back. The penile body is destroyed on the inside when placing the device, but it is a very efficient tool, a product of the advancement of science and technology.

At the cardiological level, intermediate shock waves are used, however, in Renova a transducer at a linear level is used so it covers more space in the cavernous body, unlike those transducers used in other places.

The treatment is done in a physical examination room without having to go to the operating room. The patient is placed in a lithotomy position (as is the examination done by women gynecologists), and the transducer is placed under the testicles.

With the machine, 1,600 punches are administered on both sides of the perineum below the testicles, then the device is placed above the body of the penis and 900 strokes are given on both sides.

The treatment is 45 minutes from the beginning until its end—and the patient leaves as he arrived, walking and without discomfort. There is no fasting, no trauma or hospitalization.

This process is repeated once during the following three weeks to complete the treatment and the results begin to be observed 6 weeks after initiation.

It is a practical and simple procedure to administer. It does not require specialized personnel, and it is provided by them to familiarize themselves with the response.

This new treatment is used in Spain, Brazil and in the Mexican city of Guadalajara where it has had very good results. In the United States, the Renova machine is under review by the FDA.

This procedure is recommended because it is a very noble therapy and with time it will be adopted as another option by urologists for this type of treatment. It is not a miraculous machine but it does meet its objective: improve the quality of life of patients and their sexual activity.