Efficacy of Extracorporeal Shock Wave Therapy (Eswt) in Patients With Peyronie's Disease (Pd) - First Results of a Prospective, Randomised, Placebo- Controlled, Single- Blind Study

Hatzichristodoulou, Georgios; Meisner, Christoph; Liske, P.; Stenzl, Arnulf; Lahme, Sven

doi:10.1016/s1569-9056(06)60243-1

Cited by 3 publications

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“…Apart from surgery, no treatment has been shown to definitely help the latter group of patients, except for evidence for some improvement after limited (6 weeks) of SWT [1,11–15]. There was no significant influence of SWT on plaque size [16] but benefits of SWT for pain in men with PD have been reported [17]. However, the effect of this treatment on the physical aspect of deformity (angulation/shortening) and its effect on sexual quality of life have not yet been studied.…”

Section: Discussionmentioning

confidence: 99%

Limited shock wave therapy vs sham treatment in men with Peyronie’s disease: results of a prospective randomized controlled double‐blind trial

et al. 2010

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Study Type – Therapy (RCT) Level of Evidence 1b OBJECTIVE To assess the role of extracorporeal shock wave therapy (SWT), in a prospective randomized controlled trial, comparing limited SWT vs sham therapy in men with Peyronie’s disease. PATIENTS AND METHODS In all, 36 men were randomized to six sessions of SWT or sham treatment. Geometrical measurements of penile length and deformity, and the abridged International Index of Erectile Function (IIEF) score and visual analogue score (VAS) were recorded and re‐evaluated at 6 months. The patient and assessor were unaware of the treatment type. Standard nonparametric tests were used for the statistical analysis. RESULTS A full set of outcome data was obtained for 16 patients in the intervention group and 20 in the sham/control group (mean age 58 and 60 years, respectively, mean duration of symptoms 15 and 33 months). There was no significant difference in the mean change between the control and intervention groups on any outcome measure. There were improvements in the mean (sd) dorsal and lateral angle, of 5.3 (11.66)° and 3.5 (17.38)° in the control group, and a deterioration of 0.9 (16.01)° and 0.9 (15.56)° in SWT group. Mean improvements in curved and straight lengths were 0.2 (0.58) and 0.1 (0.8) cm in the control and mean reductions of 0.1 (0.9) and 0.1 (1.49) cm in the SWT group. The mean changes in the IIEF and VAS scores were 0.1 (3.32) and −0.8 (1.77) for control and 0.56 (2.6) and −1.05 (1.79) for SWT group. CONCLUSION There were no significant differences in changes of variables in Peyronie’s disease treated with short‐term SWT.

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Section: Discussionmentioning

confidence: 99%

Limited shock wave therapy vs sham treatment in men with Peyronie’s disease: results of a prospective randomized controlled double‐blind trial

et al. 2010

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“…With regard to SWT, no listed study was double blinded. However, we are aware of one prospective, randomized, placebo‐controlled study presented at the Annual Meeting of the American Urological Association 2006 enrolling 102 patients with PD looking at the effect of SWT on pain and deformity [22]. All patients were treated six times in weekly intervals, comprising 2,000 shockwaves each session, whereby the control group was treated with interposition of a plastic membrane in the therapeutic device preventing the shock wave transmission.…”

Section: Areas Of Concern In Interpreting Pd Intervention Trialsmentioning

confidence: 99%

Peyronie’s Disease Intervention Trials: Methodological Challenges and Issues

Müller

Mulhall

2009

The Journal of Sexual Medicine

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Introduction Peyronie’s Disease (PD) has been studied for more than 260 years since Francois de la Peyronie’s description in 1743. Based on the current literature, the prevalence of PD seems 3–9% with an average age of onset in the fifth life decade. Much effort has been spent on developing nonsurgical treatment options to cure or at least prevent disease progression. Aim The recent examination of drug trials for erectile dysfunction has led us to assess PD trial methodology more closely. Methods An Iinternet search on PubMed was performed using MeSH words PD, clinical trials, oral, transdermal, intralesional and shock wave therapy focusing on 26 representing studies published over the last 15 years. Mean Outcome Measures A comprehensive review of the current literature on nonsurgical treatment options for PD was conducted to address methodological issues and challenges in PD trials highlighting trial design, patient population, and symptom and sign assessment. Results The majority of the reviewed studies are underpowered and the heterogeneity in the methodological approach and patient assessment between the studies is one of the remarkable findings from our review. Studies should use a uniform means of defining the degree and type of penile deformity and a large enough cohort of patients should be studied for adequate study power. An ideally designed PD intervention trial should comprise: (i) a randomized, placebo-controlled design; (ii) with a PD patient set representative of the general PD population; and (iii) a comprehensive symptom and sign assessment before and at the end of treatment which includes an assessment of at least deformity, pain, and sexual function. Conclusion A number of challenges exist for the design of PD intervention trials and deciphering the data generated from them. The field would benefit greatly from a consensus statement or guidelines development on the design and conduct of such trials.

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“…ESWL is not recommended as first‐line therapy for PyD. Recent placebo‐controlled trials do not demonstrate improvements in penile curvature or plaque characteristics [33,34]. Oft‐quoted supportive studies fail to objectively define changes in deformity, include a control group, or utilize validated instruments to measure changes in sexual function [17,32].…”

Section: Part Two: Nonsurgical Management Of Pydmentioning

confidence: 99%

Continuing Medical Education: Peyronie's Disease (CME)

Bella

Perelman

Brant

et al. 2007

The Journal of Sexual Medicine

103

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Introduction The management of Peyronie's disease (PyD) presents several challenges to the clinician. Despite progress in the understanding of PyD on several fronts, it remains a physically and psychologically devastating condition for the affected patient and partner. Aim The purpose of this Continuing Medical Education article is to review contemporary knowledge of the epidemiology, pathophysiology, evaluation, and management of PyD, thus enabling best-practice management. Methods An English-language MEDLINE review was performed from 1990 to present-day for PyD. Main Outcome Measure Current state of, and new developments in, PyD. Results Recent studies have established a new paradigm for the natural history and epidemiology of PyD. Prevalence approaches 5%, while less than 20% of men report spontaneous resolution of deformity. The psychological sequelae on both patient and partner are underrepresented in literature; data gleaned from select Internet websites have better established Peyronie's effects on psyche and relationships. For the majority of patients, evaluation, information, and reassurance is sufficient. Few medical treatment options are supported by data from well-designed placebo-controlled trials. For men unresponsive to nonoperative therapies, plication, grafting, or implantation of a penile prosthesis are surgical management options. Conclusions PyD does not invariably progress to a complete loss of the ability for sexual intercourse. Should deformities preclude intercourse, well-established medical or surgical options may be considered; indeed, using one or more of the treatment approaches outlined can, in most cases, result in adequate restoration of sexual function.

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Efficacy of Extracorporeal Shock Wave Therapy (Eswt) in Patients With Peyronie's Disease (Pd) - First Results of a Prospective, Randomised, Placebo- Controlled, Single- Blind Study

Cited by 3 publications

References 0 publications

Limited shock wave therapy vs sham treatment in men with Peyronie’s disease: results of a prospective randomized controlled double‐blind trial

Limited shock wave therapy vs sham treatment in men with Peyronie’s disease: results of a prospective randomized controlled double‐blind trial

Peyronie’s Disease Intervention Trials: Methodological Challenges and Issues

Continuing Medical Education: Peyronie's Disease (CME)

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