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A meta-analysis of extracorporeal shock wave therapy for Peyronie’s disease

International Journal of Impotence Research volume 28, pages 161–166 (2016)Cite this article

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Abstract

The efficiency of extracorporeal shock wave therapy (ESWT) for Peyronie’s disease (PD) has been controversial for a very long time. We aimed to evaluate the efficiency of ESWT for PD and provide possible evidence on the basis of a meta-analysis of existing comparative studies. All controlled studies, including randomized controlled trials (RCTs), cohort studies and case-control studies, that focused on the efficiency of ESWT for PD, were prospectively identified through comprehensive searches of PubMed, the Cochrane Library and Embase databases. We conducted a meta-analysis of these studies. Six studies including 443 patients were selected for the meta-analysis. Pooling data of these studies showed that ESWT could significantly increase the percentage of men with lessening of penile plaques (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.11–3.85, P=0.02), relief of pain (OR 4.46, 95% CI 2.29–8.68, P<0.0001) and complete remission of pain (OR 5.86, 95% CI 2.66–12.92, P<0.0001). However, insignificant differences were found in improvement of penile curvature (OR 1.88, 95% CI 0.97–3.65, P=0.06) and sexual function (OR 2.22, 95% CI 0.69–7.11, P=0.18) between ESWT and placebo groups. Further, similar results were shown for sensitivity and publication bias analysis when only RCTs were included. However, sporadic complications caused by ESWT were reported, but no patient needed additional treatment aside from conservative observation. ESWT may be an effective and safe treatment for lessening of penile plaques and relieving pain for men with PD, but not for improving of penile curvature and sexual function.

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References

  1. Gonzalez-Cadavid NF, Rajfer J . Mechanisms of disease: new insights into the cellular and molecular pathology of Peyronie's disease. Nat Clin Pract Urol 2005; 2: 291–297.

    Article  CAS  Google Scholar 

  2. De Berardinis E, Busetto GM, Antonini G, Giovannone R, Gentile V . Extracorporeal shock wave therapy in the treatment of Peyronie's disease: long-term results. Arch Ital Urol Androl 2010; 82: 128–133.

    PubMed  Google Scholar 

  3. Hatzimouratidis K, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Salonia A et al. EAU guidelines on penile curvature. Eur Urol 2012; 62: 543–552.

    Article  Google Scholar 

  4. Lebret T, Loison G, Herve JM, Mc Eleny KR, Lugagne PM, Yonneau L et al. Extracorporeal shock wave therapy in the treatment of Peyronie's disease: experience with standard lithotriptor (siemens-multiline). Urology 2002; 59: 657–661.

    Article  Google Scholar 

  5. Bellorofonte C, Ruoppolo M, Tura M, Zaatar C, Tombolini P, Menchini Fabris GF . Possibility of using the piezoelectric lithotriptor in the treatment of severe cavernous fibrosis. Arch Ital Urol Nefrol Androl 1989; 61: 417–422.

    CAS  PubMed  Google Scholar 

  6. Mirone V, Imbimbo C, Palmieri A, Fusco F . Our experience on the association of a new physical and medical therapy in patients suffering from induratio penis plastica. Eur Urol 1999; 36: 327–330.

    Article  CAS  Google Scholar 

  7. Hauck EW, Altinkilic BM, Ludwig M, Ludecke G, Schroeder-Printzen I, Arens C et al. Extracorporal shock wave therapy in the treatment of Peyronie's disease. First results of a case-controlled approach. Eur Urol 2000; 38: 663–669.

    Article  CAS  Google Scholar 

  8. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U et al. Extracorporeal shockwave therapy for Peyronie's disease: an alternative treatment? Asian J Androl 2006; 8: 361–366.

    Article  Google Scholar 

  9. Palmieri A, Imbimbo C, Longo N, Fusco F, Verze P, Mangiapia F et al. A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie's disease. Eur Urol 2009; 56: 363–369.

    Article  Google Scholar 

  10. Chitale S, Morsey M, Swift L, Sethia K . Limited shock wave therapy vs sham treatment in men with Peyronie's disease: results of a prospective randomized controlled double-blind trial. BJU Int 2010; 106: 1352–1356.

    Article  Google Scholar 

  11. Hatzichristodoulou G, Meisner C, Gschwend JE, Stenzl A, Lahme S . Extracorporeal shock wave therapy in Peyronie's disease: results of a placebo-controlled, prospective, randomized, single-blind study. J Sex Med 2013; 10: 2815–2821.

