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Abstract

Volume 24, Issue 1 (January 2022) 24, 45–49; 10.4103/aja.aja_40_21

Low-intensity extracorporeal shock wave therapy for Peyronie's disease: a single-center experience

Maher Abdessater, William Akakpo, Anthony Kanbar, Jérome Parra, Thomas Seisen, Emmanuel Chartier-Kastler, Sarah J Drouin, Morgan Roupret

APHP - Sorbonne University, Pitié Salpêtrière, Academic Urology Unit, 83 bvd Hôpital, Paris 75013, France

Date of Submission 24-Jan-2021 Date of Acceptance 22-Mar-2021 Date of Web Publication 21-May-2021

Abstract

The aim of this article is to assess the outcomes of a low-intensity extracorporeal shock wave therapy (LiESWT) protocol for the treatment of Peyronie's disease (PD). Patients treated for PD were prospectively recorded, and data were retrospectively reviewed. Age, characteristics of fibrous plaques, concomitant treatments, International Index of Erectile Function (IIEF-5), Lue score, and pain score on Likert scale were collected. Patients in acute phase of PD and an angulation of <40° were included. The protocol consisted of 6 weekly sessions of 4000 pulses each, applied from different directions, with a maximal power of 20 W and 8 Hz frequency. We included 39 patients (median age: 56.8 years, interquartile range [IQR]: 35.8–62.2 years). The median number of sessions received per patient was 7.2. After treatment, the median Lue score decreased from 6.8 initially to 3.3 (P = 0.003), the median Likert pain score dropped from 1.8 to 0.7 (P = 0.004), the median plaque size was reduced from 2 cm to 1.2 cm (P = 0.08), and the median penile curvature diminished from 31° to 17° (P = 0.07). On univariate and multivariate analysis, the only predictors of success were younger age (odds ratio [OR] = 0.95, P = 0.03 and OR = 0.91, P = 0.04, respectively) and concomitant use of phosphodiesterase-5 inhibitors (PDE5i; OR = 0.92, P = 0.02 and OR = 0.93, P = 0.01, respectively). LiESWT had a favorable impact on Lue score and notably penile pain, curvature, plaque size, and erectile function in patients treated for PD during the early inflammatory phase, with no side effects. Younger age and concomitant use of PDE5i were the only success predictors.

Keywords: erectile dysfunction; extracorporeal shock wave therapy; Peyronie's disease; piezoelectric waves

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