Korean J Urol.  2015 Nov;56(11):775-780. 10.4111/kju.2015.56.11.775.

Peyronie's disease and low intensity shock wave therapy: Clinical outcomes and patient satisfaction rate in an open-label single arm prospective study in Australian men

• Chung E

• KMID: 2351041
• DOI: http://doi.org/10.4111/kju.2015.56.11.775

Abstract

PURPOSE
To evaluate the efficacy, safety and patient satisfaction outcomes following low intensity extracorporeal shock wave therapy (LiESWT) in men with Peyronie's disease (PD) using a standardised protocol.
MATERIALS AND METHODS
In this open-label single arm prospective study, patients with PD were enrolled following informed consent. Patient demographics, change in penile curvature and plaque hardness, International Index of Erectile Function (IIEF)-5 score, and overall satisfaction score (on a 5-point scale) were recorded. Treatment template consists of 3000 shock waves to the Peyronie's plaque over 20 minutes, twice weekly for 6 weeks.
RESULTS
The majority of patients have PD history longer than 6 months (mean, 12.8 months; range, 6-28 months). Two thirds of patients have received and failed oral medical therapy. There were improvements in penile curvature (more than 15 degrees in 33% of men), plaque hardness (60% of men) and penile pain (4 out of 6 men) following LiESWT. There was a moderate improvement in IIEF-5 score (>5 points reported in 20% of men). No complication was reported and the majority of patients were satisfied (rated 4 out of 5; 70% of men) and would recommend this therapy to others.
CONCLUSIONS
In a carefully selected group of men with PD, LiESWT appears to be safe, has moderate efficacy and is associated with high patient satisfaction rate in the short term.

Keyword

Low intensity shock wave therapy; Male genital disease; Penile induration; Therapeutic effects and clinical outcomes

MeSH Terms

Adult
Age Distribution
Aged
Feasibility Studies
Humans
Lithotripsy/adverse effects/*methods
Male
Middle Aged
Pain/prevention & control
*Patient Satisfaction
Penile Induration/pathology/*surgery
Prospective Studies
Treatment Outcome

Figure

• 

  Fig. 1 Improvement in penile curvature following low intensity shock wave lithotripsy (LiESWT)

Reference

1. Ralph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M, et al. The management of Peyronie's disease: evidence-based 2010 guidelines. J Sex Med. 2010; 7:2359–2374.

2. Smith JF, Walsh TJ, Lue TF. Peyronie's disease: a critical appraisal of current diagnosis and treatment. Int J Impot Res. 2008; 20:445–459.

3. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol. 2006; 175:2115–2118.

4. Bellorofonte C, Ruoppolo M, Tura M, Zaatar C, Tombolini P, Menchini Fabris GF. Possibility of using the piezoelectric lithotriptor in the treatment of severe cavernous fibrosis. Arch Ital Urol Nefrol Androl. 1989; 61:417–422.

5. Hauck EW, Mueller UO, Bschleipfer T, Schmelz HU, Diemer T, Weidner W. Extracorporeal shock wave therapy for Peyronie's disease: exploratory meta-analysis of clinical trials. J Urol. 2004; 171(2 Pt 1):740–745.

6. Manikandan R, Islam W, Srinivasan V, Evans CM. Evaluation of extracorporeal shock wave therapy in Peyronie's disease. Urology. 2002; 60:795–799.

7. Hatzichristodoulou G, Meisner C, Gschwend JE, Stenzl A, Lahme S. Extracorporeal shock wave therapy in Peyronie's disease: results of a placebo-controlled, prospective, randomized, single-blind study. J Sex Med. 2013; 10:2815–2821.

8. Chitale S, Morsey M, Swift L, Sethia K. Limited shock wave therapy vs sham treatment in men with Peyronie's disease: results of a prospective randomized controlled double-blind trial. BJU Int. 2010; 106:1352–1356.

9. Palmieri A, Imbimbo C, Longo N, Fusco F, Verze P, Mangiapia F, et al. A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie's disease. Eur Urol. 2009; 56:363–369.

10. Mirone V, Imbimbo C, Palmieri A, Longo N, Fusco F, Tajana G. A new biopsy technique to investigate Peyronie's disease associated histologic alterations: results with two different forms of therapy. Eur Urol. 2002; 42:239–244.

11. Gruenwald I, Appel B, Kitrey ND, Vardi Y. Shockwave treatment of erectile dysfunction. Ther Adv Urol. 2013; 5:95–99.

12. Chung E, Yan H, De Young L, Brock GB. Penile Doppler sonographic and clinical characteristics in Peyronies disease and/or erectile dysfunction: an analysis of 1500 men with male sexual dysfunction. BJU Int. 2012; 110:1201–1205.

13. Chung E, Cartmill R. Evaluation of clinical efficacy, safety and patient satisfaction rate after low-intensity extracorporeal shockwave therapy for the treatment of male erectile dysfunction: an Australian first open-label single-arm prospective clinical trial. BJU Int. 2015; 115:Suppl 5. 46–49.

14. Abdel-Salam Y, Budair Z, Renner C, Frede T, Rassweiler J, El-Annany F, et al. Treatment of Peyronie's disease by extracorporeal shockwave therapy: evaluation of our preliminary results. J Endourol. 1999; 13:549–552.

15. Hauck EW, Altinkilic BM, Ludwig M, Ludecke G, Schroeder-Printzen I, Arens C, et al. Extracorporal shock wave therapy in the treatment of Peyronies disease. First results of a case-controlled approach. Eur Urol. 2000; 38:663–669.

16. Husain J, Lynn NN, Jones DK, Collins GN, O'Reilly PH. Extracorporeal shock wave therapy in the management of Peyronie's disease: initial experience. BJU Int. 2000; 86:466–468.

17. Lebret T, Loison G, Herve JM, Mc Eleny KR, Lugagne PM, Yonneau L, et al. Extracorporeal shock wave therapy in the treatment of Peyronie's disease: experience with standard lithotriptor (siemens-multiline). Urology. 2002; 59:657–661.

18. Taylor J, Forster JA, Browning AJ, Biyani CS. Extracorporeal shockwave therapy for Peyronie's disease: who benefits? J Endourol. 2006; 20:135–138.

19. Claro JA, Passerotti CC, Figueiredo Neto AC, Nardozza A Jr, Ortiz V, Srougi M. An alternative non-invasive treatment for Peyronie's disease. Int Braz J Urol. 2004; 30:199–204.

20. Palmieri A, Imbimbo C, Creta M, Verze P, Fusco F, Mirone V. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie's disease and erectile dysfunction: results from a prospective randomized trial. Int J Androl. 2012; 35:190–195.