What is the difference between focused and radial waves?
They are different technologies that happen to share a name in advertising. Focused shockwave devices, including linear-focused versions, concentrate energy into a zone inside the tissue. Radial devices produce pressure waves that spread out from the applicator, and their energy drops off as they travel.
Researchers treat them as separate treatments. The authors of a 2022 sham-controlled radial trial wrote that radial waves work in a way that differs substantially from shockwaves, so the evidence for shockwave cannot be applied to them. Cleveland Clinic notes that radial devices deliver much less energy and does not consider them effective for ED.
| Focused or linear shockwave | Radial pressure waves | |
|---|---|---|
| How energy behaves | Concentrated at a depth in the tissue | Spreads from the applicator and weakens with distance |
| Share of ED studies | Most published trials | Fewer trials |
| Sham-controlled results in ED | Mixed, with several positive trials | One trial of 80 men found no difference from sham |
| FDA status for ED | Not approved or cleared | Not approved or cleared |
Which device type did most ED studies use?
Focused shockwave, by a wide margin. A 2026 systematic review commissioned by the International Society for Sexual Medicine found 36 comparative studies, and 23 of them evaluated focused shockwave. Even for focused devices, results against sham were mixed, and the reviewers called for better trials before routine use.
Radial devices have far less behind them. In the radial trial, 80 men with moderate ED received six weekly sessions of radial waves or sham, all with low-dose sildenafil, and the two groups improved by similar amounts. A 2025 meta-analysis of 15 studies found that both types were associated with improved scores, but focused treatment produced consistently better outcomes than radial.
Why does the name get confusing?
“Acoustic wave” is a loose, friendly label. Some clinics use it for focused shockwave, some for radial devices, and some for both. Ultimate Male’s own pages describe shockwave as targeted acoustic pulses, so the phrase alone does not tell you what device is in the room. Neither does a brand name you have never heard of.
What should you ask a clinic before you book?
Ask enough to know what you are actually buying. Good questions include:
- Is the device focused, linear or radial?
- What energy level and how many pulses per session? For reference, a 2016 sham-controlled trial used 1,500 pulses at 0.09 mJ/mm2 per session.
- How many sessions, how far apart, and when will results be judged?
- What published studies used this type of device for ED?
- Who performs the treatment, and who decides whether it suits you?
- What is the device’s make and model, so you can look it up yourself?
Write the answers down. Comparing them with the protocols in the published trials tells you more than any brochure.
Our comparison of focused vs radial shockwave goes deeper into the technology.
Related question: does shockwave suit my type of ED?
Device type matters only if you are a good candidate in the first place. Shockwave is studied mainly in ED caused by reduced blood flow; our pages on vascular erectile dysfunction and on who is a candidate for shockwave explain the difference.
Asking Ultimate Male about its device
Bring these same questions to the free 10-minute phone call. You can ask which device type the clinic uses, the settings for a typical session and how the planned course compares with the trials above, and expect plain answers before you commit to anything.
From there, labs and a consultation at our San Gabriel or Downey clinic confirm whether shockwave fits your situation at all. Read more about shockwave therapy for ED at Ultimate Male.
