The effects of shockwaves on animals were researched by the German department of defence throughout the 1960’s and into the early 1970’s. The scientists were especially interested in high energy shockwaves and their effects over distances. These examiners observed the side effects of shockwaves as they passed through soft tissues. Experimenters found that shockwaves had low level side effects dangerous to the lung, brain and abdominal organs.
Around this time it was first noted that the most effective way of applying shockwaves to living tissue was either through water or through a water based gel.
They proved that there is very low dissipation of shockwave energy through water. This observation later proved important as it led on to the use of shockwaves as a method of mapping under water areas.
First Medical Uses
Haeusler and Kiefer first described non-direct contact disintegration of a kidney stone in 1971. Additional experiments provided further evidence of the abaility of shockwaves to break up kidney stones. So, in 1974, the Department of Research and Science of Germany financed the development of first medical shockwave therapy. In 1990, prototype machine, the Dornier Lithotripter HM1 was first used to treat a patient for kidney stones (Chaussy et al, 1980). The protoype machine was refined and in was launced as the first commercial lithotripter, the Dornier Lithotripter HM3, in 1983.
Subsequently, shockwaves were used to treat other organs including the gall bladder, bile duct, pancreas and salivary glands (Sauerbruch et al, 1986, Sauerbruch et al, 1987, Iro et al, 1989, Iro et al, 1992).
Early lithotripters needed a bath of water to work. However, following the success of a German prototype in 1986, most recent machines work without the need for a body of water. Modern machines are also often equipped with xray or ultrasound localisation systems.
During the 1990’s shockwave machines were successfully trialled for use in the treatment orthopaedic disorders, including non-union fractures, pseudo-arthroses, osteochondrosis and various tendinopathies (Haupt, 1997). This stimulated the development of a shockwave device more suited to orthopaedic medicine. OssaTron (HMT AG) released the first machine with a freely movable head in 1993. Further research demonstrated positive results in shockwave treatment of heel spurs and epicondylitis and triggered the development of many new and more durable shockwave devices.
Although a relatively new technology, shockwave therapy continues to increase in popularity in orthopaedic medicine. Treatment with shockwaves is described by many names, the most popular being “shockwave therapy” or, to give it’s full name, “extracorporeal shockwave therapy”.
Extracorporeal Shockwave Therapy in Urology
More recently the medical use of shockwaves has returned to the field of urology. Early animal studies looking at the use of low intensity extracorporeal shockwave therapy (Li-ESWT) for erectile dysfunction proved promising (A. Müller et al, 2008). As shockwave therapy was already known to have minimal side effects, the results were promising enough for human trials to go ahead. Several subsequent human studies have indicated the potential of shockwave therapy in treating ED of a vasculogenic origin (R. Clavijo et al, 2016). Furthermore, in 2017, a survey of sexual medicine experts attending the CES conference in Europe found that over 70% of practitioners would recommend Li-ESWT as a treatment for ED. Harley Street Mens Clinic are now making low intensity extracorporeal shockwave therapy for erectile dysfunction available in the UK.