World J Mens Health.  2019 Sep;37(3):339-346. 10.5534/wjmh.180100.

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

• di Mauro M
• Russo GI
• Della Camera PA
• di Maida F
• Cito G
• Mondaini N
• Capece M
• Falcone M
• Sessa F
• Mari A
• Campi R
• Sabini C
• Serni S
• Gacci M
• Minervini
• Carini M
• Cimino S
• Morelli G
• Cocci A

• KMID: 2455410
• DOI: http://doi.org/10.5534/wjmh.180100

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 cm2 (1.43-2.17 cm2) to 1.53 cm2 (1.31-1.96 cm2) (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.

Keyword

Erectile dysfunction; Extracorporeal shockwave therapy; Penile diseases; Penile induration; Peyronie's disease; Treatment

MeSH Terms

Alprostadil
Appointments and Schedules
Clinical Study
Erectile Dysfunction
Humans
Male
Observational Study*
Penile Diseases
Penile Induration*
Shock*
Treatment Outcome*
Alprostadil

Figure

• 

  Fig. 1 Median difference between questionnaires before and after treatment. IIEF: international index of erectile function, OS: overall satisfaction, IS: intercourse satisfaction, SD: sexual desire, OF: orgasmic function, EF: erectile function, TOT: tatal, PDQ: Peyronie's disease-questionnaire, BD: bother domain, PP: penile pain, PS: physical symptom, VAS: visual analogue scale.

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