Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Low-intensity shockwave therapy in Peyronie’s disease: long-term results from a prospective, randomized, sham-controlled trial

Abstract

Low-intensity shockwave therapy (LiST) is an effective treatment for pain reduction in patients with Peyronie’s disease (PD). We aimed to report the long-term results of a previously published randomized, sham-controlled trial on LiST for PD management. For the initial study, 102 patients with stable PD were randomly assigned to six sessions of LiST (n = 51) or sham (n = 51) therapy. All participants were subsequently contacted for an additional evaluation at 3 years after completion of the initial treatment and 63 of them (LiST = 34 and sham therapy = 29) presented for the evaluation. Among them, improvement of pain was reported in 23 participants (LiST = 16, sham = 7, p = 0.005) at 4 weeks and in 22 (LiST = 15, sham = 7, p = 0.031) at 3 years. We detected a mean difference of 2.2 points (95%CI: 0.9–3.5, p = 0.002) in the visual analog pain scale at 4 weeks and a mean difference of 2.5 points (95%CI: 1–4, p = 0.002) at 3 years between the two groups. No treatment-related complications occurred during the sessions or the follow-up period. Regarding the improvement of penile curvature or sexual function, no significant differences between the two groups were observed. Overall, LiST constitutes a safe and effective therapeutic approach for pain management both in the short- and long term.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1: Study flow chart.

References

  1. 1.

    Devine CJ, Somers KD, Jordan SG, Schlossberg SM. Proposal: trauma as the cause of the Peyronie’s lesion. J Urol. 1997;157:285–90.

    Article  Google Scholar 

  2. 2.

    Chung E, Ralph D, Kagioglu A, Garaffa G, Shamsodini A, Bivalacqua T, et al. Evidence-based management guidelines on Peyronie’s disease. J Sex Med. 2016;13:905–23.

    Article  Google Scholar 

  3. 3.

    Levine LA, Becher EF, Bella AJ, Brant WO, Kohler TS, Martinez-Salamanca JI, et al. Penile prosthesis surgery: current recommendations from the international consultation on sexual medicine. J Sex Med. 2016;13:489–518.

    Article  Google Scholar 

  4. 4.

    Gao L, Qian S, Tang Z, Li J, Yuan J. A meta-analysis of extracorporeal shock wave therapy for Peyronie’s disease. Int J Impot Res. 2016;28:161–6.

    CAS  Article  Google Scholar 

  5. 5.

    Capogrosso P, Frey A, Jensen CFS, Rastrelli G, Russo GI, Torremade J, et al. Low-intensity shock wave therapy in sexual medicine-clinical recommendations from the European society of sexual medicine (ESSM). J Sex Med. 2019;16:1490–505.

    Article  Google Scholar 

  6. 6.

    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;10:2815–21.

    Article  Google Scholar 

  7. 7.

    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;56:363–9.

    Article  Google Scholar 

  8. 8.

    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;106:1352–6.

    Article  Google Scholar 

  9. 9.

    Salonia A, Bettochi C, Carvalho J, Corona G, Jones TH, Kadioğlu A, et al. EAU guidelines on sexual and reproductive health 2020. In: European Association of Urology Guidelines 2020 edition. Arnhem, The Netherlands: European Association of Urology Guidelines Office; 2020. https://uroweb.org/guideline/sexual-and-reproductive-health/.

  10. 10.

    Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194:745–53.

    Article  Google Scholar 

  11. 11.

    Goldstein I, Lipshultz LI, McLane M, Hu Y, Xiang Q, Liu G, et al. Long-term safety and curvature deformity characterization in patients previously treated with collagenase clostridium histolyticum for Peyronie’s disease. J Urol. 2020;203:1191–7.

    Article  Google Scholar 

  12. 12.

    Gelbard MK, Dorey F, James K. The natural history of Peyronie’s disease. J Urol. 1990;144:1376–9.

    CAS  Article  Google Scholar 

  13. 13.

    Bekos A, Arvaniti M, Hatzimouratidis K, Moysidis K, Tzortzis V, Hatzichristou D. The natural history of Peyronie’s disease: an ultrasonography-based study. Eur Urol. 2008;53:644–50.

    Article  Google Scholar 

  14. 14.

    Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332. CONSORT Group

    Article  Google Scholar 

  15. 15.

    Hauck EW, Altinkilic BM, Ludwig M, Lüdecke 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;38:663–9. discussion 670

    CAS  Article  Google Scholar 

  16. 16.

    Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. J Urol. 2006;175:2115–8. discussion 2118

    Article  Google Scholar 

  17. 17.

    Berookhim BM, Choi J, Alex B, Mulhall JP. Deformity stabilization and improvement in men with untreated Peyronie’s disease. BJU Int. 2014;113:133–6.

    Article  Google Scholar 

  18. 18.

    Capoccia E, Ziegelmann M, Emmerson J, Lankford J, Ofori-Marfoh C, Levine L. Long-term patient-reported outcomes in men with Peyronie’s disease undergoing nonsurgical and nonintralesional injection management. Int J Impot Res. 2021;33:75–81.

  19. 19.

    Kadioglu A, Küçükdurmaz F, Sanli O. Current status of the surgical management of Peyronie’s disease. Nat Rev Urol. 2011;8:95–106.

    Article  Google Scholar 

  20. 20.

    Fode M, Østergren PB. Contemporary thoughts on the role of shockwave therapy in Peyronie’s disease. J Sex Med. 2020;17:174–9.

    Article  Google Scholar 

  21. 21.

    Fojecki GL, Tiessen S, Osther PJS. Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain. World J Urol. 2017;35:1–9.

    CAS  Article  Google Scholar 

  22. 22.

    Fode M, Russo GI, Verze P. Therapeutic areas of Li-ESWT in sexual medicine other than erectile dysfunction. Int J Impot Res. 2019;31:223–30.

    Article  Google Scholar 

  23. 23.

    Srirangam SJ, Manikandan R, Hussain J, Collins GN, O’Reilly PH. Long-term results of extracorporeal shockwave therapy for Peyronie’s disease. J Endourol. 2006;20:880–4.

    Article  Google Scholar 

  24. 24.

    Amighi A, Eleswarapu SV, Mendhiratta N, Nork JJ, Mills JN. Discontinuation from collagenase clostridium histolyticum therapy for Peyronie’s disease: review and single-center cohort analysis. Sex Med Rev. 2019;7:690–8.

    Article  Google Scholar 

  25. 25.

    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;35:190–5.

    CAS  Article  Google Scholar 

  26. 26.

    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;36:327–30.

    CAS  Article  Google Scholar 

  27. 27.

    Liu T, Shindel AW, Lin G, Lue TF. Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy. Int J Impot Res. 2019;31:170–6.

    CAS  Article  Google Scholar 

  28. 28.

    Krieger JR, Rizk PJ, Kohn TP, Pastuszak A. Shockwave therapy in the treatment of Peyronie’s disease. Sex Med Rev. 2019;7:499–507.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Contributions

All authors participated in the drafting, writing, and editing of the manuscript.

Corresponding author

Correspondence to Georgios Hatzichristodoulou.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sokolakis, I., Pyrgidis, N., Lahme, S. et al. Low-intensity shockwave therapy in Peyronie’s disease: long-term results from a prospective, randomized, sham-controlled trial. Int J Impot Res (2021). https://doi.org/10.1038/s41443-021-00447-2

Download citation

Search

Quick links