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

Abdessater, Maher; Akakpo, W.; Kanbar, Anthony; Parra, J.; Seisen, Thomas; Chartier‐Kastler, Emmanuel; Drouin, S.; Rouprêt, Morgan

doi:10.4103/aja.aja_40_21

Cited by 7 publications

(3 citation statements)

References 30 publications

(58 reference statements)

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“…That said, only 63 patients in the initial study group were available for long‐term evaluation 97 . Available retrospective trials also did not show its efficacy 98,99 …”

Section: Other Non‐invasive Methods Of Treatmentmentioning

confidence: 99%

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Current trends in non‐surgical management of Peyronie's disease—A narrative review

Kozub,

Suleja,

Chłosta

et al. 2023

Andrology

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Peyronie's disease (PD) is a connective tissue disorder affecting the tunica albuginea. It can cause pain and penile deformation, and its prevalence increases with age. Although surgery is the gold standard for the chronic phase of the disease, there are several conservative treatment methods available, and the optimal management of the acute phase of the disease remains a matter of debate. In this article, we aim to summarize the recent trends in research on the subject of non‐surgical treatment of PD. The search was performed in PubMed, Scopus, and Web of Science databases and included studies in English published between 2012 and 2022 investigating the clinical outcomes of non‐surgical PD management in humans. We have identified 20 distinct conservative treatment strategies. Among the oral therapeutics, only the use of phosphodiesterase type 5 inhibitors is currently recommended for clinical use in patients with concomitant erectile dysfunction. The use of collagenase from Clostridium histolyticum is supported by the best quality evidence in terms of intralesional injections for patients suffering from significant penile curvature; however, interferon alpha‐2b can also be an option in such patients. Among other non‐invasive methods, extracorporeal shockwaves can be useful for pain reduction, and penile traction therapy can lead to a reduction in penile curvature and plaque size. Despite a wide range of non‐surgical methods available for PD treatment, the majority are not supported by sufficient scientific evidence, and the treatment efficacy is underwhelming. Further research on the subject of non‐surgical management of PD is highly warranted.

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“…That said, only 63 patients in the initial study group were available for long‐term evaluation 97 . Available retrospective trials also did not show its efficacy 98,99 …”

Section: Other Non‐invasive Methods Of Treatmentmentioning

confidence: 99%

“…97 Available retrospective trials also did not show its efficacy. 98,99 In comparison with other conservative treatment methods, ESWT seems to be associated with poor outcomes, and despite a favorable safety profile, there might be limited merit to further research on this subject.…”

Section: Extracorporeal Shockwave Therapymentioning

confidence: 99%

Current trends in non‐surgical management of Peyronie's disease—A narrative review

Kozub,

Suleja,

Chłosta

et al. 2023

Andrology

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“…The first hypothesis suggests that the shock waves directly damage the penile plaques, leading to penile tissue remodeling, while the second hypothesis suggests that the heat generated by the shock waves causes an inflammatory reaction that leads to increased macrophage activity and subsequent degradation of the plaque. Available studies with extracorporeal shock therapy (Table 1) have shown a reduction in pain in patients with PD [19][20][21][22][23][24][25][26], a reduction in PD [19][20][21]25,26], a reduction in plaque [20,21,25] , improving erectile function (EF) [20,21,23,25], lengthening the penis [21], improving quality of life [23]. Only one clinical study did not observe any significant change after the application of ESWT [27].…”

Section: Introductionmentioning

confidence: 99%

Мodern Non-Invasive Methods for Treating Peyronie's Disease

Tosev

Vladeva

Dimov

2023

RS Global - World Science

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Summary: Peyronie's disease (PD) is a common disease in men that can lead to significant penile deformity and pain, erectile dysfunction, and mental health problems. So far, surgical correction with plaque removal offers the greatest likelihood of success during the stable phase of the disease. However, for men in the acute phase of PD or those with a milder deformity who choose to avoid surgery, conservative treatment methods are also available. New innovative methods are extracorporeal shock wave therapy (ESWT) and ultrasound therapy. Intralesional therapy with IFN-α2b, verapamil, and Clostridium histolyticum (CCH) collagenase can significantly reduce penile deviation (PD), but these results may not be clinically significant in men with more severe disease. Iontophoresis (EMDA, electromotive drug administration) of verapamil and cortisone have shown reductions in PD and penile pain.Penile traction therapy offers clinically significant improvement in penile length and curvature. It requires daily therapy lasting several hours. Oral therapies with substances such as L-arginine, L-citrulline, vitamin E and phosphodiesterase inhibitors are most helpful as part of a combination regimen rather than as monotherapy. Regenerative therapies with stem cells and platelet-rich plasma, as well as intralesional therapy with botulinum toxin (Botox) have not yet been well clinically studied and their possible application is currently taking place within the framework of clinical research. The combination of various oral, topical, intralesional therapies, extracorporeal shock wave therapy, ultrasound and traction therapies together with clinical psychosexual therapy if needed could provide a more effective treatment, which in turn could prevent or reduce the need for definitive reconstructive penile surgery. Materials and methods: For the purposes of the literature review, a systematic search was conducted for articles in German and English on non-invasive treatment methods for Peyronie's disease. The articles were selected according to their relevance to the given topic. The main findings were summarized and presented in tabular form.

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Long-term experiences with high-energy shock wave therapy in the management chronic phase Peyronie’s disease using two different electromagnetic lithotripters

Rassweiler,

Scheitlin,

Goezen

et al. 2024

World J Urol

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Background Extracorporeal shock wave lithotripsy represents one option for the non-surgical management of Peyronie’s disease. Despite promising results, several questions are still pending. We want to present the long-term results of a retrospective study using high-energy extracorporeal shock wave lithotripsy. Material and methods We evaluated retrospectively 110 patients treated between 1996 and 2020 at the Department of Urology, SLK Kliniken Heilbronn for chronic phase Peyronie’s disease using two electromagnetic lithotripters (Siemens Lithostar Plus Overhead Module, Siemens Lithoskop) applying high-energy shock waves under local anesthesia and sonographic or fluoroscopic control. A standardized questionnaire focused on the change in pain, curvature, sexual function and the need of penile surgery. Results In 85 of the 110 patients (mean age 54 years) we had sufficient data for evaluation. The median follow-up was 228 (6–288) months. There were no significant complications. Pain reduction was achieved in all patients, 65 (76%) patients were free of pain. Improvement of penile curvature was achieved in 43 patients (51%) ranging from 25% improvement (deflected angle < 30°) to 95% (angle 30–60°). 59 patients (69%) reported problems with sexual intercourse, 40 of those (68%) reported improvement. Only 9 (10.5%) patients underwent surgical correction. We did not observe any significant differences between both electromagnetic devices with stable long-term results. Conclusions High-energy shock wave therapy delivered by two standard electromagnetic lithotripters is safe and efficient providing stable long-term results. In cases with significant plaque formation, the concept of high-energy ESWT should be considered in future studies.

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

Cited by 7 publications

References 30 publications

Current trends in non‐surgical management of Peyronie's disease—A narrative review

Current trends in non‐surgical management of Peyronie's disease—A narrative review

Мodern Non-Invasive Methods for Treating Peyronie's Disease

Long-term experiences with high-energy shock wave therapy in the management chronic phase Peyronie’s disease using two different electromagnetic lithotripters

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