Extracorporeal shockwave therapy for Peyronie's disease: an alternative treatment?

Aim: To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy (ESWT) in patients with Peyronie’s disease. Methods: Fifty-three patients with stable Peyronie’s disease underwent ESWT (group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control (group 2). The patients’ erectile function (International Index of Erectile Function [IIEF-5] score), pain severity (visual analog scale), plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2. Results: The mean follow-up time was 32 months (range: 6–64 months) in group 1 and 35 months (range: 9–48 months) in group 2. All the patients were available for the follow-up. Considering erectile function and plaque size, no significant changes (P > 0.05) were observed in group 1 before or after the ESWT. A total of 39 patients (74%) reported a significant effect in pain relief in group 1 after ESWT. However, regarding improvement in pain, IIEF-5 score and plaque size, no significant differences were observed between the two groups. In 21 patients (40%) of group 1, the deviation angle was decreased more than 10° with a mean reduction in all patients of 11° (range: 6–20°). No serious complications were noted considering ESWT procedure. Conclusion: ESWT is a minimally invasive and safe alternative procedure for the treatment of Peyronie’s disease. However, the effect of ESWT on penile pain, sexual function and plaque size remains questionable. (Asian J Androl 2006 May; 8: 361–366)