Department of Urology, University of Miami, Miami, FL, USA.
Department of Urology, University of California at Davis, Davis, CA, USA.
Sex Med Rev. 2020 Jan;8(1):100-105. doi: 10.1016/j.sxmr.2019.09.004. Epub 2019 Nov 14.
Over the past decade, low-intensity extracorporeal shockwave therapy (Li-ESWT) has emerged as a treatment modality for erectile dysfunction (ED). To better appreciate the differences between the various devices for the treatment of ED, it is imperative for physicians to understand the underlying physics of the different shockwave generators.
In this article, we explain the physics of shockwaves by establishing a foundation regarding the basics of waves, specifically soundwaves. We also describe the different shockwave generators available and assess their potential clinical utility.
We reviewed basic principles of wave propagation, randomized controlled trials investigating Li-ESWT for ED and other medical diseases, and individual industry shockwave generator websites, in order to describe the basic physics underlying Li-ESWT.
We primarily aimed to describe the physics underlying shockwave generators and to provide a framework for understanding the relevant subtypes and adjustable parameters.
A wave is a disturbance in a medium that transports energy without permanently transporting matter. In shockwaves, a soundwave is generated with a speed faster than the local speed of sound. Shockwaves are classically generated by three different types of energy sources: electrohydraulic, electromagnetic, or piezoelectric, which all create a shockwave through the conversion of electric potential energy to mechanical energy. Importantly, radial pressure waves do not behave the same as conventional shockwaves and are more like "ordinary" sound waves in that they achieve a significantly lower peak pressure, a slower rise time, and propagate outwards without a focal point.
Li-ESWT is not currently approved by the U.S. Food and Drug Administration and is considered investigational in the United States. However, it is currently available to patients under clinical trial protocols and it is important to understand the basic physics of shockwaves to understand the differences between the different shockwave devices.
STRENGTH & LIMITATIONS: This is a comprehensive review of the physics underlying Li-ESWT but only tangentially explores the biological impact of shockwaves.
Physicians currently using or those contemplating purchasing a Li-ESWT device should understand the basic physics underlying the device, as well as which treatment protocols were used to demonstrate clinical efficacy in treating ED. Katz JE, Clavijo RI, Rizk P, et al. The Basic Physics of Waves, Soundwaves, and Shockwaves for Erectile Dysfunction. Sex Med Rev 2020;8:100-105.
在过去的十年中，低强度体外冲击波疗法（Li-ESWT）已成为治疗勃起功能障碍（ED）的一种治疗方式。为了更好地了解治疗 ED 的各种设备之间的差异，医生必须了解不同冲击波发生器的基础物理学。
本文通过建立有关波，特别是声波的基础知识，解释了冲击波的物理学。我们还描述了可用的不同冲击波发生器，并评估了它们的潜在临床实用性。
我们回顾了波传播的基本原理、用于 ED 和其他医学疾病的 Li-ESWT 的随机对照试验以及各个行业冲击波发生器网站，以描述 Li-ESWT 的基础物理学。
我们的主要目的是描述冲击波发生器的基础物理学，并为理解相关亚型和可调参数提供框架。
波是一种在介质中传播能量而不永久传输物质的干扰。在冲击波中，会产生速度快于当地声速的声波。冲击波通常由三种不同类型的能源产生：电液，电磁或压电，它们都通过将电势能量转换为机械能来产生冲击波。重要的是，径向压力波的行为与常规冲击波不同，更像是“普通”声波，因为它们的峰值压力要低得多，上升时间要慢得多，并且没有焦点地向外传播。
Li-ESWT 目前未获得美国食品和药物管理局（FDA）批准在美国被视为研究性治疗。但是，根据临床试验方案，它已向患者提供，了解冲击波的基本物理学对于了解不同冲击波设备之间的差异非常重要。
这是对 Li-ESWT 基础物理学的全面回顾，但仅间接地探讨了冲击波的生物学影响。
目前正在使用或正在考虑购买 Li-ESWT 设备的医生应了解设备的基础物理学，以及哪些治疗方案用于证明治疗 ED 的临床疗效。
