Comparison

Shockwave vs PRP: Comparing Two Treatments You Probably Should Not Buy

Both are sold as regenerative cures. Both are classed as investigational by urological guidelines. One at least has sham-controlled trials behind it — which is the only reason this comparison is not a tie.

By EDTG editorialUpdated 18 NOV 20253 min read

Key takeaways

Neither has FDA approval for treating erectile dysfunction. Devices used for shockwave are cleared for other indications and used off-label.
Major urological guidance classes both as investigational and advises they be used within research protocols.
Shockwave has a real body of sham-controlled evidence showing modest benefit in mild vascular ED. PRP does not.
Placebo response in ED trials routinely reaches 20–30%, which is why uncontrolled testimonials tell you nothing.
The main risk in both cases is financial, not physical — with the exception of unapproved stem cell products.

Side by side

Attribute	Shockwave therapy	PRP / stem cell
Guideline status	Investigational	Investigational
FDA approval for ED	None	None
Sham-controlled trials	Several exist	Very few
Average benefit shown	Modest, in mild vascular ED	Not convincingly above placebo
Durability	Studied to 6–12 months	Not established
Typical course cost	$3,000–$6,000	$1,500–$3,000 per injection
Insurance	None	None
Physical risk	Low	Low for PRP; higher for unapproved stem cell products
Main risk	Financial	Financial

The verdict

If you are going to spend money on one of these anyway, shockwave has the better evidence — several sham-controlled trials showing modest average improvement in men with mild vascular ED. PRP does not currently have that. But the honest recommendation is neither: both are classed as investigational, neither is FDA-approved for erectile dysfunction, and the money buys an uncertain result that established treatments would deliver reliably. If the appeal is treating the cause rather than the symptom, [exercise and cardiovascular risk reduction](/treatments/lifestyle-changes) does exactly that, with far better evidence and no cost.

Why these two get compared

They are sold from the same clinics, to the same men, with the same pitch: this treats the underlying cause rather than masking the symptom, and it is what the pharmaceutical industry does not want you to know about. Frequently they are sold together as a package.

The pitch is appealing because the underlying idea is legitimate. Regenerative approaches to erectile dysfunction are a real and active research field. The gap is between plausible mechanism and demonstrated clinical benefit — and that gap is where several thousand dollars of your money currently sits.

Where the evidence differs

Shockwave therapy: Multiple randomised, sham-controlled trials exist. They show modest average improvement in erectile function scores, concentrated in men with mild to moderate vasculogenic ED who already respond partly to tablets. Protocols vary so widely between studies that pooling them is difficult, and follow-up rarely extends beyond a year.
PRP and stem cell therapy: Most published work is small, single-arm and uncontrolled. The few sham-controlled PRP studies have not established a clear, durable advantage over placebo. Preparations are not standardised, so results from one clinic do not transfer to another.

If you are going ahead anyway

Some men will proceed regardless, and the safety profile in trials has been reassuring. Go in with your eyes open.

Which specific device or preparation is used, and what is its regulatory status?
What is the total cost, and what happens if there is no improvement?
Are outcomes measured with a validated instrument such as the IIEF, before and after?
Is a urologist involved, and have my other causes been investigated?
What published evidence supports this exact protocol — not the category in general?
Is there a clinical trial I could join instead? Trials are frequently free and better monitored — search ClinicalTrials.gov.

FAQ

Frequently asked questions

Is shockwave therapy better than PRP for ED?

It has better evidence — several sham-controlled trials showing modest benefit in mild vascular ED, which PRP currently lacks. Both are classed as investigational.

Are either FDA-approved for erectile dysfunction?

No. No shockwave device is approved or cleared for ED in the US, and PRP is not approved for this use either.

Will insurance cover them?

Essentially never, because both are considered investigational.

Is there anything that genuinely treats the cause?

Yes — exercise, weight loss, stopping smoking and glycaemic control improve endothelial function directly, with far better evidence and no cost. See lifestyle changes.

Sources

What this is based on

We link to primary sources — clinical guidelines, regulator publications and peer-reviewed research — wherever possible. Links open on third-party sites we do not control.

[01]American Urological Association. Erectile Dysfunction: AUA Guideline (2018).
[02]National Library of Medicine. ClinicalTrials.gov — find studies you can join.
[03]Federal Trade Commission. Health Products Compliance Guidance.
[04]National Library of Medicine. PubMed — search the primary literature.

Not medical advice:This article is general information. Talk to a licensed clinician about your own situation. Full disclaimer.

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