Erectile Dysfunction (ED) is a common condition in male urology and andrology clinics. As the population ages, the incidence of ED is increasing, leading to significant negative impacts on both the patient's health and family harmony. ED can be classified into three categories: psychological ED, organic ED, and mixed ED. Psychological ED, also known as functional ED, is caused by psychological factors; organic ED is caused by systemic diseases, chronic illnesses, genital malformations, medications, injuries, etc.; mixed ED results from both psychological and organic factors. The causes of organic ED include vascular and nerve damage, anatomical changes, endocrine and metabolic disorders, and more. Vascular and nerve damage accounts for 50-60% of the causes of organic ED.

Currently, clinical research shows that oral tadalafil-based medications are the conventional treatment for ED. However, these medications have limitations in that they do not improve the penile cavernous vascular system in treating ED.

Low-Intensity Pulsed Ultrasound (LIPUS) treatment is a new non-invasive approach that uses pulse waves to activate the body's dormant endogenous stem cells through its mechanical and cavitation effects. This process promotes cell proliferation, differentiation, migration, and enhances local growth factors expression, improving endothelial function and angiogenesis. It may also promote nerve fiber regeneration and regulate relevant cellular signaling pathways to repair damaged blood vessels and nerve matrices, ultimately restoring physiological function.

New Clinical Treatment Approach: Can LIPUS be Combined with Medications for Treating Mild to Moderate ED?

WBL's LIPUS Combined with Qingre Zhuyu Decoction and Tadalafil

In 2023, the Jiangxi University of Traditional Chinese Medicine Affiliated Hospital published an article titled "Study on the Effectiveness and Safety of Qingre Zhuyu Decoction Combined with Low-Intensity Pulsed Ultrasound for Erectile Dysfunction" in the Shizhen Guoyi Guoyao Research Journal, Vol. 34, Issue 4.

Reference:LSHIZHEN MEDICINE AND MATERIA MEDICA RESEARCH 2023 VOL. 34 NO.4

The study aimed to observe the effectiveness and safety of Qingre Zhuyu Decoction combined with LIPUS in treating ED. The method included a control group treated with tadalafil combined with LIPUS and an experimental group treated with Qingre Zhuyu Decoction in addition to the control treatment. Outcomes measured included traditional Chinese medicine (TCM) syndrome scores, penile hemodynamics during erection, nocturnal penile tumescence (NPT) test results, the International Index of Erectile Function (IIEF-5) scores, clinical efficacy, and incidence of adverse reactions.

Results showed that after treatment, both groups exhibited increased peak systolic velocity (PSV) and resistance index (RI) of the cavernous artery, decreased TCM syndrome scores, and improved erectile parameters, with the experimental group showing more significant improvements. The total clinical efficacy of the experimental group was higher than that of the control group. The incidence of adverse reactions (constipation, dry mouth, facial flushing, nasal discomfort, headache) was similar between the two groups.

Conclusion: The combination of Qingre Zhuyu Decoction and LIPUS significantly improves ED patients' TCM syndrome, penile hemodynamics, and erectile function. It enhances erectile hardness and stability, increases the frequency and duration of erections, and provides a notable improvement in sexual function while regulating organ function, with high safety.

LIPUS Combined with Tadalafil

In 2024, an article titled "Effectiveness of Low-Intensity Pulsed Ultrasound Combined with Tadalafil for Mild to Moderate Erectile Dysfunction" was published in Chinese Sexual Science, Vol. 33, Issue 11.

Reference:DOl:10.3969/j.issn.1672-1993.2024.11.004

The study aimed to explore the effects of combining LIPUS with tadalafil in treating mild to moderate ED. The method involved an observation group treated with both LIPUS and tadalafil and a control group treated with tadalafil alone. The effectiveness of both treatments was compared by assessing erectile duration, frequency, penile hardness, IIEF-5 scores, and incidence of adverse reactions.

Results showed that the combination group had significantly higher IIEF-5 scores, effective erection duration and frequency, and penile hardness compared to the medication-only group.

Conclusion: LIPUS combined with tadalafil was more effective than tadalafil alone in improving erectile function in mild to moderate ED patients, with good safety.

LIPUS Combined with Sildenafil Citrate and Dendrobium to Treat Kidney Yang Deficiency Erectile Dysfunction

In 2024, an article titled "Effect of Dendrobium Yishen Pills Combined with Low-Intensity Pulsed Ultrasound on Kidney Yang Deficiency Erectile Dysfunction" was published in Chinese Journal of Integrated Traditional and Western Medicine Surgery, Vol. 30, Issue 5.

Reference:DOI:10.3969/j.issn.1007-6948.2024.05.003

The study aimed to observe the effects of Dendrobium Yishen Pills combined with LIPUS on kidney yang deficiency erectile dysfunction. The control group received sildenafil citrate and LIPUS treatment, while the experimental group received the same treatment with the addition of Dendrobium Yishen Pills. After four weeks of treatment, the efficacy of both groups was measured using IIEF-5 scores, TCM syndrome scores, penile hemodynamics, and nocturnal penile tumescence monitoring.

Results showed that the experimental group had a significantly higher total efficacy rate (93.33% vs. 76.67%) than the control group. Additionally, the experimental group had better outcomes in terms of IIEF-5 scores, PSV, erectile hardness, and nocturnal penile tumescence.

Conclusion: Dendrobium Yishen Pills combined with LIPUS significantly improved erectile function in kidney yang deficiency ED, and the results were better than the control group. It offers a promising approach for clinical application.

Research Conclusion

LIPUS therapy primarily works by promoting angiogenesis and tissue regeneration, as well as activating endogenous stem cells. These mechanisms improve local blood circulation and facilitate tissue repair, playing a key role in ED treatment. Based on the studies above, the combination of LIPUS with medications provides a multi-mechanism approach to treatment, enhancing endothelial function and penile blood flow. This treatment targets both the symptoms and root causes of ED, improving patient outcomes and boosting therapeutic confidence with high safety.

The LIPUS equipment used in the trials is the WBL LIPUS device model WBL-ED.

WBL Medical Devices Co., Ltd. is the pioneer of LIPUS technology and has led the application of low-intensity pulsed ultrasound in ED treatment with their WBL-ED device. Since receiving approval from the China Food and Drug Administration (CFDA) in 2018, WBL LIPUS has filled a technological gap in this field, earning recognition as a National Medical Device Innovation Product, underscoring the company's leadership and technical strength in the industry.