Di Mauro M. et al., 2019: 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 A, Carini M, Cimino S, Morelli G, Cocci A. Urology Section, Department of Surgery, University of Catania, Catania, Italy. Department of Urology, University of Florence, Florence, Italy. Andrology Center, Villa Donatello Hospital, Florence, Italy. Department of Urology, University of Naples, Naples, Italy.
Department of Urology, Molinette Hospital, University of Turin, Turin, Italy. Department 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.
World J Mens Health. 2019 Mar 26. doi: 10.5534/wjmh.180100. [Epub ahead of print]. FREE ARTICLE
Comments 1
The authors emphasize the common occurrence of Peyronies´s disease (PD). The prevalence of 13% is higher than I personally was aware of.
In this study the Duolith SDI ultra device (Storz Medical) was used to treat 325 patients with PD. The report is based on a retrospective analysis and accordingly associated with all shortcomings seen with such studies.
Nevertheless, following 6 treatments with 3000 shockwaves administered during a period of 6 weeks, significant improvements were recorded in penile curvature and length in erection. Moreover, the IIEF score and PDQ levels were improved as was the intensity of pain.
The differences relative to a control group were generally of moderate degree. But it is obvious that the non-invasive ESWT regimen might be a useful therapeutic alternative, worthwhile to apply in patients with PD.