Abstract
To evaluate whether extracorporeal shockwave therapy (ESWT) offers an effective treatment for the main complications of Peyronie's disease (PD), that is, penile deformity and angulation, painful erection and most importantly unsatisfied sexual intercourse. From September 1999 to January 2001, 52 patients with PD were treated with ESWT. Pain during erection was assessed with a visual analogue scale. Penile deviation was determined by photographs with a goniometer. Five treatment sessions were performed at weekly intervals. Each consisted of 3000 shockwaves with an emission frequency of 120 shockwaves/min and a mean intensity of 0.17 mJ/mm2. A Storz Minilith SL 1 with integrated inline ultrasound probe was used. In all, 52 patients were evaluated 6 weeks after ESWT for early follow-up. Before ESWT intercourse was difficult or impossible for 40 men; 29 patients suffered mainly from penile deformity, 14 from painful erection and eight mainly from loss of distal rigidity. A total of 30 patients mentioned painful erection before treatment. In 28 patients (93%) pain reduction was achieved. A total relief of pain was observed in 19 patients (63%). Mean pain score dropped from 4.2 to 1.3 in patients who suffered predominantly from painful erections. Intercourse satisfaction improved in 11 patients after therapy. Mean angulation before (40°) and after (37°) ESWT did not change significantly. Late follow-up after 11.1 months (4–17 months) could be completed in 36 patients. In total, 19 men reported that ESWT improved their PD. Of these, 16 noted no change. Only one of the patients noticed a worsening of his disease during or after treatment. Complication rate was low with only minor side effects such as minimal skin bruising; one urethral bleeding occurred. ESWT did reduce pain during erection in patients suffering mainly from painful erection due to PD. However, penile angulation did not improve significantly in our setup and thus intercourse difficulties did improve only in 28% of the patients. Therefore, we do not recommend ESWT as a primary treatment for PD.
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References
De la Peyronie F . Sur quelques obstacles qui s’oppose à l’ejaculation naturelle de la semence. Mém Acad R Chir 1743; 1: 425–434.
Gholami SS et al. Peyronie's disease: a review. J Urol 2003; 169: 1234–1241, (Review).
Bellorofonte C et al. Possibility of using the piezoelectric lithotriptor in the treatment of severe cavernous fibrosis. Arch Ital Urol Nefrol Androl 1989; 61: 417–422.
Heller KD, Niethard FU . Using extracorporeal shockwave therapy in orthopedics—a meta-analysis. Z Orthop Ihre Grenzgeb 1998; 136: 390–401.
Mirone V et al. A new biopsy technique to investigate Peyronie's disease associated histologic alterations: results with two different forms of therapy. Eur Urol 2002; 42: 239–244, (discussion 244).
Butz M, Teichert HM . Treatment of Peyronie's disease (PD) by extracorporal shockwaves (ESW). J Urol 1998; 159(Suppl): 118.
Hauck EW 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, (discussion 670).
Husain J et al. Extracorporeal shock wave therapy in the management of Peyronie's disease: initial experience. BJU Int 2000; 86: 466–468.
Hamm R et al. Peyronie's disease-the Plymouth experience of extracorporeal shockwave treatment. BJU Int 2001; 87: 849–852.
Manikandan R, Islam W, Srinivasan V, Evans CM . Evaluation of extracorporeal shock wave therapy in Peyronie's disease. Urology 2002; 60: 795–799, discussion 799–800.
Lebret T et al. Extracorporeal shock wave therapy in the treatment of Peyronie's disease: experience with standard lithotriptor (siemens-multiline). Urology 2002; 59: 657–661.
Michel MS et al. Objective and subjective changes in patients with Peyronie's disease after management with shockwave therapy. J Endourol 2003; 17: 41–44, (discussion 44).
Devine Jr CJ, Somers KD, Jordan GH, Schlossberg SM . Proposal: trauma as the cause of the Peyronie's lesion. J Urol 1997; 157: 285–290.
Jarow JP, Lowe FC . Penile trauma: an etiologic factor in Peyronie's disease and erectile dysfunction. J Urol 1997; 158: 1388–1390.
Sautter T, Bangerter U, Tullio S, Hauri D . Extracorporal shockwave (ESW) as a new effective treatment in Peyronie's disease. Eur Urol 1999; 35(Suppl 2): 124.
Gelbard MK, Dorey F, James K . The natural history of Peyronie's disease. J Urol 1990; 144: 1376–1379.
Baumann M, Tauber R . Induratio penis plastica—Extrakorporale piezoelektrische Stosswellentherapie als neuer Therapieansatz. Akt Urol 1998; 29: 1–5.
Gianneo E, Nespoli R, Conti G, Comeri G . La Peyronie's disease (IPP) and extracorporal shock waves therapy (ESWT): our experience. J Urol 1999; 161(Suppl): 205.
Michel MS et al. Shock-wave therapy for the treatment of Peyronie's disease: first clinical investigation for the objective determination of deviation improvement by means of artificial erection. J Urol 1999; 161(Suppl): 262.
Wilson KA, Dowling AJ, Abdolell M, Tannock IF . Perception of quality of life by patients, partners and treating physicians. Qual Life Res 2000; 9: 1041–1052.
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Strebel, R., Suter, S., Sautter, T. et al. Extracorporeal shockwave therapy for Peyronie's disease does not correct penile deformity. Int J Impot Res 16, 448–451 (2004). https://doi.org/10.1038/sj.ijir.3901192
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DOI: https://doi.org/10.1038/sj.ijir.3901192
Keywords
- Peyronie's disease
- extracorporeal shockwave therapy
- erectile dysfunction
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