Rapid pain relief, high rate of satisfaction: New study describes the long-term outcomes of ESWT in patients with acute Peyronie's disease
The aim of a new retrospective observational study1 by Spirito et al was to describe long-term outcomes of Extracorporeal Shock Wave Therapy (ESWT) in patients with acute Peyronie's disease. The large patient population (194) and the long mean follow-up time of 10.5 years contribute to the significance of the positive results.
The study was conducted in men with acute Peyronie's disease who underwent ESWT between 2009-2013. The ESWT protocol consisted of one session per week for four weeks (3,000 shock waves, 0.10 – 0.25 mJ/mm2, 4 – 6 Hz, DUOLITH®). The primary endpoint was penile pain, the secondary endpoints were erectile function (IIEF-5), patient satisfaction* and penile curvature.
Results and conclusions
Mean penile pain improved significantly at 3 months (6.5 vs. 3.1 points; p < 0.001) and at 12 months (3.1 vs. 1.0 points; p = 0.001) and remained stable over the remainder of the study period until the final follow-up (1.0 vs. 1.0 points; p = 0.074). Mean IIEF-5 (five-point version of the International Index of Erectile Function) increased significantly at 3 months (14.5 vs. 17.9 points; p = 0.001), remained stable at 12 months (17.9 vs. 18.5 points; p = 0.082), and worsened in the long term (18.5 vs. 15.8 points; p = 0.003). The proportion of patients satisfied with ESWT treatment was 92.3% at 3 months, 91.2% at 12 months, and 90.2% in the long term. The mean penile curvature worsened significantly at 3 months (18.3 vs. 21.5 degrees; p = 0.023) and at 12 months (21.5 vs. 28.6 degrees; p = 0.001) and stabilized in the long term (28.6 vs. 28.8 degrees; p = 0.335). The long-term analysis showed no new acute phase and a low rate of surgery (4.1%).
The authors conclude that ESWT in patients with acute Peyronie's disease appears to result in rapid and sustained relief of penile pain, temporary improvement in erectile function, and a high rate of patient satisfaction. Further controlled prospective studies are needed to confirm these long-term results.
* Patient satisfaction was assessed with the question, »Overall, are you satisfied with the results of shock wave treatment, yes or no?«
1 Spirito L, Manfredi, C, La Rocca R, et al. Long-term outcomes of extracorporeal shock wave therapy for acute Peyronie’s disease: a 10-year retrospective analysis. Int J Impot Res 2023. https://doi.org/10.1038/s41443-023-00673-w