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Maiti K. et al., 2023: Low-intensity extracorporeal shockwave therapy for Peyronie's disease: An Indian experience

Maiti K, Srivastava SK, Pal DK.
Department of Urology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India.

Abstract

Introduction: Efficacy of low-intensity extracorporeal shockwave therapy (LiESWT) in Peyronie's disease (PD) has not been studied in an Indian population. Here, we studied the effect of LiESWT in Indian PD patients.

Methods: This prospective study was conducted on 25 patients who completed weekly sessions of LiESWT for 6 weeks with a follow-up of 6 months. Patients were evaluated using International Index of Erectile Function (IIEF)-5 questionnaire for erectile dysfunction and visual analog scale for pain. Baseline and follow-up examinations included measurement of plaque size and curvature. The primary outcome was to assess remission of pain and reduction of plaque size along with improvement of penile curvature and erectile function as the secondary outcome.

Results: Primary goal of pain reduction and ≥50% reduction of plaque size was achieved in 64% and 20% of patients, respectively. Improvement in vaginal penetration during sexual intercourse and IIEF-5 score increase of ≥3 was achieved 20% and 36% cases, respectively. The mean reduction of penile curvature was more with plaque calcification (PC), but the difference was not statistically significant (P = 0.26). The difference in mean visual analog scale reduction was more in noncalcified plaque (P = 0.002). The mean reduction of plaque size in patients with PC was significant (P = 0.03).

Conclusions: Shockwave therapy is a probable alternative treatment option. A significant improvement was observed in pain and plaque size in patients treated by LiESWT. The presence of PC may affect the outcome of LiESWT in PD.
Indian J Urol. 2023 Jul-Sep;39(3):209-215. doi: 10.4103/iju.iju_22_23. Epub 2023 Jun 30. PMID: 37575155. FREE ARTICLE

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Comments 1

Jens Rassweiler on Tuesday, 13 February 2024 09:50

The article explores the use of low-intensity extracorporeal shockwave therapy (LiESWT) in treating Peyronie's disease (PD) in an Indian population. The study involved 25 patients who underwent weekly LiESWT sessions for six weeks usung the Dornier Compact Delta, with a follow-up of six months. 1800 shocks were delivered per session at Energy Flux Density of 0.23 mJ/mm2. The primary goal was to assess the remission of pain and a ≥50% reduction in plaque size, while the secondary outcome focused on improvements in penile curvature and erectile function.
The results indicated that 64% of patients achieved the primary goal of pain reduction, and 20% experienced a ≥50% reduction in plaque size. Additionally, 36% of cases saw an improvement in the International Index of Erectile Function (IIEF)-5 score by ≥3 points. The study suggested that LiESWT could be a viable alternative treatment for PD, showing significant improvements in pain and plaque size.
The presence of plaque calcification (PC) was noted to potentially influence the outcomes, with a more significant reduction in plaque size in patients with PC. However, changes in penile curvature and length were not statistically significant. The article acknowledges the limitations of the study, such as the absence of a control group and the need for further research with larger sample sizes to establish the efficacy of shockwave therapy compared to standard treatments for PD like surgery.
In conclusion, the article suggests that LiESWT could be considered as an alternative treatment for PD, particularly in cases where surgery may pose risks. However, the need for further research and randomized controlled trials with larger sample sizes is emphasized to validate these findings and establish the therapy's efficacy in the long term. Unfortunately, the authors did not use higher energy levels for treating the severe plaques, which would have been possible with this device. This could have a better impact on plaques and penile deviation. Finally, the paper provides a good overview of the current literature.

Jens Rassweiler

The article explores the use of low-intensity extracorporeal shockwave therapy (LiESWT) in treating Peyronie's disease (PD) in an Indian population. The study involved 25 patients who underwent weekly LiESWT sessions for six weeks usung the Dornier Compact Delta, with a follow-up of six months. 1800 shocks were delivered per session at Energy Flux Density of 0.23 mJ/mm2. The primary goal was to assess the remission of pain and a ≥50% reduction in plaque size, while the secondary outcome focused on improvements in penile curvature and erectile function. The results indicated that 64% of patients achieved the primary goal of pain reduction, and 20% experienced a ≥50% reduction in plaque size. Additionally, 36% of cases saw an improvement in the International Index of Erectile Function (IIEF)-5 score by ≥3 points. The study suggested that LiESWT could be a viable alternative treatment for PD, showing significant improvements in pain and plaque size. The presence of plaque calcification (PC) was noted to potentially influence the outcomes, with a more significant reduction in plaque size in patients with PC. However, changes in penile curvature and length were not statistically significant. The article acknowledges the limitations of the study, such as the absence of a control group and the need for further research with larger sample sizes to establish the efficacy of shockwave therapy compared to standard treatments for PD like surgery. In conclusion, the article suggests that LiESWT could be considered as an alternative treatment for PD, particularly in cases where surgery may pose risks. However, the need for further research and randomized controlled trials with larger sample sizes is emphasized to validate these findings and establish the therapy's efficacy in the long term. Unfortunately, the authors did not use higher energy levels for treating the severe plaques, which would have been possible with this device. This could have a better impact on plaques and penile deviation. Finally, the paper provides a good overview of the current literature. Jens Rassweiler
Monday, 20 May 2024