Consultant Urologist & Andrologist in London
Discreet Private Men’s Health Care
Erectile Dysfunction and Peyronie's disease Expert
London | United Kingdom | England
Shockwave Therapy for Erectile Dysfunction in London
Consultant-led care | Harley Street, London | Personalised treatment plans | Transparent pricing
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Not only a machine
Shockwave therapy at our clinic is never offered as a stand-alone machine-based service. It is delivered within a specialist holistic erectile dysfunction programme designed to improve outcomes through diagnosis, vascular assessment, medical optimisation, lifestyle intervention, and where appropriate combination therapy.
Shockwave Therapy for Erectile Dysfunction in London
At our London clinic, shockwave therapy for erectile dysfunction is never offered as a stand-alone, machine-based treatment. Erectile dysfunction is often a multifactorial condition, influenced not only by penile blood flow, but also by cardiovascular health, metabolic factors, hormonal balance, medication response, psychological burden, lifestyle habits, and overall men’s health.
For this reason, our approach is different. Every patient is assessed by a consultant urologist and andrologist with expertise in erectile dysfunction, regenerative andrology and men’s sexual health. The goal is not simply to deliver a course of shockwave sessions, but to determine whether shockwave is appropriate, whether the erectile dysfunction is likely to be vasculogenic, and how treatment can be integrated into a broader personalised strategy designed to improve outcomes.
Current European guideline recommendations support lifestyle optimisation and risk-factor modification as part of ED treatment, recommend PDE5 inhibitors as first-line therapy, and recognise a role for low-intensity shockwave therapy with or without PDE5 inhibitors in selected men, particularly those with mild vasculogenic erectile dysfunction or poor response to tablets. This is highly relevant, because in clinical practice the success of shockwave therapy often depends less on the device itself and more on correct diagnosis, patient selection, and treatment integration.
At Holistic Andrology, shockwave therapy may therefore be combined, when clinically appropriate, with optimisation of tadalafil or sildenafil response, cardiovascular and metabolic assessment, exercise and weight-management strategies, hormone review, vacuum support, and in selected cases discussion of regenerative or advanced adjunctive treatments. Our philosophy is simple: treat the man, not just the symptom; treat the cause where possible, not just the erection.
What is shockwave therapy for ED?
Shockwave therapy for erectile dysfunction uses low-intensity acoustic waves applied to penile tissue with the aim of stimulating a vascular response and improving blood flow. It is a non-surgical treatment and does not require anaesthetic or downtime in most cases.
This treatment may be considered for selected men with erectile dysfunction, especially where symptoms are thought to have a vascular component. A specialist consultation is essential before treatment, as shockwave therapy is not suitable for every cause of ED.
We deliver this using STORZ MEDICAL’s DUOLITH® SD1 T-TOP »ultra« shock wave therapy system, which is capable of highly accurate and focused treatment to deep-lying areas.
How shockwave therapy works
Shockwave therapy delivers low-intensity pulses to targeted areas of penile tissue. The aim is to stimulate local biological activity associated with tissue repair and blood vessel function. In appropriately selected patients, this may help improve erectile function over time.
Treatment is usually performed in clinic and is designed to be straightforward, discreet, and minimally disruptive to daily life.
Why shockwave therapy should not be used in isolation
Why shockwave therapy works better within a holistic ED programme
Erectile dysfunction is rarely caused by one single factor
Why a machine-only approach is often not enough
Why specialist assessment improves treatment selection
Many clinics offer shockwave therapy as a simple package of sessions. The problem is that erectile dysfunction is rarely that simple.
A man may have reduced penile blood flow, but he may also have insulin resistance, hypertension, obesity, poor sleep, low testosterone, medication-related ED, performance anxiety, endothelial dysfunction, or an inadequate response to oral treatment because the tablets have never been properly optimised. If these contributors are ignored, shockwave therapy is more likely to underperform.
