Low-intensity Extracorporeal Shock Wave Therapy for Peyroniès Disease: a Systematic Review and Meta-analysis

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2024 Oct 7

PMID 39375617

Authors

Guizhong Li

Xiao Xu

Libo Man

Affiliations

Soon will be listed here.

Abstract

Background: A systematic review of the evidence was conducted to assess the efficacy of low-intensity extracorporeal shock wave therapy (LI-ESWT) for patients with Peyronie`s Disease (PD).

Methods: A comprehensive search of the Cochrane Registry, PubMed and Embase databases was conducted to identify all controlled trials, including randomised controlled trials (RCTs), cohort studies and case-control studies, focusing on the efficacy of LI-ESWT in treating PD, and published before February 2023. The size of plaques, curvature deviation, visual analog scale [VAS] and International Index of Erectile Function (IIEF) were the most commonly used tool to evaluate the treatment effectiveness of LI-ESWT.

Results: There were 7 studies including 475 patients from 1999 to 2023. The meta-analysis of the data revealed that LI-ESWT could considerably enhance the proportion of men experiencing a reduction in penile plaques (RD 0.27, 95% CI: 0.04-0.50, P = 0.02), improvement in penile curvature (RD: 0.13; 95% CI, 0-0.26; p = 0.05), alleviation of pain (RD 0.22, 95% CI: 0.01-0.42, P = 0.04), and complete remission (RD 0.38, 95% CI 0.23-0.52, P < 0.00001). However, there were no significant differences in improvement of sexual function (MD: 1.44; 95% CI, -3.10-5.97; p = 0.53) between LI-ESWT and the placebo group.

Conclusions: According to these studies, LI-ESWT has the potential to decrease plaque size and improve penile curvature or pain in men with PD. The publication of robust evidence from additional well-designed long-term multicenter randomized controlled trials would provide more confidence regarding use of these devices in patients with PD.

References

Hayashi D, Kawakami K, Ito K, Ishii K, Tanno H, Imai Y . Low-energy extracorporeal shock wave therapy enhances skin wound healing in diabetic mice: a critical role of endothelial nitric oxide synthase. Wound Repair Regen. 2012; 20(6):887-95. DOI: 10.1111/j.1524-475X.2012.00851.x. View

Fu M, Sun C, Lin Y, Wang C, Wu C, Ko S . Extracorporeal shock wave therapy reverses ischemia-related left ventricular dysfunction and remodeling: molecular-cellular and functional assessment. PLoS One. 2011; 6(9):e24342. PMC: 3167851. DOI: 10.1371/journal.pone.0024342. View

Becker M, Goetzenich A, Roehl A, Huebel C, de la Fuente M, Dietz-Laursonn K . Myocardial effects of local shock wave therapy in a Langendorff model. Ultrasonics. 2013; 54(1):131-6. DOI: 10.1016/j.ultras.2013.07.005. View

Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U . Extracorporeal shockwave therapy for Peyronie's disease: an alternative treatment?. Asian J Androl. 2006; 8(3):361-6. DOI: 10.1111/j.1745-7262.2006.00138.x. View

Liu T, Shindel A, Lin G, Lue T . Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy. Int J Impot Res. 2019; 31(3):170-176. PMC: 6587965. DOI: 10.1038/s41443-019-0113-3. View

Sokolakis I, Pyrgidis N, Lahme S, Hatzichristodoulou G . Low-intensity shockwave therapy in Peyronie's disease: long-term results from a prospective, randomized, sham-controlled trial. Int J Impot Res. 2021; 34(5):487-494. DOI: 10.1038/s41443-021-00447-2. View

Bakr A, El-Sakka A . Extracorporeal Shockwave Therapy in Peyronie's Disease: Systematic Review and Meta-Analysis. J Sex Med. 2021; 18(10):1705-1714. DOI: 10.1016/j.jsxm.2021.06.012. View

Hatzimouratidis K, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Salonia A . EAU guidelines on penile curvature. Eur Urol. 2012; 62(3):543-52. DOI: 10.1016/j.eururo.2012.05.040. View

Hazan-Molina H, Reznick A, Kaufman H, Aizenbud D . Periodontal cytokines profile under orthodontic force and extracorporeal shock wave stimuli in a rat model. J Periodontal Res. 2014; 50(3):389-96. DOI: 10.1111/jre.12218. View

10.

Goldstein I, Lipshultz L, McLane M, Hu Y, Xiang Q, Liu G . Long-Term Safety and Curvature Deformity Characterization in Patients Previously Treated with Collagenase clostridium Histolyticum for Peyronie's Disease. J Urol. 2020; 203(6):1191-1197. DOI: 10.1097/JU.0000000000000743. View

11.

Wang H, Cheng J, Chuang Y . Potential applications of low-energy shock waves in functional urology. Int J Urol. 2017; 24(8):573-581. DOI: 10.1111/iju.13403. View

12.

Palmieri A, Imbimbo C, Longo N, Fusco F, Verze P, Mangiapia F . A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie's disease. Eur Urol. 2009; 56(2):363-9. DOI: 10.1016/j.eururo.2009.05.012. View

13.

Gao L, Qian S, Tang Z, Li J, Yuan J . A meta-analysis of extracorporeal shock wave therapy for Peyronie's disease. Int J Impot Res. 2016; 28(5):161-6. DOI: 10.1038/ijir.2016.24. View

14.

Shimpi R, Jain R . Role of extracorporeal shock wave therapy in management of Peyronie's disease: A preliminary report. Urol Ann. 2017; 8(4):409-417. PMC: 5100144. DOI: 10.4103/0974-7796.192100. View

15.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151(4):264-9, W64. DOI: 10.7326/0003-4819-151-4-200908180-00135. View

16.

Fojecki G, Tiessen S, Osther P . 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. 2016; 35(1):1-9. DOI: 10.1007/s00345-016-1834-2. View

17.

Hauck E, Altinkilic B, Ludwig M, Ludecke G, Schroeder-Printzen I, Arens C . Extracorporal shock wave therapy in the treatment of Peyronie's disease. First results of a case-controlled approach. Eur Urol. 2000; 38(6):663-9;discussion 670. DOI: 10.1159/000020359. View

18.

Hauck E, Mueller U, Bschleipfer T, Schmelz H, Diemer T, Weidner W . Extracorporeal shock wave therapy for Peyronie's disease: exploratory meta-analysis of clinical trials. J Urol. 2004; 171(2 Pt 1):740-5. DOI: 10.1097/01.ju.0000108060.30363.8d. View

19.

Mirone V, Imbimbo C, Palmieri A, Fusco F . Our experience on the association of a new physical and medical therapy in patients suffering from induratio penis plastica. Eur Urol. 1999; 36(4):327-30. DOI: 10.1159/000020013. View

20.

Herati A, Pastuszak A . The Genetic Basis of Peyronie Disease: A Review. Sex Med Rev. 2016; 4(1):85-94. PMC: 4778255. DOI: 10.1016/j.sxmr.2015.10.002. View