Shockwave Therapy in the Treatment of Peyronie’s Disease

Krieger, Jordan R.; Rizk, Paul; Kohn, Taylor P.; Pastuszak, Alexander W.

doi:10.1016/j.sxmr.2019.02.001

Cited by 18 publications

(18 citation statements)

References 18 publications

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“…15 This realization was the origin of Li-ESWT. 16 Li-ESWT has since become recognized for its potential clinical therapeutic effects in the treatment of various musculoskeletal pathologies, [17][18][19] Peyronie's disease, [20][21][22] chronic prostatitis/chronic pelvic pain syndrome, 23,24 chronic wound treatments, 25,26 and several cardiovascular pathologies. [27][28][29][30][31][32] In 2010, Li-ESWT began to be explored as an alternative means of treating ED, 33 with the first randomized controlled trial (RCT) published in 2012.…”

Section: Low-intensity Extracorporeal Shockwave Therapymentioning

confidence: 99%

Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction

Drury

Natale

2021

Therapeutic Advances in Urology

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Erectile dysfunction (ED) is both a common and complex disease process. Existing ED treatments do not always achieve adequate results. There is clinical interest in employing regenerative therapies, including low-intensity extracorporeal shockwave therapy (Li-ESWT), platelet rich plasma (PRP), and stem cell therapy (SCT), in the treatment of ED as adjunct or alternative treatments. Here, we present evidence for emerging shockwave- and cell-based regenerative therapies for the treatment of ED following a thorough review of the existing PubMed literature pertaining to Li-ESWT, PRP, and SCT in relation to the treatment of ED. Li-ESWT causes microtrauma in tissue that hypothetically upregulates angiogenesis and recruits stem cells. Several large-scale systematic reviews and meta-analyses have reported that Li-ESWT improved ED in humans. Additionally, evidence has commenced to show that Li-ESWT may be effective against two recognized and complex etiologies of ED: diabetic and neurogenic. PRP delivers an autologous sample rich in growth factors to damaged tissue. Animal model studies have demonstrated improved erectile function recovery as well as preservation of cavernous nerve axons. Studies with PRP in humans are limited. SCT utilizes the regenerative potential of stem cells for healing of damaged tissue. In the treatment of ED, SCT has been used in the setting of diabetic and post-prostatectomy ED. Results of human studies are varied, although SCT treatments did result in increased erectile rigidity with some patients recovering the ability to achieve penetration. While these regenerative therapies show potential to augment the current treatment regimen for ED, there is a paucity of evidence to support the safety and efficacy of these treatments. Further research is necessary to define the role of these alternative therapies in the treatment of ED.

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Section: Low-intensity Extracorporeal Shockwave Therapymentioning

confidence: 99%

Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction

Drury

Natale

2021

Therapeutic Advances in Urology

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“…It is proposed that ESWT works by remodeling the penile plaque, resulting in a local enhancement of macrophage activity through stimulation of inflammatory reaction with subsequent lysis of fibrotic tissue and increasing of angiogenesis around PD plaque. Eventually, these effects may lead to reducing plaque size, diminishing penile deformity, and alleviating pain [55][56][57].In one study, Chitale et al demonstrated that there were no significant differences between ESWT and sham therapy in an improvement of penile curvature and pain [58].In another placebo-controlled, randomized study, Hatzichristodoulou et al showed that in 40% cases, ESWT had led to worsening of penile deviation, and there were not any differences in plaque size between the intervention group and placebo( p=0.33) [59]. In one meta-analysis, Gao et al demonstrated that ESWT reduces penile plaque size and relieves pain syndrome but not improve penile curvature and sexual function [60 ].However, Shimpi et al reported that ESWT improved pain and penile curvature and reduced PD plaque [61].…”

Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

Non-Surgical Treatment of Peyronie’s Disease: A Comprehensive Review

Chernylovskyi

Krakhotkin²,

Chaikovskyi

2021

Wiad Lek

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This review article focuses on conservative treatment options, topical, intralesional therapy, traction and vacuum therapy. A PubMed database search was performed for studies that were published between 1948 and 2019. Search keywords included “Peyronie’s disease,” “conservative therapy,” “traction treatment,” “extracorporeal shock wave therapy,” “topical and oral therapies,” and “vaccum therapy.” Clinical trials in men with Peyronie’s disease and scientific articles relating to pharmacologic data were included in the review. When possible, large, randomized, and well-designed trials were selected. Non-English-language articles were excluded.

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“…Pain data from controlled and noncontrolled trials are variable. 18 Previous controlled studies showed that shock waves, alone, 17 or in combination with PDE5i, 16 significantly improved pain and erectile function. Previous studies have reported an improvement in penile pain in up to 84% of patients without using a standardized method of pain measurement.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of LiESWT in the treatment of PD is unclear. 15 16 17 18 19 20 The therapeutic effect of shock wave therapy on bony and connective tissues was first reported in 1988. 21 The first application of shock wave therapy in patients with PD was described 7 years later.…”

Section: Discussionmentioning

confidence: 99%

Low-intensity extracorporeal shock wave therapy for Peyronie's disease

Abdessater

Akakpo²,

Kanbar³

et al. 2022

Asian Journal of Andrology

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The aim of this article is to assess the outcomes of a low-intensity extracorporeal shock wave therapy (LiESWT) protocol for the treatment of Peyronie's disease (PD). Patients treated for PD were prospectively recorded, and data were retrospectively reviewed. Age, characteristics of fibrous plaques, concomitant treatments, International Index of Erectile Function (IIEF-5), Lue score, and pain score on Likert scale were collected. Patients in acute phase of PD and an angulation of <40° were included. The protocol consisted of 6 weekly sessions of 4000 pulses each, applied from different directions, with a maximal power of 20 W and 8 Hz frequency. We included 39 patients (median age: 56.8 years, interquartile range [IQR]: 35.8–62.2 years). The median number of sessions received per patient was 7.2. After treatment, the median Lue score decreased from 6.8 initially to 3.3 ( P = 0.003), the median Likert pain score dropped from 1.8 to 0.7 ( P = 0.004), the median plaque size was reduced from 2 cm to 1.2 cm ( P = 0.08), and the median penile curvature diminished from 31° to 17° ( P = 0.07). On univariate and multivariate analysis, the only predictors of success were younger age (odds ratio [OR] = 0.95, P = 0.03 and OR = 0.91, P = 0.04, respectively) and concomitant use of phosphodiesterase-5 inhibitors (PDE5i; OR = 0.92, P = 0.02 and OR = 0.93, P = 0.01, respectively). LiESWT had a favorable impact on Lue score and notably penile pain, curvature, plaque size, and erectile function in patients treated for PD during the early inflammatory phase, with no side effects. Younger age and concomitant use of PDE5i were the only success predictors.

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Shockwave Therapy in the Treatment of Peyronie’s Disease

Cited by 18 publications

References 18 publications

Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction

Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction

Non-Surgical Treatment of Peyronie’s Disease: A Comprehensive Review

Low-intensity extracorporeal shock wave therapy for Peyronie's disease

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