Role of Shock wave Therapy in Peyronie's Disease

Shock wave therapy (ESWT) for the treatment of Peyronie's Disease (PD) is still controversial. The aim of this study is to evaluate the efficacy of shock wave therapy in patients candidates for surgical treatment of stable PD for at least 12 months. 238 patients affected by PD were treated with ESWT since January 2000. We selected those patients (65 cases) who were having a stable disease for at least 12 months, previously treated unsuccessfully with different therapy (pharmacological, ionophoresis or infiltrations), and with an adequate follow-up. The parameters considered were the size modification of the lesion, the reduction of the penile deviation and the overall satisfaction for reaching an adequate sexual activity after the ESWT treatment. All patients received a 3000 shock waves treatment in 4 occasions during 2 weeks according to the institutional protocol. All the study patients reported to have an inadequate sexual function before the ESWT treatment. The mean age was 57 years, the penile deviation varied between 30° and 90° and the average follow-up was 18 months. In 43 cases (66%) the ultrasounds revealed a significant reduction of the penile deviation and 39 patients (60%) reported to have reached an adequate sexual activity after the ESWT treatment. ESWT represents a valid option in the treatment of PD considering that the patients’ main goal is to regain a satisfactory sexual activity. Therefore this non-invasive treatment should be included in the therapeutic guidelines of PD together with other non-surgical treatments.