Preliminary findings from a new animal model for Peyronie’s disease involving extracorporeal shock waves

Abstract

OBJECTIVE To develop an experimental model in rabbits to analyse the efficiency of extracorporeal shock wave therapy (ESWT) for Peyronie’s disease. MATERIALS AND METHODS We used 15 adult male rabbits divided into three equal groups. In group 1 (no penile ESWT) rabbits had three sessions of ESWT with 2000 shocks each (15 kV), but a rubber mat was placed between the shock head and rabbit to protect the penis; the rabbits were killed at 7 days after the last session of ESWT. In group 2 the rabbits had three sessions of ESWT using the same parameters, and were killed immediately after the last session to analyse the penis. In group 3 the rabbits had three sessions of ESWT as before but were killed at 7 days after the last session, and the penile tissue analysed macroscopically and histologically. RESULTS The results showed clearly that the model was efficient, creating a similar situation to that when applying ESWT in the human penis. All of the rabbits in groups 2 and 3 had haematomas and diffuse petechiae after ESWT, and only four had urethral and penile bleeding. Almost all macroscopic changes disappeared after 48 h and only one rabbit in group 3 after 7 days had a haematoma on the dorsal penile surface. The histology (assessed using haematoxylin and eosin staining) of the cavernous body of the penis showed: unchanged histology in group 1; in group 2 there was a dilated and congested vascular space in the cavernous body, with interstitial extensive bleeding in the dermis; and in group 3 there was an increase in interstitial fibrous tissue in the cavernous septum, with deposition of collagen fibres and thickening of the tunica albuginea. CONCLUSION The present model was efficient in producing tissue injury in the normal penis when treated with ESWT, suggesting that this promising model should be considered for use future studies of Peyronie’s disease.

Extracorporeal Shock Wave Therapy in Dupuytren’s Disease

“…[15] In an animal model for Peyronie's disease, 2000 shockwaves were applied. [16] Using the technique in 44 patients with Peyronie's disease in their controlled study, they achieved a reduction in pain, significant recovery in erectile function, and an increase in quality of life. [17] The same study clinical randomized controlled trial in Peyronie's disease shock waves significantly reduced pain and improved erectile function and quality of life.…”

European Society of Sexual Medicine consensus statement on the use of animal models for studying Peyronie’s disease

“…Other fibrosis inducers were thrombin only 33 or in combination with fibrin, 17 , 30 , 54 allograft of TA tissue from another rat, 55 autologous blood 26 or plasma, 15 chlorhexidine, 23 sodium tetradecyl sulfate , 27 , 32 and extracorporeal shockwave ( Table 1 ). 37 …”