黃柏仁醫師 Po-Jen Huang, M.D.

First of all, Dr. Huang has personally used the three types of extracorporeal shockwave systems mentioned below, and all have demonstrated good clinical outcomes. None has been shown to be superior to the others.

More importantly, based on current evidence-based medicine:

🔹 Extracorporeal shockwave therapy (ESWT) can be broadly divided into focused and radial types. In the treatment of male erectile dysfunction, focused shockwave therapy is generally the primary modality used.

🔹 Focused shockwave therapy can be further categorized into three main types:

Electromagnetic (EM)
Piezoelectric (PE)
Electrohydraulic (EH)

All three modalities have been shown to be effective in treating erectile dysfunction. At present, there are no head-to-head comparative studies demonstrating that one type is more effective than the others. Therefore, patients do not need to overly focus on differences between machines; any device approved by the Ministry of Health and Welfare for the appropriate indication can be considered a valid treatment option.

📌 Key Points from Current Evidence

1. Low-intensity extracorporeal shockwave therapy (LI-ESWT) has evidence supporting its ability to improve vasculogenic erectile dysfunction (ED) by enhancing blood flow and promoting tissue repair.

2. Most systematic reviews and randomized controlled trials focus on the effectiveness of LI-ESWT itself, rather than on specific brands or machine models.

3. Some studies compare different shockwave modalities (focused vs radial), but because these techniques are fundamentally different, the overall body of evidence remains limited.

📌 Current Published Medical Literature

(PubMed / Systematic Reviews / Cochrane Reviews)

There are no randomized controlled trials or meta-analyses that directly compare different focused shockwave systems and demonstrate the superiority of one over another.

📌 Therefore, the Evidence Can Be Summarized as Follows:

✅ Low-intensity extracorporeal shockwave therapy (LI-ESWT) is effective for treating vasculogenic erectile dysfunction and certain chronic tendon or soft-tissue conditions.
❓ Is any specific shockwave system better than the others? → There is currently no strong clinical evidence to support such a claim.

📌 In Clinical Practice, When Treating Erectile Dysfunction, Physicians Are Often More Concerned About:

👉 What treatment options are available and suitable for the individual patient
👉 Whether the patient’s lifestyle factors (diet, exercise, smoking, alcohol use) are beneficial or harmful
👉 The presence of chronic diseases and how well they are controlled
👉 The patient’s ability to adhere to treatment in order to achieve optimal outcomes

References

https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/management-of-erectile-dysfunction

https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

Postscript

🔹 The motivation for writing this article comes from the fact that many clinics claim their shockwave machines are superior to others. While self-promotion is understandable, as a medical professional I feel obligated to state the facts—especially when certain heavily advertised shockwave systems claim to be “more effective than other shockwaves,” a statement that is not supported by medical evidence. Someone has to clarify this.

🔹 If it were merely advertising, I might not have noticed. However, a large number of patients repeatedly ask me about these claims and even show me the advertisements they have seen. Because this has become so common, I decided to write this article to address the issue directly.

🔹 “Axxa Duo” is an electrohydraulic shockwave system. There is currently no clinical evidence demonstrating that Axxa Duo is more effective or superior to other shockwave therapies.

既然震波可以有效治療勃起障礙，那麼，有哪一臺震波機器效果特別好嗎？

先說結論：沒有！

首先，黃醫師用過下面提到的三種體外震波，臨床治療效果都很好，沒有誰更優於誰。

再來，

從目前實證醫學來看：

🔹 體外震波可分為聚焦式（focused) 及徑向式（radial)兩大類，一般治療男性勃起功能障礙以聚焦式（focused)震波為主。

🔹聚焦式震波又分三大類：電磁式（Electromagnetic, EM）、壓電式（Piezoelectric, PE）、水電式（Electrohydraulic, EH），這三種震波皆可有效治療男性勃起功能障礙，目前並沒有彼此橫向比較的研究證明何者更有效，因此民眾不必太在意不同機器的差別，只要有取得衛福部核准之適應症即是好的治療機型。

📌 目前實證醫學重點：

1. 低能量體外震波治療 LI-ESWT 是有一定證據支持可幫助改善血管性勃起功能障礙（ED）並促進血液循環與組織修復。

2. 多篇系統性回顧與隨機臨床試驗都集中在 LI-ESWT 的效果，而不是特定品牌或機型。

3. 有些研究比較不同震波模式（聚焦 vs 放射式 shockwave），兩者原理不同，證據量相對不足。

📌 目前公開的醫學文獻（PubMed / 系統性回顧 / Cochrane）沒有明確對比各種聚焦式震波治療的隨機控制試驗或 Meta-analysis。

📌 所以可以這樣理解：

✅ 低強度體外震波治療（LI-ESWT）能有效治療勃起功能障礙 (vascular ED) 或慢性肌腱、軟組織問題。

❓ 但特定震波系統是否更好？ → 尚缺乏堅實的臨床證據支持。

📌 治療男性勃起功能障礙時，醫師實務上可能更在乎：

👉有哪些治療方式可提供並適合個案

👉個案的飲食、運動、菸酒等生活習慣是否有益或有害

👉個案是否有慢性疾病，以及是否控制穩定

👉個案是否能配合治療以達到最佳治療效果

References:

https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/management-of-erectile-dysfunction

https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline

p.s.🔹寫這篇的起因在於，很多診所會號稱他們家的震波機器比其他家更好，雖然說「老王賣瓜自賣自誇」是常情，但身為專業醫師的我還是必須說出實情，尤其是最近某些打廣告打很兇的震波常以「比其他震波更有效」為賣點，這在醫學事實上是站不住腳的，總是要有人出來以正視聽。

🔹如果只是自己打廣告，我不知道也就算了，重點是太多門診病人會問我，而且會拿他們看到的廣告給我看，因為數量實在太多，因此才決定寫這一篇以便澄清。

🔹野X波屬於水電式震波，沒有臨床證據能證明「野X波（Axxa Duo）」比其他震波治療更有效或更好。

2026年2月20日星期五

婦女尿失禁轉介專科醫師的適應症 Indications for Specialist Referral for Female Urinary Incontinence

1. 突然發生的尿失禁

2. 在沒有泌尿道感染（UTI）的情況下，出現肉眼或顯微鏡下血尿

3. 合併神經學症狀的尿失禁

4. 培養證實的反覆性泌尿道感染 （6 個月內 2 次，或 1 年內 3 次）

5. 骨盆解剖構造異常 （例如：超過處女膜的嚴重骨盆器官脫垂、骨盆腫塊、泌尿道瘻管、尿道憩室）

6. 排尿後殘餘尿量持續偏高，或需長期導尿

7. 曾接受骨盆重建手術或骨盆放射治療

8. 置入尿管困難

1. Sudden onset incontinence

2. Gross or microscopic hematuria without a urinary tract infection (UTI)

3. Incontinence with neurologic symptoms

4. Culture-documented recurrent UTI (2 in 6 months or 3 in 1 year)

5. Abnormal pelvic anatomy (eg, advanced pelvic organ prolapse beyond the hymen, pelvic mass, urinary fistula, urethral diverticulum)

6. Persistently elevated postvoid residual or chronic catheterization

7. History of pelvic reconstructive surgery or pelvic irradiation

8. Difficulty passing a urinary catheter

References:

https://www.uptodate.com/contents/female-urinary-incontinence-treatment

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體外震波治療男性力不從心相關迷思 Common Myths About Extracorporeal Shockwave Therapy for Erectile Dysfunction

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