Short answer: No.
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://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.