That is why our clinic takes a different approach. We use shockwave therapy as one component of a broader specialist-led strategy. In the right patient, low-intensity shockwave may help stimulate vascular function and support erectile recovery. However, the best outcomes are often achieved when the surrounding clinical picture is properly addressed: cardiovascular risk, hormonal health, metabolic factors, lifestyle, relationship context, and response to medical therapy.
This is particularly important in men who have been told elsewhere that shockwave is a “quick fix”. In reality, the men who benefit most are usually those who have been assessed carefully, selected appropriately, and treated within a coherent pathway rather than a one-size-fits-all protocol.
Who is the ideal candidate for shockwave for ED?
Men with mild to moderate vasculogenic erectile dysfunction
Men with incomplete response to tablets
Why not every patient is suitable
Shockwave therapy is not the right treatment for every man with erectile dysfunction. The patients most likely to benefit are usually men with mild to moderate erectile dysfunction in whom a vasculogenic component is suspected. This includes men whose erection problems are related to impaired penile blood flow, endothelial dysfunction or early vascular compromise.
Shockwave therapy may also be considered in selected men who have had an incomplete response to tablets such as sildenafil or tadalafil, especially when the clinical picture suggests that vascular support and broader optimisation may improve the final outcome.
However, not all ED is vasculogenic. Some men have predominantly psychosexual, hormonal, medication-related, neurological or post-surgical erectile dysfunction. Others have a mixed picture. This is why proper assessment matters. The purpose of the consultation is not simply to confirm that shockwave is available, but to determine whether it is likely to make sense for you and how it should fit into a broader treatment strategy. 
Shockwave therapy is only one part of the treatment plan
Optimising tablets such as sildenafil or tadalafil
Lifestyle, exercise and weight optimisation
Hormonal and metabolic assessment
Vacuum device support in selected men
PRP and advanced adjunctive options where appropriate
At our clinic, shockwave therapy is used within a personalised erectile dysfunction strategy rather than as an isolated intervention. The treatment plan depends on the patient’s symptoms, age, vascular profile, previous response to treatment, general health, hormonal status and long-term goals.
For many men, one of the most important steps is the optimisation of oral medication. Some patients have tried sildenafil or tadalafil without obtaining the best response simply because the drug was not taken correctly, was not used consistently, was not prescribed in the most appropriate regimen, or was never combined with broader optimisation of vascular health. In selected men, shockwave therapy may sit alongside PDE5 inhibitor optimisation rather than replacing it.
Lifestyle is equally important. Erectile dysfunction is often linked to cardiometabolic health, and this means that exercise, diet, weight management, sleep improvement, smoking reduction and better control of cardiovascular risk factors can play a major role in improving erectile function and in supporting treatment response.
In selected patients, hormonal and metabolic review is also relevant. Testosterone deficiency, insulin resistance, diabetes, obesity and other systemic contributors may affect libido, confidence, energy and erection quality. Where clinically indicated, these issues should be evaluated rather than ignored.
Some patients may also benefit from vacuum device support, either as part of a conservative treatment plan or as an adjunct within a broader rehabilitation strategy. In carefully selected men, PRP or other advanced adjunctive options may also be discussed. However, these treatments should always be presented honestly and responsibly, because not every patient is suitable and the strength of evidence is not the same for every intervention.
This is the key difference in our approach: we do not ask whether shockwave should be sold. We ask how erectile dysfunction should be treated properly in that specific patient, and whether shockwave is one of the tools that can help within the full treatment plan.
Scientific evidence: shockwave therapy alone vs combination treatment
What guidelines say about shockwave therapy
What studies suggest about combining treatments
What we tell patients honestly about PRP and other adjuncts
Scientific evidence does not support the idea that shockwave therapy should be marketed as a universal stand-alone solution for all men with erectile dysfunction. Instead, current evidence supports a selective and integrated approach.
European guidelines on sexual and reproductive health emphasise that erectile dysfunction treatment should include lifestyle optimisation and cardiovascular risk-factor management. The same guidelines continue to recommend PDE5 inhibitors as first-line therapy and recognise a role for low-intensity shockwave therapy in selected men, with or without PDE5 inhibitors, especially where vasculogenic erectile dysfunction is suspected.
