Extracorporeal Shock Wave Therapy for Peyronie's Disease: Exploratory Meta-Analysis of Clinical Trials

Hauck, Ekkehard W.; Muêller, U.; Bschleipfer, Thomas; Schmelz, Hans Ulrich; Diemer, Thorsten; Weidner, W.

doi:10.1097/01.ju.0000108060.30363.8d

Cited by 88 publications

(79 citation statements)

References 15 publications

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“…85 A recent attempt at meta-analysis of these results suggests an overall benefit in decreasing penile pain and improving sexual function. 86 These data do not provide convincing evidence of benefit with this therapy.…”

Section: Intralesional Therapymentioning

confidence: 93%

Peyronie's disease: a critical appraisal of current diagnosis and treatment

2008

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Peyronie's disease is a fibrotic disorder of the tunica albuginea of the penis resulting in varying degrees of penile curvature and sexual dysfunction. Diagnosis of the disorder is made by detailed sexual history and focused physical examination. A wide range of medical treatments has been employed to treat the disorder. Verapamil treatment administered by intraplaque injection is supported by generally consistent randomized controlled trials (RCT). Some RCT evidence exists to support the use of colchicine, potaba, L-carnitine and liposomal superoxide dismutase. Future studies of medical efficacy should focus on improving RCT design, implementation and results reporting to improve the quality of evidence generated by each study. The surgical treatment of Peyronie's disease is a viable and recommended alternative for men with compromised sexual function due to severe curvature or lesions causing penile instability. The choice of corrective procedure should be tailored to each patient after a detailed evaluation of disease severity and sexual function.

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Section: Intralesional Therapymentioning

confidence: 93%

Peyronie's disease: a critical appraisal of current diagnosis and treatment

2008

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“…Nach Vorlie gen streng pros pek tiv aus ge leg ter Stu di en mit ex akt de fi nier ten Er fas sungs me tho den der kli ni schen Ver läu fe, ei ner ex plo ra ti ven Me ta ana ly se [6] der bis he ri gen Stu di en und Da ten ei ner ran do mi sier ten Ein zelblind stu die kann die Durch füh rung ei ner ESWT zur The ra pie der IPP nicht mehr emp foh len wer den. Die ESWT hat nach den neues ten kri tischen Er kennt nis sen kei nen Ef fekt auf die Symp to me Plaque grö ße und De via ti on.…”

Section: Ex Tra Kor Po Ra Le Stoß Wel Len the Ra Pie (Eswt)unclassified

Induratio penis plastica

Diemer

Weidner

2006

Urologe

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Peyronie's disease is characterized by the formation of a plaque of the tunica albuginea that leads to a mainly dorsally directed penile curvature and penile shortening due to scarification. The exact ethiopathology remains unclear. The natural history of the disease is variable, ranging from spontaneous remissions to chronic, and including severe penile curvature. Therapy should be conservative in the early, painful, progressive phase. No conservative medical or semi-invasive treatment modality, such as extracorporeal shock wave therapy or radiation therapy, is currently available for curing all of the symptoms of this disorder in all patients. All studies with a controlled design showed poor therapeutic outcomes that are frequently identical to the natural course. Surgical therapy should only be performed in the stable stage of the disease. This means that Peyronie's disease should have been present for at least 12 months, and the patient should not have suffered from pain or the progression of symptoms for at least 6 months. The surgical treatment modalities comprise plication procedures (Essed-Schroeder, Nesbit), plaque-incisions with grafting, and the insertion of penile implants with simultaneous correction of the curvature by "penile cracking" or incisions of the plaque.

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“…Mittlerweile liegen 20 Originalarbeiten von 14 Arbeitsgruppen in gereviewten Journalen zur ESWT bei IPP vor (Überblick in [3]). Trotzdem bleiben viele Aspekte dieser Therapieform unklar.…”

Section: Indikation Zur Eswtunclassified

“…Die Durchführung einer Metaanalyse ist, wie bereits ausgeführt, aufgrund der unvollständigen Datenlage und unterschiedlichen Auswertungsprotokollen in den Ergebnissen limitiert.Die Daten unserer explorativen Metaanalyse [3] aller publizierten Studien im Vergleich zu Kontrollkollektiven zeigte folgende Ergebnisse: Es gibt für die Gesamtpopulation im Vergleich zu den Kontrollen keinen signifikanten Effekt bezüglich der objektiven Parameter Plaquegröße und Deviation.…”

Section: Ergebnisse Einer Metaanalyseunclassified

Stellungnahme der DGU

Weidner

Hauck

2004

Der Urologe A

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Die IPP ist durch die die Symptome peniler Plaque, penile Schmerzen, Deviation und in Einzelfällen auch durch eine begleitende Erektile Dysfunktion (ED) gekennzeichnet. Morphologisch liegt der Induratio penis plastica eine Plaquebildung der Tunica albuginea der Corpora cavernosa zugrunde. Deren Ätiopathogenese ist jedoch unklar, sodass es bisher auch keine kausale medikamentöse, instrumentelle oder operative Therapie gibt.

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Extracorporeal Shock Wave Therapy for Peyronie's Disease: Exploratory Meta-Analysis of Clinical Trials

Cited by 88 publications

References 15 publications

Peyronie's disease: a critical appraisal of current diagnosis and treatment

Peyronie's disease: a critical appraisal of current diagnosis and treatment

Induratio penis plastica

Stellungnahme der DGU

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