Extracorporeal shock wave therapy (ESWT) cannot be recommended as a treatment for Peyronie’s disease, according to German researchers.
ESWT has been used to treat Peyronie’s disease for over twenty years. The procedure has brought pain relief to some men, but has not been as successful in correcting penile curvature.
The study authors noted that most previous research on the subject was not randomized and standardized protocols were not used. With this in mind, they designed a placebo-controlled prospective study to examine the efficacy of ESWT for men with Peyronie’s disease.
One hundred two men with the condition participated. Half were randomly assigned to received six weekly ESWT treatments. The remaining men (the placebo group) also received treatments, but a plastic membrane was attached to the ESWT instrument, preventing any shock waves from reaching the penis.
Before treatment, the researchers assessed plaque localization and size, level of pain, degree of deviation, and sexual function for each man. At a follow-up appointment one to six months later, these measurements were taken again.
Overall, the researchers found ESWT effective for pain, but not for deviation, plaque size, or sexual function.
They questioned whether pain should be treated with ESWT, considering the cost involved and the number of treatments required. Pain is not considered a major symptom of Peyronie’s disease, they explained. In most cases, pain associated with Peyronie’s disease goes away on its own in about 18 months. Many men can manage pain with medication.
However, ESWT could be helpful for men with unmanageable pain, the authors said.
Penile deviation is often the biggest concern for men with Peyronie’s disease, as it most likely to interfere with their sex lives. But for deviation, ESWT was problematic. In fact, for 40% of the men in the ESWT group, deviation worsened. As a result, the authors recommended that surgery continue as the gold standard for treating curvature.
The study was published online in July in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Hatzichristodoulou, Georgios, MD, et al.
“Extracorporeal Shock Wave Therapy in Peyronie's Disease: Results of a Placebo-Controlled, Prospective, Randomized, Single-Blind Study”
(Full-text. First published online: July 30, 2013)