Treatment of Peyronie's disease by extracorporeal shockwave therapy: evaluation of our preliminary results.

BACKGROUND: Peyronie's disease is an idiopathic disorder of the penis that produces erectile dysfunction. It affects mainly the tunica albuginea. We describe our preliminary results with extracorporal shockwave therapy (ESWT) as a new noninvasive modality for the treatment of Peyronie's disease. PATIENTS AND METHODS: In this study, 24 patients aged 36 to 67 years were treated with ESWT on the Lithostar overhead-module (Siemens). All our patients had unsuccessful medical treatment before ESWT. The average plaque was 7x15 mm. The number of shockwaves ranged from 15,000 to 25,000 (18-21 kV) delivered in four to ten sessions. Most patients needed local anesthesia before therapy. RESULTS: Four patients (17%) showed marked improvement and complete remission of the penile deviation. Six patients (25%) showed partial remission with painless erections after treatment. Four patients had painless erections after treatment but still had some penile deviation. In 10 patients (41%), ESWT failed, necessitating subsequent penile surgery. CONCLUSIONS: Our preliminary results with a response rate of 59% with ESWT for Peyronie's disease, including a 17% complete remission rate, is encouraging. However, further multicenter studies will have to prove if ESWT is a real therapeutic option for this disease.