title: Treatment of Peyronie's disease by extracorporeal shockwave therapy: evaluation of our preliminary results.
abstract: BACKGROUND
  Peyronie's disease is an idiopathic disorder of the penis that produces erectile dysfunction. It affects mainly the tunica albuginea. We describe our preliminary results with extracorporal shockwave therapy (ESWT) as a new noninvasive modality for the treatment of Peyronie's disease.
  
  
  METHODS
  In this study, 24 patients aged 36 to 67 years were treated with ESWT on the Lithostar overhead-module (Siemens). All our patients had unsuccessful medical treatment before ESWT. The average plaque was 7x15 mm. The number of shockwaves ranged from 15,000 to 25,000 (18-21 kV) delivered in four to ten sessions. Most patients needed local anesthesia before therapy.
  
  
  RESULTS
  Four patients (17%) showed marked improvement and complete remission of the penile deviation. Six patients (25%) showed partial remission with painless erections after treatment. Four patients had painless erections after treatment but still had some penile deviation. In 10 patients (41%), ESWT failed, necessitating subsequent penile surgery.
  
  
  CONCLUSIONS
  Our preliminary results with a response rate of 59% with ESWT for Peyronie's disease, including a 17% complete remission rate, is encouraging. However, further multicenter studies will have to prove if ESWT is a real therapeutic option for this disease.
authors.affiliation: Urology Department, Klinikum Heilbronn, University at Heidelberg, Germany.
authors.forename: Y
authors.initials: Y
authors.lastname: Abdel-Salam
authors.forename: Z
authors.initials: Z
authors.lastname: Budair
authors.forename: C
authors.initials: C
authors.lastname: Renner
authors.forename: T
authors.initials: T
authors.lastname: Frede
authors.forename: J
authors.initials: J
authors.lastname: Rassweiler
authors.forename: F
authors.initials: F
authors.lastname: El-Annany
authors.forename: H
authors.initials: H
authors.lastname: El-Magraby
authors.forename: M
authors.initials: M
authors.lastname: El-Akkad
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D007172:Erectile Dysfunction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D010413:Penis / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography