title: Role of extracorporeal shock wave therapy in management of Peyronie's disease: A preliminary report.
abstract: BACKGROUND
  Peyronie's Disease (PD) is a disease causing psycho social trauma to the patient. Multiple treatment options are available with variable results. Extra Corporeal Shock Wave Therapy (ESWT) is a new insight into the non invasive modality of management. It focuses on the mechanism of inducing angiogenesis in the penile cavernous tissue.
  
  
  METHODS
  The aim of the study is to determine the role of ESWT in the management of PD. The objectives include demonstrating the improvement in mean International Index of Erectile Function Score (IIEFS), improvement in pain score by Visual Analogue Scale (VAS), change in cavernosal artery flow on colour penile Doppler, reduction in plaque size, and improvement in penile curvature degree after the therapy. 30 patients, between 25-65 years, who were non responders to conservative line of management, were treated with ESWT. The results were evaluated at baseline and 18-24 weeks after the therapy.
  
  
  RESULTS
  ESWT significantly improves the cavernosal artery velocity, thereby supporting the theory of angiogenesis. ESWT improves all the domains of IIEF including Erectile Function, Sexual Desire, Sexual Satisfaction, Orgasm and Overall Satisfaction. There is a significant improvement in the pain and penile curvature, and reduction in the plaque size. No adverse effects have been recorded.
  
  
  CONCLUSIONS
  ESWT offers a safe, minimally invasive, OPD based option to the management of the patients of PD in the stable phase of the disease. Patients who do not respond to the conservative line of management can be really benefited by ESWT.
authors.affiliation: Department of Urology and Genito-Urinary Surgery, Ruby Hall Clinic, Pune, Maharashtra, India.
authors.forename: Rajendra Kashinath
authors.initials: RK
authors.lastname: Shimpi
authors.affiliation: Department of Urology and Genito-Urinary Surgery, Ruby Hall Clinic, Pune, Maharashtra, India.
authors.forename: Ravi Jineshkumar
authors.initials: RJ
authors.lastname: Jain
keywords: Cavernosal artery velocity; International Index of Erectile Function Score; Peyronie's disease; extracorporeal shock wave therapy; plaque; visual analogue score