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Extracorporeal Shock Wave Therapy for Peyronie's Disease: Exploratory Meta-Analysis of Clinical Trials

2004; Lippincott Williams & Wilkins; Volume: 171; Issue: 2 Linguagem: Inglês

10.1097/01.ju.0000108060.30363.8d

1527-3792

Ekkehard W. Hauck, Ulrich Müeller, Thomas Bschleipfer, Hans Schmelz, Thorsten Diemer, W. Weidner,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2004Extracorporeal Shock Wave Therapy for Peyronie's Disease: Exploratory Meta-Analysis of Clinical Trials EKKEHARD W. HAUCK, ULRICH O. MUELLER, THOMAS BSCHLEIPFER, HANS U. SCHMELZ, THORSTEN DIEMER, and WOLFGANG WEIDNER EKKEHARD W. HAUCKEKKEHARD W. HAUCK , ULRICH O. MUELLERULRICH O. MUELLER , THOMAS BSCHLEIPFERTHOMAS BSCHLEIPFER , HANS U. SCHMELZHANS U. SCHMELZ , THORSTEN DIEMERTHORSTEN DIEMER , and WOLFGANG WEIDNERWOLFGANG WEIDNER View All Author Informationhttps://doi.org/10.1097/01.ju.0000108060.30363.8dAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Extracorporeal shock wave therapy (ESWT) for the treatment of Peyronie's disease is still controversial. This exploratory meta-analysis of published studies in the international literature investigates its therapeutic effects. Materials and Methods: The treatment outcomes from 17 study groups identified by a computerized literature search were compared with natural history outcomes and data from control groups from 2 controlled ESWT studies. An exploratory meta-analysis was performed because a methodologically sound meta-analysis lege artis did not appear appropriate, since treated groups differ considerably in structure, the selection of outcome measures is inconsistent and measurement is not standardized. Results: ESWT seems to have an effect on penile pain during erection and on the improvement of sexual function. Pain seems to resolve faster after ESWT than during the course of the natural history. The effect on plaque size and penile curvature is less impressive. Conclusions: ESWT in Peyronie's disease at least seems to be effective in regard to penile pain and sexual function compared to natural history. Deducing from these data the effect on plaque size and curvature remains questionable. However, ESWT is not an evidence based therapy at present. A controlled (preferably pairwise matched), single blind, multicenter study with careful, detailed documentation of disease symptoms before intervention and of outcomes is required to evaluate the real effect of ESWT. References 1 : Treatment of Peyronie's disease by extracorporeal shockwave therapy: evaluation of our preliminary results. J Endourol1999; 13: 549. Google Scholar 2 : Extracorporal shock wave therapy (ESWT) in combination with local verapamil injections in the treatment of IPP (induratio penis plastica). Aktuel Urol2001; 32: 61. Google Scholar 3 : Possibility of using the piezoelectric lithotriptor in the treatment of severe cavernous fibrosis. Arch Ital Urol Nefrol Androl1989; 61: 417. Google Scholar 4 : Extracorporal shock wave therapy (ESWT) in Induratio penis plastica—development and topical ranking. Aktuel Urol2001; 32: 55. Google Scholar 5 : Peyronie's disease: ultrasonographic follow-up. 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Google Scholar 12 : Objective and subjective changes in patients with Peyronie's disease after management with shockwave therapy. J Endourol2003; 17: 41. Google Scholar 13 : A new biopsy technique to investigate Peyronie's disease associated histologic alterations: results with two different forms of therapy. Eur Urol2002; 42: 239. Google Scholar 14 : Extracorporeal shock wave therapy (ESWT) in the treatment of Peyronie's disease. Aktuel Urol2001; 32: 58. Google Scholar 15 : Extracorporeal shock-wave therapy for Peyronie's disease—two year results. J Urol2002; 167: 204. abstract 824. Google Scholar 16 : La Peyronie's disease (IPP) and extracorporeal shock waves therapy (ESWT): our experience. J Urol1999; 161: 205. abstract 786. Google Scholar 17 : Extracorporal shockwave (ESW) as a new effective treatment in Peyronie's disease. Eur Urol1999; 35: 124. abstract 496. Google Scholar 18 : The natural history of Peyronie's disease. J Urol1990; 144: 1376. Link, Google Scholar 19 : A retrospective review of 307 men with Peyronie's disease. J Urol2002; 168: 1075. Link, Google Scholar 20 : Ultrasound guided ESWT in Peyronie's disease plaques. Arch Ital Urol Androl2000; 72: 384. Google Scholar From the Department of Urology, Justus Liebig University, Giessen (EWH, HUS, TD, WW), the Institute of Medical Sociology and Social Medicine, Philipps University, Marburg (UOM), and the Department of Urology, Federal Armed Forces Hospital, Ulm (TB, HUS), Germany© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 171Issue 2February 2004Page: 740-745 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsmeta-analysislithotripsypenile indurationMetricsAuthor Information EKKEHARD W. HAUCK More articles by this author ULRICH O. MUELLER More articles by this author THOMAS BSCHLEIPFER More articles by this author HANS U. SCHMELZ More articles by this author THORSTEN DIEMER More articles by this author WOLFGANG WEIDNER More articles by this author Expand All Advertisement PDF downloadLoading ...