    Article  Google Scholar 

  12. Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A et al. Subjective and objective analysis of the prevalence of Peyronie's disease in a population of men presenting for prostate cancer screening. J Urol 2004; 171: 2350–2353.

    Article  Google Scholar 

  13. Arafa M, Eid H, El-Badry A, Ezz-Eldine K, Shamloul R . The prevalence of Peyronie's disease in diabetic patients with erectile dysfunction. Int J Impot Res 2007; 19: 213–217.

    Article  CAS  Google Scholar 

  14. Palmieri A, Imbimbo C, Creta M, Verze P, Fusco F, Mirone V . Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie's disease and erectile dysfunction: results from a prospective randomized trial. Int J Androl 2012; 35: 190–195.

    Article  CAS  Google Scholar 

  15. Pavone C, D'Amato F, Dispensa N, Torretta F, Magno C . Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie's disease? Analysis in 279 patients with a control group in Sicily. Arch Ital Urol Androl 2015; 87: 20–24.

    Article  CAS  Google Scholar 

  16. Choi MJ, Song KM, Park JM, Kwon MH, Kwon KD, Park SH et al. Effect of SMAD7 gene overexpression on TGF-beta1-induced profibrotic responses in fibroblasts derived from Peyronie's plaque. Asian J Androl 2015; 17: 487–492.

    CAS  PubMed  Google Scholar 

  17. Mulhall JP, Schiff J, Guhring P . An analysis of the natural history of Peyronie's disease. J Urol 2006; 175: 2115–2118.

    Article  Google Scholar 

  18. Husain J, Lynn NN, Jones DK, Collins GN, O'Reilly PH . Extracorporeal shock wave therapy in the management of Peyronie's disease: initial experience. BJU Int 2000; 86: 466–468.

    Article  CAS  Google Scholar 

  19. Kiyota H, Ohishi Y, Asano K, Hasegawa N, Madarame J, Miki K et al. Extracorporeal shock wave treatment for Peyronie's disease using EDAP LT-02; preliminary results. Int J Urol 2002; 9: 110–113.

    Article  Google Scholar 

  20. Manikandan R, Islam W, Srinivasan V, Evans CM . Evaluation of extracorporeal shock wave therapy in Peyronie's disease. Urology 2002; 60: 795–799.

    Article  CAS  Google Scholar 

  21. Hauck EW, Hauptmann A, Bschleipfer T, Schmelz HU, Altinkilic BM, Weidner W . Questionable efficacy of extracorporeal shock wave therapy for Peyronie's disease: results of a prospective approach. J Urol 2004; 171: 296–299.

    Article  Google Scholar 

  22. Strebel RT, Suter S, Sautter T, Hauri D . Extracorporeal shockwave therapy for Peyronie's disease does not correct penile deformity. Int J Impot Res 2004; 16: 448–451.

    Article  CAS  Google Scholar 

  23. Olsen AB, Persiani M, Boie S, Hanna M, Lund L . Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol 2015; 49: 329–333.

    Article  Google Scholar 

  24. Yee CH, Chan ES, Hou SS, Ng CF . Extracorporeal shockwave therapy in the treatment of erectile dysfunction: a prospective, randomized, double-blinded, placebo controlled study. Int J Urol 2014; 21: 1041–1045.

    Article  Google Scholar 

  25. Vardi Y, Appel B, Kilchevsky A, Gruenwald I . Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol 2012; 187: 1769–1775.

    Article  Google Scholar 

  26. Hauck EW, Mueller UO, Bschleipfer T, Schmelz HU, Diemer T, Weidner W . Extracorporeal shock wave therapy for Peyronie's disease: exploratory meta-analysis of clinical trials. J Urol 2004; 171: 740–745.

    Article  Google Scholar 

  27. Muller A, Akin-Olugbade Y, Deveci S, Donohue JF, Tal R, Kobylarz KA et al. The impact of shock wave therapy at varied energy and dose levels on functional and structural changes in erectile tissue. Eur Urol 2008; 53: 635–642.

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported by the Natural Science Foundation of China (No.81170565 and 81270691), International cooperation project of Sichuan province (No.2013HH0008), and science and technology support program of Sichuan province (No.2012SZ0151).

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  1. L Gao and S Qian: These two authors contributed equally to this work.

Authors and Affiliations

  1. The Andrology Laboratory and Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China

    L Gao, S Qian, Z Tang, J Li & J Yuan

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Correspondence to J Yuan.

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Gao, L., Qian, S., Tang, Z. et al. A meta-analysis of extracorporeal shock wave therapy for Peyronie’s disease. Int J Impot Res 28, 161–166 (2016). https://doi.org/10.1038/ijir.2016.24

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