Extracorporeal Shockwave Therapy for Peyronie's Disease: Who Benefits?

Taylor, Jennifer; Forster, James A.; Browning, Anthony J.; Biyani, Chandra Shekhar

doi:10.1089/end.2006.20.135

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…Subgroup analysis from some of the previous case series [18] showed that the best outcomes after SWT were in relatively younger men (<55 years) with milder penile curvatures (<30°). A degree of success in improving pain and penile curvature has also been reported for the combination of SWT with peri‐lesional injection of a calcio‐antagonist [19,20] or high‐dose oral vitamin E [21].…”

Section: Discussionmentioning

confidence: 95%

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: 95%

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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“…In contrast to the published literature supporting the role of LiESWT in men with ED ( 17 , 18 ), the reported changes in erectile function following LiESWT for the treatment of PD has been mixed. While International Index of Erectile Function-5 (IIEF-5) score is frequently used to evaluate sexual function in men with PD, it has never been specifically validated for use in this disease state.…”

Section: Sexual (Erectile) Functionmentioning

confidence: 78%

“…It is also more likely that men who reported improvement in penile curvature had a PD history of less than 12 months, indicating likely active disease process, which is more susceptible to a mechanical effect. Furthermore, subgroup analysis of patients in the LiESWT group showed an overall better outcome in younger patients with a relatively milder degree of curvature ( 15 , 17 ). Comparative studies between LiESWT with other treatment modality showed that LiESWT is not superior to other options ( 1 , 11 , 12 ) and when used in combination with other therapeutic options such as intralesional injection or tadalafil for men with PD and ED, there were improvements in erectile function score and quality of life score while the plaque size and curvature were unchanged ( 24 ).…”

Section: Controversy and Unresolved Issuesmentioning

confidence: 95%

Pro: does shockwave therapy have a place in the treatment of Peyronie’s disease?

Chung

2016

Transl. Androl. Urol.

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“…While published literature has largely failed to demonstrate significant benefit in the use of LiESWT to treat penile curvature [ 1 5 7 8 9 14 15 16 17 18 19 20 ] ( Table 3 ), these outcomes should be interpreted with some caution due to underlying methodological flaws [ 7 8 9 14 15 16 17 18 19 ] and perhaps inappropriate use of shock wave energy flow density [ 7 15 16 17 18 ]. Interestingly, subgroup analysis of patients in the LiESWT group showed an overall better outcome in younger patients with a relatively milder degree of curvature [ 8 18 ]. Comparative studies between LiESWT with other treatment modality showed that LiESWT is not superior to other options [ 1 5 10 ] and when used in combination with other therapeutic options such as intralesional injection or tadalafil for men with PD and ED, there were improvement in erectile function score and quality of life score while the plaque size and curvature were unchanged [ 19 20 ].…”

Section: Discussionmentioning

confidence: 99%

Peyronie's disease and low intensity shock wave therapy: Clinical outcomes and patient satisfaction rate in an open-label single arm prospective study in Australian men

Chung

2015

Korean J Urol

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PurposeTo evaluate the efficacy, safety and patient satisfaction outcomes following low intensity extracorporeal shock wave therapy (LiESWT) in men with Peyronie's disease (PD) using a standardised protocol.Materials and MethodsIn this open-label single arm prospective study, patients with PD were enrolled following informed consent. Patient demographics, change in penile curvature and plaque hardness, International Index of Erectile Function (IIEF)-5 score, and overall satisfaction score (on a 5-point scale) were recorded. Treatment template consists of 3000 shock waves to the Peyronie's plaque over 20 minutes, twice weekly for 6 weeks.ResultsThe majority of patients have PD history longer than 6 months (mean, 12.8 months; range, 6-28 months). Two thirds of patients have received and failed oral medical therapy. There were improvements in penile curvature (more than 15 degrees in 33% of men), plaque hardness (60% of men) and penile pain (4 out of 6 men) following LiESWT. There was a moderate improvement in IIEF-5 score (>5 points reported in 20% of men). No complication was reported and the majority of patients were satisfied (rated 4 out of 5; 70% of men) and would recommend this therapy to others.ConclusionsIn a carefully selected group of men with PD, LiESWT appears to be safe, has moderate efficacy and is associated with high patient satisfaction rate in the short term.

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Extracorporeal Shockwave Therapy for Peyronie's Disease: Who Benefits?

Abstract: The response to EWST is not the same for all men with Peyronie's disease. Younger men and those with milder curvature have the best outcomes.

Cited by 10 publications

References 30 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

Pro: does shockwave therapy have a place in the treatment of Peyronie’s disease?

Peyronie's disease and low intensity shock wave therapy: Clinical outcomes and patient satisfaction rate in an open-label single arm prospective study in Australian men

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