1, 2 Most patients prefer an initial trial of noninvasive treatment. Surgical treatment is reserved for selected cases of disabling disease, due to the perioperative risks and potential disadvantages of this procedure, including penile shortening, changes in penile sensation, and de novo erectile dysfunction. 3 PD can occur at any age, but most commonly, patients are in their fifth decade of life. The prevalence rates are unclear and vary between 0.39% and 22.5%. 1, 2 Patients usually seek medical care for pain during erection or penile deformity. In one report, a spontaneous improvement was observed in 12% of patients, stabilization in 67%, and worsening of symptoms in 21%. Peyronie's disease (PD) is characterized by an initial acute painful inflammatory phase followed by a chronic stage where the plaque stabilizes. Younger age and concomitant use of PDE5i were the only success predictors. LiESWT had a favorable impact on Lue score and notably penile pain, curvature, plaque size, and erectile function in patients treated for PD during the early inflammatory phase, with no side effects. On univariate and multivariate analysis, the only predictors of success were younger age (odds ratio = 0.95, P = 0.03 and OR = 0.91, P = 0.04, respectively) and concomitant use of phosphodiesterase-5 inhibitors (PDE5i OR = 0.92, P = 0.02 and OR = 0.93, P = 0.01, respectively). After treatment, the median Lue score decreased from 6.8 initially to 3.3 ( P = 0.003), the median Likert pain score dropped from 1.8 to 0.7 ( P = 0.004), the median plaque size was reduced from 2 cm to 1.2 cm ( P = 0.08), and the median penile curvature diminished from 31° to 17° ( P = 0.07). The median number of sessions received per patient was 7.2. We included 39 patients (median age: 56.8 years, interquartile range : 35.8–62.2 years). The protocol consisted of 6 weekly sessions of 4000 pulses each, applied from different directions, with a maximal power of 20 W and 8 Hz frequency. Patients in acute phase of PD and an angulation of <40° were included. Age, characteristics of fibrous plaques, concomitant treatments, International Index of Erectile Function (IIEF-5), Lue score, and pain score on Likert scale were collected. Patients treated for PD were prospectively recorded, and data were retrospectively reviewed. The aim of this article is to assess the outcomes of a low-intensity extracorporeal shock wave therapy (LiESWT) protocol for the treatment of Peyronie's disease (PD).
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