Extracorporeal shock wave therapy for Peyronie's disease: exploratory meta-analysis of clinical trials.
OBJECTIVE
Extracorporeal shock wave therapy (ESWT) for the treatment of Peyronie's disease is still controversial. This exploratory meta-analysis of published studies in the international literature investigates its therapeutic effects.


METHODS
The treatment outcomes from 17 study groups identified by a computerized literature search were compared with natural history outcomes and data from control groups from 2 controlled ESWT studies. An exploratory meta-analysis was performed because a methodologically sound meta-analysis lege artis did not appear appropriate, since treated groups differ considerably in structure, the selection of outcome measures is inconsistent and measurement is not standardized.


RESULTS
ESWT seems to have an effect on penile pain during erection and on the improvement of sexual function. Pain seems to resolve faster after ESWT than during the course of the natural history. The effect on plaque size and penile curvature is less impressive.


CONCLUSIONS
ESWT in Peyronie's disease at least seems to be effective in regard to penile pain and sexual function compared to natural history. Deducing from these data the effect on plaque size and curvature remains questionable. However, ESWT is not an evidence based therapy at present. A controlled (preferably pairwise matched), single blind, multicenter study with careful, detailed documentation of disease symptoms before intervention and of outcomes is required to evaluate the real effect of ESWT.
Hauck
Ekkehard W
EW
Department of Urology, Justus Leibig University, Giessen, Germany.
Mueller
Ulrich O
UO
Bschleipfer
Thomas
T
Schmelz
Hans U
HU
Diemer
Thorten
T
Weidner
Wolfgang
W
D002986:Clinical Trials as Topic; D006801:Humans; D008096:Lithotripsy; D008297:Male; D010411:Penile Induration / Q000628:therapy*