Extracorporeal Shock Wave Therapy in Peyronie's Disease: Clinical Efficacy and Safety from a Single-Arm Observational Study

Abstract

Purpose In this study, we aimed to determine the role of extracorporeal shockwave therapy (ESWT) in the management of Peyronie's disease (PD). Materials and Methods A total of 325 patients suffering from PD were enrolled in this single-arm clinical study. All patients were received ESWT using a schedule of 1 treatment/wk. Penile curvature was measured by a goniometer after intracavernosal drug-induced erection using Alprostadil. Plaque size was measured with a ruler and sexual function assessed by the international index of erectile function (IIEF)-15 score. Severity of erectile dysfunction was classified as severe (IIEF-15 ≤10), moderate (IIEF-15 between 11 and 16), or mild (IIEF-15 between 17 and 25). Results were evaluated at baseline and 3 months after the treatment. Results All the patients completed the study protocol. Median age was 59.0 years (55.0–64.0 years). After treatment, the median (interquartile range, IQR) plaque size reduced from 1.78 cm 2 (1.43–2.17 cm 2 ) to 1.53 cm 2 (1.31–1.96 cm 2 ) (p<0.001); the median (IQR) penile length in erection increased from 13.0 cm (12.0–14.0 cm) to 14 cm (13.0–15.0 cm) (p<0.001) and the median (IQR) penile curvature from 30.4° (22.2°–35.4°) to 25.0° (20.2°–30.4°) (p<0.001). We also observed a decrease in pain assessed by visual analogue scale (7 vs. 3; p<0.001), an improvement in each of the IIEF sub-domains (p<0.001) and an improvement in all three PD questionnaire domains (p<0.001). Conclusions Based on our findings, ESWT could be considered a safe and efficient minimally invasive option for the management of the patients suffering from PD.

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

“…In another recent study, Di Mauro et al demonstrated that ESWT decreased plaque size, penile curvature, and pain assessed by visual analogue scale (p<0.001). They also showed that ESWT might improve an erectile function measured by IIEF and increase a penile length in erection (p<0.001) [62].…”

The Natural History of Peyronie's Disease

“…It has been shown that younger age at disease onset and the presence of baseline vascular comorbidities (i.e., diabetes and dyslipidemia) demand even more urgency for early recognition and prompt intervention because of a higher risk for disease progression [ 25 36 ]. Retrospective series have proven that patients younger than 40 years are more likely to ask for treatment sooner, present with multiple palpable plaques and have at least one cardiovascular risk factors, as compared with older subjects.…”

Comparison of Intralesional Hyaluronic Acid vs. Verapamil for the Treatment of Acute Phase Peyronie's Disease: A Prospective, Open-Label Non-Randomized Clinical Study

“…Treatment of PD includes both medical and surgical approaches and the management is tailored to the phase of the disease, the degree of deformity, the quality of the erections and patient's choice [ 4 9 10 ]. Currently, intralesional injections of corticosteroids and verapamil represent the most common treatments offered for the management of acute phase of PD [ 10 11 ].…”