This broader approach is also supported by the literature on combination treatment. A large systematic review and meta-analysis reported that combination therapies can improve erectile dysfunction outcomes compared with monotherapy, with particularly supportive evidence for combinations involving PDE5 inhibitors. The same analysis also suggested additional benefit signals for combinations involving daily tadalafil, shockwave therapy or a vacuum device, although some of these findings were based on limited data.
More recent evidence has further strengthened the rationale for selected combination strategies. A 2025 systematic review and meta-analysis reported that combining a PDE5 inhibitor with low-intensity shockwave therapy significantly improved erectile function, particularly in men with vasculogenic erectile dysfunction or diabetes.
At the same time, honesty remains essential. PRP is an emerging option with promising data, and a recent meta-analysis suggested that adding PRP to Li-SWT may improve IIEF outcomes, but larger trials are still needed before this can be presented as routine standard treatment. A similar note of caution applies to botulinum toxin, which may have a role in refractory erectile dysfunction but is not a routine first-line therapy.
This is exactly why our clinic does not oversimplify treatment. We use shockwave therapy within a structured medical framework, guided by current evidence, patient selection and realistic expectations.
Why patients choose Fabio Castiglione for shockwave therapy in London
Consultant-led care rather than technician-led sessions
Academic and clinical expertise in erectile dysfunction and regenerative andrology
A personalised approach rather than a fixed protocol
Fabio Castiglione PhD Urologist London
Consultant Andrology
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Patients exploring shockwave therapy in London often discover many clinics that appear similar online. The real difference is not the marketing language or the machine itself. The real difference is the level of specialist expertise behind the diagnosis, the patient selection and the treatment plan.
Dr Fabio Castiglione is a consultant urologist and andrologist at King’s College Hospital and Guy’s and St Thomas’ Hospital. He is a Full Professor in Urology in Italy, an Associate Professor at University College London, and an Honorary Reader at King’s College London. His clinical and academic work has focused strongly on erectile dysfunction, men’s sexual health and regenerative andrology.
This matters because shockwave therapy should not be delivered as a technician-led cosmetic-style service. It should be prescribed and integrated by a specialist who understands the wider biology of erectile dysfunction, the difference between vascular and non-vascular causes, the role of PDE5 inhibitors and combination treatment, and the limits as well as the promise of emerging restorative therapies.
Patients choose our clinic because they want more than access to a device. They want expert consultant-led judgement, evidence-based advice, proper candidacy assessment and a personalised strategy built around long-term sexual health, not just a short course of sessions. 
What your personalised ED plan may include
Assessment and diagnosis
Medical optimisation
Lifestyle and metabolic support
Regenerative and adjunctive options
Follow-up and treatment adjustment
Depending on your clinical profile, your personalised plan may include a number of treatment elements rather than one isolated intervention.
This may begin with a detailed specialist consultation, review of erection quality, previous treatment history, cardiovascular risk, medication use, hormonal background and general men’s health profile. Where appropriate, this may be followed by optimisation of sildenafil or tadalafil treatment, lifestyle and exercise interventions, weight and metabolic support, vacuum-based support, and a structured discussion of whether shockwave therapy is likely to be useful.
In selected cases, regenerative or advanced adjunctive options may also be considered, but only after careful review of the evidence, suitability and realistic expectations. Follow-up is equally important, because erectile dysfunction treatment often requires adjustment over time rather than a one-off intervention.
Our aim is not to apply a fixed protocol to every patient. It is to build the right plan for the right patient. 
What happens during treatment?
Initial consultation and diagnosis
Your first appointment is focused on understanding the underlying cause of your erectile dysfunction. This includes a confidential discussion of symptoms, medical history, previous treatments, lifestyle factors, and overall sexual health. Where appropriate, further investigations may be recommended before confirming suitability for shockwave therapy.
Your treatment sessions
If shockwave therapy is recommended, treatment is carried out in a series of sessions at our London clinic. The procedure is non-invasive and usually takes only a short time per session. Most patients are able to return to normal daily activities immediately afterwards.
