Evaluation of extracorporeal shock wave therapy in Peyronie's disease

Objectives. To evaluate the results of extracorporeal shock wave therapy (ESWT) in patients with Peyronie's disease. Methods. This study included 42 patients (mean age 55.4 years, range 32 to 72, SD 9.92) with Peyronie's disease. The mean duration of disease was 16.5 months (range 3 to 60, SD 13.31). Before treatment, the degree of angulation was assessed artificially by injection of 10 to 20 mug alprostadil, and Polaroid photographs were taken. Patients were also questioned about pain on erection, whether sexual intercourse was possible, and the quality of erections. All were initially treated with three sessions of ESWT (3000 shock waves). After three sessions, patients who believed that improvement had resulted or who wanted to undergo additional treatment went on to have further sessions. The mean duration of follow-up was 5.9 months (range 2 to 18, SD 4.4), after which the results were analyzed. Results. Those who believed that improvement in angulation had resulted were asked to provide Polaroid photographs to assess the improvement objectively. Six (14%) said that they had excellent results, 21 (50%) had significant improvement, 7 (17%) had slight improvement, and 8 (19%) had no change. Of the 25 who had pain on erection before treatment, 21 (84%) reported complete or near complete relief after treatment. Five patients said that the quality of the erections had improved after treatment. Eight patients complained of mild and one of severe pain during or immediately after treatment; 2 of these 9 patients had both pain and bruising. Conclusions. The initial results with ESWT are promising, with minimal complications. The long-term results need to be evaluated. (C) 2002, Elsevier Science Inc.