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Objective and subjective changes in patients with Peyronie's disease after management with shockwave therapy.
J Endourol. 2003 Feb; 17(1):41-4; discussion 44.JE

Abstract

BACKGROUND AND PURPOSE

Very few reports have been published on the management of Peyronie's disease by shockwave therapy. Existing publications on this topic are based on subjective improvement described by the patients themselves. Our aim was to determine objectively the effect of shockwave therapy on the signs and symptoms caused by Peyronie's disease.

PATIENTS AND METHODS

To date, 65 patients (age 58.4 +/- 8.7 years) have been enrolled in a therapeutic pilot study. The disease duration was 33.7 +/- 42.9 months. Inclusion criteria were palpable plaque together with deviation, pain (visual pain scale), or loss of distal rigidity. Clinical examination (prior to first therapy and 1, 6, and 18 months after last shockwave delivery) included palpation and sonography of the plaque (mean surface size 2.2 +/- 1.1 cm(2)), measurement of deviation, assessment of pain and distal loss of rigidity (artificial erection induced by intracavernosal injection of 5 microg of alprostadil [Caverject]). Shockwaves (1,000 impulses at 12 kV per square centimeter of plaque) were delivered to the nonerect penis once a week for a period of 5 weeks with the Minilith; Storz Medical.

RESULTS

Eighteen months (N = 35) after the last shockwave session, the deviation angle had decreased from 59.3 degrees +/- 38.1 degrees to 49.3 degrees +/- 32.5 degrees (N = 24; P = 0.1496). Pain during erection disappeared in 15 of 17 patients and was reduced in 1 other patient (P < 0.0001). There was no effect on distal rigidity in any patient. Six patients achieved satisfactory sexual intercourse (vaginal penetration) before and 15 patients after shockwave therapy. The adverse effects were small skin hematomas in 90% of patients and initial transient macrohematuria in 30%.

CONCLUSION

Our study demonstrates objective and subjective changes in patients with Peyronie's disease after shockwave therapy. Artificial erection served as a control to assess improvement of the deviation angle.

Authors+Show Affiliations

Department of Urology, University Hospital, Mannheim, Germany. maurice-stephen.michel@uro.ma.uni_heidelberg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12639361

Citation

Michel, Maurice Stephan, et al. "Objective and Subjective Changes in Patients With Peyronie's Disease After Management With Shockwave Therapy." Journal of Endourology, vol. 17, no. 1, 2003, pp. 41-4; discussion 44.
Michel MS, Ptaschnyk T, Musial A, et al. Objective and subjective changes in patients with Peyronie's disease after management with shockwave therapy. J Endourol. 2003;17(1):41-4; discussion 44.
Michel, M. S., Ptaschnyk, T., Musial, A., Braun, P., Lenz, S. T., Alken, P., & Köhrmann, K. U. (2003). Objective and subjective changes in patients with Peyronie's disease after management with shockwave therapy. Journal of Endourology, 17(1), 41-4; discussion 44.
Michel MS, et al. Objective and Subjective Changes in Patients With Peyronie's Disease After Management With Shockwave Therapy. J Endourol. 2003;17(1):41-4; discussion 44. PubMed PMID: 12639361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Objective and subjective changes in patients with Peyronie's disease after management with shockwave therapy. AU - Michel,Maurice Stephan, AU - Ptaschnyk,Taras, AU - Musial,Anton, AU - Braun,Peter, AU - Lenz,Sylvia Tamara, AU - Alken,Peter, AU - Köhrmann,Kai Uwe, PY - 2003/3/18/pubmed PY - 2003/6/7/medline PY - 2003/3/18/entrez SP - 41-4; discussion 44 JF - Journal of endourology JO - J Endourol VL - 17 IS - 1 N2 - BACKGROUND AND PURPOSE: Very few reports have been published on the management of Peyronie's disease by shockwave therapy. Existing publications on this topic are based on subjective improvement described by the patients themselves. Our aim was to determine objectively the effect of shockwave therapy on the signs and symptoms caused by Peyronie's disease. PATIENTS AND METHODS: To date, 65 patients (age 58.4 +/- 8.7 years) have been enrolled in a therapeutic pilot study. The disease duration was 33.7 +/- 42.9 months. Inclusion criteria were palpable plaque together with deviation, pain (visual pain scale), or loss of distal rigidity. Clinical examination (prior to first therapy and 1, 6, and 18 months after last shockwave delivery) included palpation and sonography of the plaque (mean surface size 2.2 +/- 1.1 cm(2)), measurement of deviation, assessment of pain and distal loss of rigidity (artificial erection induced by intracavernosal injection of 5 microg of alprostadil [Caverject]). Shockwaves (1,000 impulses at 12 kV per square centimeter of plaque) were delivered to the nonerect penis once a week for a period of 5 weeks with the Minilith; Storz Medical. RESULTS: Eighteen months (N = 35) after the last shockwave session, the deviation angle had decreased from 59.3 degrees +/- 38.1 degrees to 49.3 degrees +/- 32.5 degrees (N = 24; P = 0.1496). Pain during erection disappeared in 15 of 17 patients and was reduced in 1 other patient (P < 0.0001). There was no effect on distal rigidity in any patient. Six patients achieved satisfactory sexual intercourse (vaginal penetration) before and 15 patients after shockwave therapy. The adverse effects were small skin hematomas in 90% of patients and initial transient macrohematuria in 30%. CONCLUSION: Our study demonstrates objective and subjective changes in patients with Peyronie's disease after shockwave therapy. Artificial erection served as a control to assess improvement of the deviation angle. SN - 0892-7790 UR - https://wwww.unboundmedicine.com/medline/citation/12639361/Objective_and_subjective_changes_in_patients_with_Peyronie's_disease_after_management_with_shockwave_therapy_ DB - PRIME DP - Unbound Medicine ER -