Aftercare and follow-up
Follow-up is important to assess progress, response to treatment, and whether any additional or combined treatment strategies should be considered. Outcomes vary from patient to patient, depending on the underlying cause and severity of ED.
Shockwave therapy for ED price in London
Treatment For Erectile dysfunction starts from £200 per session dependiShockwave therapy pricing should always be interpreted in the context of the level of specialist assessment, treatment planning and follow-up included. At our clinic, the goal is not simply to provide access to a device, but to deliver shockwave therapy within a consultant-led, evidence-based erectile dysfunction programme tailored to the individual patient.ng on the number of sessions you book.
6 Sessions
Mild-to-moderate Erectile Dysfunction.
£280 per session
9 Sessions
Moderate Erectile Dysfunction
£250 per session
12 Sessions
Moderate-to-severe Erectile Dysfunction
£200 per session
Why choose our London clinic?
Choosing the right clinic for erectile dysfunction treatment is about more than convenience. It is about receiving specialist-led care, careful diagnosis, and a treatment plan based on your individual needs.
At our Harley Street clinic, patients benefit from:
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consultant-led assessment and treatment planning
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confidential and discreet care
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a central London location
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personalised treatment recommendations
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transparent pricing
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a focus on men’s sexual health and andrology
Certified by the European Committee of Sexual Medicine (MJCSM)
Dr. Fabio Castiglione, certified Andrologist by the European Committee of Sexual Medicine (MJCSM)
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Shockwave Therapy For ED: the latest treatment strategy for patients suffering from ED.
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Improves Sexual Performance
Increases blood flow in the penis
Enhances Erections
Increases Sensation in the Penis
More Spontaneous Erections
Better Orgasms
We guarantee empathy:Â We focus on expert care, concierge service and exceptional results
We provide an efficient and qualified service, quickly and at sustainable costs, with the most innovative technologies in the male sexual medicine field. We guarantee empathy, total privacy and full support for the entire treatment.
Frequently Asked Questions
1 / What is shockwave therapy for erectile dysfunction?
Shockwave therapy is a non-invasive treatment that uses low-intensity acoustic waves with the aim of improving blood flow and supporting erectile function in selected patients.
2 / Who is a suitable candidate for shockwave treatment?
It may be suitable for selected men with mild to moderate erectile dysfunction, particularly where a vascular cause is suspected. A consultation is needed to assess suitability.
3 / Does shockwave therapy hurt?
Most patients tolerate treatment well. The procedure is non-invasive and is usually performed without anaesthetic.
4 / How many sessions will I need?
The number of sessions depends on your individual treatment plan, symptoms, and clinical assessment. This is discussed during consultation.
5 / How long does each session take?
Sessions are typically short and performed in clinic, allowing most patients to resume normal activities afterwards.
6 / When can I expect results?
Response times vary. Some patients notice changes gradually over time, while others may require additional follow-up to assess benefit.
7 / Are the results permanent?
Results vary according to the underlying cause of erectile dysfunction, overall health, and response to treatment. No treatment can guarantee permanent results in every patient.
8 / Do I need a consultation before treatment?
Yes. A specialist assessment is essential to determine whether shockwave therapy is appropriate and whether other causes of ED need to be addressed first.
9 / Can shockwave therapy be combined with other ED treatments?
In some cases, yes. A specialist may recommend combining treatment approaches depending on your symptoms and treatment history.
10 / How much does shockwave therapy for ED cost in London?
Pricing depends on the number of sessions recommended. Full costs and options are discussed clearly during consultation.
Book a confidential consultation
If you are considering shockwave therapy for erectile dysfunction in London, the most important step is not simply to book treatment sessions, but to understand whether you are the right candidate and how treatment should be personalised.
At our clinic, shockwave therapy is integrated into a broader erectile dysfunction pathway that may include medical optimisation, lifestyle intervention, vascular and metabolic review, and selected adjunctive treatments where appropriate. Book a confidential consultation with Dr Fabio Castiglione to discuss whether shockwave therapy is suitable for you and how it may fit into a holistic plan for long-term sexual health.
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