Extracorporeal shock wave therapy in the treatment of Peyronie's disease: long-term results.

Controversial data on ESWT (Extracorporeal Shock Wave Therapy) for the treatment of Peyronie's disease are controversial. This study was performed to access the efficacy, reliability and the side-effects of the ESWT. From 2000 to 2004, 157 patients with an average age of 58 years and with Peyronie's disease were enrolled for a conservative treatment. All 150 eligible patients were treated with ESWT, using Dornier Compact Delta II UIMS lithotripter. The median number of treatments per patient was 3.5 with the delivery of 2000 shock waves (SW) for each treatment. There was no use of anaesthesia and analgesy. An ultrasound study was made for each patient before treatment. We considered: plaque size, penis curvature, pain, penis rigidity and tumescence, sexual intercourse ability and side-effects. Median follow-up of the study was 36.9 months. Average duration of the treatment was 20 minutes without relevant side-effects. With reference to the curvature, we obtained a significative reduction in 33.3% of the patients, whereas the plaque size was not statistically reduced. Regarding the pain issue we achieved good results with a reduction in more than 90% of the patients and a complete relief in 6%. The quality of the intercourse was reported slightly enhanced. No significant difference was observed in penis tumescence and rigidity. ESWT is a non-invasive treatment for the Peyronie's disease. Our study confirms that the best results are obtained regarding pain and less with the curvature. For the plaque size and quality of sexual intercourse the results are not satisfactory.