What does the long-term follow-up show?
The longest follow-up comes from a 2018 study that followed shockwave responders for two years. Researchers screened 156 men who had the same 12-session protocol, and 99 of them (63.5%) had a meaningful improvement one month after treatment. Those 99 were then checked at 6, 12, 18 and 24 months.
| Group | What happened by two years |
|---|---|
| All initial responders | 53 of 99 (53.5%) still had the benefit |
| Milder ED, no diabetes | 76% still had the benefit |
| Severe ED | Benefit faded sooner |
| Diabetes with severe ED | Benefit lost in every man |
The decline was gradual rather than sudden. The authors concluded that shockwave is effective in the short term but that the effect held at two years in only half of patients, and was more likely to last in milder ED.
How does that compare with other estimates?
It fits. Cleveland Clinic says the effects are not permanent and usually last about one to two years. Most trials do not look that far ahead: the men in a 2017 meta-analysis of seven sham-controlled trials were followed for an average of 19.8 weeks. That makes the two-year study unusually useful. Results beyond two years are largely unknown, so a promise of benefit lasting many years would go beyond the data.
Why does the effect fade in some men?
The study did not test reasons, but the pattern follows the underlying disease. Shockwave is aimed at ED from reduced blood flow, and the conditions that narrow blood vessels, such as diabetes, high blood pressure, smoking and excess weight, keep working after the course ends. Men with severe ED or diabetes had the most damage to start with and lost the benefit soonest.
That makes the time after a course important. Getting blood sugar under control, losing weight and stopping smoking all protect the blood vessels that shockwave is trying to help. Our pages on whether weight loss helps ED and whether quitting smoking improves ED explain what is realistic.
How are repeat courses decided?
By symptoms, not the calendar. Ultimate Male’s approach is a first course, then maintenance only as needed: some men keep their improvement for a long time after one course, while others benefit from occasional maintenance sessions. The decision rests on a few questions:
- Has erection quality slipped back toward where you started?
- Are you needing pills again, or higher doses?
- How well did the first course work, and how long did it last?
- Has anything changed, such as new diabetes, new medicines or weight gain?
No guideline sets a maintenance schedule. The AUA still classes shockwave as investigational, so repeat treatment is a judgement call made with your provider.
Related question: how many sessions is a course?
At Ultimate Male a course is six to twelve sessions over several weeks. Our page on how many shockwave sessions you need explains how the number is set, and our comparison of shockwave vs ED pills helps if you are weighing a course against daily medication.
Follow-up after a course at Ultimate Male
Your care does not end at the last session. It helps to note how your erections feel a month after the course, since that is your baseline for spotting any later slide. Follow-up visits check how you are doing, and if the benefit starts to slip, the provider looks at why before suggesting more sessions, starting with labs if anything has changed.
If you are considering shockwave for the first time, start with the free phone call and an evaluation at our San Gabriel or Downey clinic. Our shockwave therapy page explains the treatment and how to book.
