Erectile dysfunction is highly prevalent in type II diabetes mellitus.Low intensity extracorporeal shock wave therapy improves erectile function inpatients with erectile dysfunction of vasculogenic origin, including diabetes.However, its mode of action remains unknown. We investigated the effects of low intensity extracorporeal shock wave therapy compared to or combined with sildenafil on erectile dysfunction in a type II diabetes mellitus model. Our purpose was to test our hypothesis of a mode of action targeting the cavernous nitricoxide/cyclic guanosine monophosphate pathway.