Efficacy of low-intensity pulsed ultrasound (LIPUS) in the treatment of erectile dysfunction: a systematic review.

Abstract

Purpose: Low-intensity pulsed ultrasound (LIPUS) is a form of mid-frequency ultrasound (0.7-3 MHz) delivered in pulse wave mode (100 and 1000 Hz). LIPUS delivers high-frequency sound waves with low-intensity mechanical energy that can be transmitted to cells and thus tissues, thereby producing biological effects. The regenerative activity of LIPUS in tissues, including the cavernous nerve, has been demonstrated in numerous studies. In this systematic review, we aimed to evaluate the efficacy of LIPUS on erectile dysfunction (ED).

Methods: A systematic search was conducted using PubMed-MEDLINE and Web of Science databases with the following search terms as of March 2, 2025: ''low-intensity pulsed ultrasound AND erectile dysfunction'',''LIPUS AND erectile dysfunction'', ''low-intensity pulsed ultrasound AND erectile function'', ''low-intensity pulsed ultrasound AND penile erection '' by combining PICO (population, intervention, comparison, outcome) terms.

Results: A total of six studies involving 615 patients undergoing LIPUS were identified. Three of these were randomized controlled trials (RCT), and three were non-RCT. Two studies have analysed ED associated with Peyronie's disease and chronic prostatitis/chronic pelvic pain syndrome. One study compared LIPUS with LIPUS + tadalafil and one study compared LIPUS with LIPUS + biofeedback electric stimulation in patients with ED. One study compared LIPUS with a sham-treated control group, and another study compared the efficacy of LIPUS treatment 2-3 times per week. The studies reported a significant increase in IIEF scores after LIPUS treatment compared to baseline levels.

Conclusion: In spite of limited reports in the literature, LIPUS may be a promising non-invasive treatment for the management of ED.