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Krieger JR. et al., 2019: Shockwave Therapy in the Treatment of Peyronie's Disease

Krieger JR, Rizk PJ, Kohn TP, Pastuszak A.
Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Urology, University of Miami, Miami, FL, USA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.

Abstract

INTRODUCTION: Peyronie's disease is an acquired condition of the connective tissue of the penis that affects 0.5-20.3% of the male population and is marked by fibrotic plaques in the tunica albuginea. It can result in penile curvature/deviation, painful erections, and sexual dysfunction. Several treatment modalities have been proposed, with studies from the past decade investigating extracorporeal shockwave therapy's (ESWT) potential efficacy in Peyronie's management. AIMS: To investigate the effects of ESWT on Peyronie's disease parameters such as penile curvature, plaque size, erectile function, and penile pain. METHODS: We reviewed the literature examining the effects of ESWT on Peyronie's disease. MAIN OUTCOME MEASURES: The main outcome measures after receiving extracoporeal shockwave therapy included changes in degree of penile curvature, penile plaque size, International Index of Erectile Function-5 questionnaire score, and visual analogue scale score. RESULTS: Randomized controlled trials examining the efficacy of ESWT in Peyronie's disease do not show a statistically significant benefit in curvature reduction, plaque size, or erectile function, although a recent meta-analysis demonstrates a benefit in plaque size reduction. A statistically significant reduction in penile pain has been observed across multiple studies. CONCLUSION: Extracorporeal shockwave therapy may be beneficial in the management of Peyronie's disease for refractory penile pain and plaque size reduction. However, penile pain typically resolves spontaneously over time, and shockwave therapy can pose a substantial financial burden to patients. A multi-institutional randomized controlled trial with standardization of methods and strict inclusion criteria regarding disease duration would prove beneficial in determining the true efficacy of shockwave therapy in Peyronie's disease. Krieger JR, Rizk PJ, Kohn TP, et al. Shockwave Therapy in the Treatment of Peyronie's Disease.

 

Sex Med Rev 2019 Mar 26. pii: S2050-0521(19)30007-1. doi: 10.1016/j.sxmr.2019.02.001. [Epub ahead of print] Review.

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