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

Affiliations
  • 1Urology Section, Department of Surgery, University of Catania, Catania, Italy. giorgioivan1987@gmail.com
  • 2Department of Urology, University of Florence, Florence, Italy.
  • 3Andrology Center, Villa Donatello Hospital, Florence, Italy.
  • 4Department of Urology, University of Naples, Naples, Italy.
  • 5Department of Urology, Molinette Hospital, University of Turin, Turin, Italy.
  • 6Department of Urology, University of Pisa, Pisa, Italy.

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
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