Extracorporeal shock wave therapy in the treatment of Peyronie's disease: experience with standard lithotriptor (siemens-multiline).
OBJECTIVE
To assess in a prospective study whether extracorporeal shock wave therapy (ESWT) using a standard radioscopic location lithotriptor is effective in the treatment of Peyronie's disease.


METHODS
Fifty-four patients were included in this prospective study. Before and after treatment, the angulation was calculated by auto-photography. Pain severity was assessed by a visual analog pain scale. A self-evaluation questionnaire (International Index of Erectile Function) was used. All patients had symptoms (35 had pain during erection and 51 angulation greater than 20 degrees ). The mean disease duration was 16 months. The mean angulation before treatment was 48 degrees (range 10 degrees to 100 degrees ). Twenty-four patients had erectile dysfunction (questionnaire score less than 18). The Multiline Siemens lithotriptor was used. The plaque was located by palpation, and 1 mL of contrast agent was injected. Scopic visualization was used. Each patient received a minimum of one session of ESWT (3000 shock waves, 7 kJ) applied to a flaccid penis.


RESULTS
All patients completed the protocol. The tolerance and safety were excellent. Of the 35 patients with pain on erection, 31 (91%) noticed relief immediately after ESWT (mean reduction 2.9 on the visual analog pain scale) (P <0.00001). For 29 patients (53.7%), an improvement in angulation (greater than 10 degrees ) was observed, with a mean reduction of 31 degrees (P <0.001). For patients with erectile dysfunction, only 6 (25%) had an increased questionnaire score (greater than 4). Twenty-five patients thought the plaque was smoother.


CONCLUSIONS
ESWT with a standard lithotriptor (without the mobile arm) in Peyronie's disease is a feasible, safe, and effective treatment for pain on erection and significantly improves the penile angle.
Lebret
Thierry
T
Department of Urology, Hôpital Foch, Suresnes, France.
Loison
Guillaume
G
Hervé
Jean-Marie
JM
Mc Eleny
Kevin R
KR
Lugagne
Pierre-Marie
PM
Yonneau
Laurent
L
Orsoni
Jean-Luc
JL
Saporta
François
F
Butreau
Martine
M
Botto
Henry
H
D000328:Adult; D000368:Aged; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010410:Penile Erection; D010411:Penile Induration / Q000628:therapy*; D011446:Prospective Studies