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Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie's disease, erectile dysfunction and chronic pelvic pain.
World J Urol. 2017 Jan; 35(1):1-9.WJ

Abstract

PURPOSE

The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders.

METHODS

We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline and PubMed was carried out. The systematic review was performed according to PRISMA guidelines.

RESULTS

We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie's disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile deviation and plaque size were observed. Four studies on erectile dysfunction (ED) including 337 participants were included. Using International Index of Erectile Function (IIEF-EF) and erectile hardness scale (EHS) data suggested a significant positive effect of ESWT in phosphodiesterase-5 inhibitor (PDE-5i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard to treatment techniques and outcome measures, making it difficult to compare results.

CONCLUSIONS

ESWT may resolve pain in PD patients, while evidence for reducing curvature and plaques size is poor. Effects of ESWT on IIEF in ED patients are inconsistent; however, data on EHS does imply that the treatment potentially may recover natural erection in PDE-5i responders. ESWT seems to be able to resolve pain in CPP patients in the short term. In all three disease entities, long-term outcome data are still warranted.

Authors+Show Affiliations

Department of Urology, Hospital of Southern Jutland, University of Southern Denmark, Sønderborg, Denmark.Department of Urology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.Department of Urology, Urological Research Center, Lillebaelt Hospital, University of Southern Denmark, Fredericia, Denmark. Palle.Joern.Osther@rsyd.dk.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

27108421

Citation

Fojecki, Grzegorz Lukasz, et al. "Extracorporeal Shock Wave Therapy (ESWT) in Urology: a Systematic Review of Outcome in Peyronie's Disease, Erectile Dysfunction and Chronic Pelvic Pain." World Journal of Urology, vol. 35, no. 1, 2017, pp. 1-9.
Fojecki GL, Tiessen S, Osther PJ. Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie's disease, erectile dysfunction and chronic pelvic pain. World J Urol. 2017;35(1):1-9.
Fojecki, G. L., Tiessen, S., & Osther, P. J. (2017). Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie's disease, erectile dysfunction and chronic pelvic pain. World Journal of Urology, 35(1), 1-9. https://doi.org/10.1007/s00345-016-1834-2
Fojecki GL, Tiessen S, Osther PJ. Extracorporeal Shock Wave Therapy (ESWT) in Urology: a Systematic Review of Outcome in Peyronie's Disease, Erectile Dysfunction and Chronic Pelvic Pain. World J Urol. 2017;35(1):1-9. PubMed PMID: 27108421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie's disease, erectile dysfunction and chronic pelvic pain. AU - Fojecki,Grzegorz Lukasz, AU - Tiessen,Stefan, AU - Osther,Palle Jörn Sloth, Y1 - 2016/04/23/ PY - 2016/03/07/received PY - 2016/04/12/accepted PY - 2016/4/25/pubmed PY - 2017/6/15/medline PY - 2016/4/25/entrez KW - Chronic pelvic pain KW - Erectile dysfunction KW - Extracorporeal shock wave therapy KW - Peyronie’s disease KW - Systematic review KW - Urology SP - 1 EP - 9 JF - World journal of urology JO - World J Urol VL - 35 IS - 1 N2 - PURPOSE: The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders. METHODS: We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline and PubMed was carried out. The systematic review was performed according to PRISMA guidelines. RESULTS: We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie's disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile deviation and plaque size were observed. Four studies on erectile dysfunction (ED) including 337 participants were included. Using International Index of Erectile Function (IIEF-EF) and erectile hardness scale (EHS) data suggested a significant positive effect of ESWT in phosphodiesterase-5 inhibitor (PDE-5i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard to treatment techniques and outcome measures, making it difficult to compare results. CONCLUSIONS: ESWT may resolve pain in PD patients, while evidence for reducing curvature and plaques size is poor. Effects of ESWT on IIEF in ED patients are inconsistent; however, data on EHS does imply that the treatment potentially may recover natural erection in PDE-5i responders. ESWT seems to be able to resolve pain in CPP patients in the short term. In all three disease entities, long-term outcome data are still warranted. SN - 1433-8726 UR - https://wwww.unboundmedicine.com/medline/citation/27108421/Extracorporeal_shock_wave_therapy__ESWT__in_urology:_a_systematic_review_of_outcome_in_Peyronie's_disease_erectile_dysfunction_and_chronic_pelvic_pain_ DB - PRIME DP - Unbound Medicine ER -