NanoVi Exo Clinical Evidence

Clinical governance statement

All treatments undertaken by MansMatters (Shockwave Clinics Ltd) are subject to clinical review before they are introduced into practice and at regular intervals thereafter. This review considers the safety profile of each intervention, including contraindications and adverse effects as specified in the manufacturer’s instructions for use or the Summary of Product Characteristics; the regulatory status of each medical device and medicinal product; the position of current UK and European clinical guidance, including the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE) and the British Association of Urological Surgeons (BAUS); the qualifications and scope of practice of the treating clinicians; the stage and severity of the condition being treated; and the requirements for informed consent. Each patient is assessed individually, and treatment is offered only where it is clinically appropriate.

The basis of clinical evidence

Clinical evidence is derived from several sources, which carry different weight. Systematic reviews and meta-analyses pool the results of multiple studies and provide the highest level of evidence. Randomised controlled trials, including sham-controlled trials, compare a treatment against a control group under defined conditions. Prospective and retrospective cohort studies, published in peer-reviewed journals, describe outcomes in defined groups of patients over time, and the replication of results by independent research groups in different countries strengthens confidence in a finding. Laboratory and mechanistic studies explain how a treatment is thought to act. In-clinic observational studies and structured outcome audits record the results achieved in routine practice and contribute to the developing evidence base, particularly for newer and combined treatments. Long-term follow-up establishes the durability of results and the safety of a treatment over time.

The evidence relevant to this treatment is summarised below. All citations are hyperlinked to the original source.

Is it safe?

NanoVi Exo is made by Eng3 Corporation (Seattle, USA). It passes ordinary room air, humidified with distilled water, over infrared light and delivers it through a nasal cannula while you breathe normally. It does not deliver oxygen, medication or electrical current, and there is no contact beyond the cannula. No adverse events have been reported, and the manufacturer lists no contraindications (Eng3). We use single-use cannulas and replace the distilled water regularly. We describe NanoVi Exo to patients as a supportive wellness device.

What the evidence shows

Oxidative stress, an excess of reactive oxygen molecules that reduce nitric oxide and damage the lining of blood vessels, is a well-documented contributor to erectile dysfunction, especially in men with diabetes, high cholesterol or a history of smoking (Zhu et al., Int J Mol Sci 2025). A 2025 meta-analysis of 23 randomised trials found that reducing oxidative stress with antioxidant supplements improved erectile function scores by 5.5 points more than placebo (Ramasamy et al., World J Mens Health 2025). NanoVi Exo is one of the ways we support the body’s response to oxidative stress during a programme. Research into NanoVi Exo in men’s health is continuing.

Guidelines and regulation

The European Association of Urology and the International Society for Sexual Medicine both recognise oxidative stress and damage to the blood-vessel lining as mechanisms in erectile dysfunction. Urological guidelines do not yet cover NanoVi Exo. Treatment is delivered by HCPC- and NMC-registered clinicians in a clinic registered with the Care Quality Commission.

Independent research

The peer-reviewed laboratory studies of NanoVi come from Moscow State University and declare no funding from the manufacturer. Air treated by the device changed the physical properties of water (Yablonskaya et al., Water 2021), and enzymes damaged by heat or oxidation partly regained their activity after exposure (Yablonskaya et al., Int J Mol Sci 2022). The link between oxidative stress and erectile dysfunction has been described by independent teams in the US and Europe (Agarwal et al., J Androl 2006; Kaltsas et al., Curr Issues Mol Biol 2024).

How NanoVi Exo compares

NanoVi Exo is a passive, drug-free supportive therapy used during clinic sessions, alongside focused shockwave therapy and EMTT. It is not a treatment for erectile dysfunction in its own right. We also discuss diet, exercise, smoking and sleep with every patient, as these support blood-vessel health.

How NanoVi Exo is thought to work

The device imprints an infrared signal onto water droplets in the air stream. When inhaled, this is proposed to help the water around the body’s proteins become more ordered, supporting protein folding and the repair of oxidative damage. By supporting the body’s response to oxidative stress, it may help protect the blood-vessel lining on which erections depend.

Long-term results and our experience

Research is continuing. We have used NanoVi Exo for four years and record outcomes for every patient on our programmes.

Who is most likely to benefit

We include NanoVi Exo as an optional supportive therapy for men on our Multimodal or ED360 programmes, and alongside NESA for men with performance anxiety. It is not offered as a standalone treatment.

Before your treatment

Your clinician will explain what NanoVi Exo is and that it is optional and answer any questions. You will be asked to give your consent before treatment begins. Sessions last around 30 minutes, during the same appointment as your other treatments.