Shimpi Rajendra Kashinath, Jain Ravi Jineshkumar
Department of Urology and Genito-Urinary Surgery, Ruby Hall Clinic, Pune, Maharashtra, India.
Urol Ann. 2016 Oct-Dec;8(4):409-417. doi: 10.4103/0974-7796.192100.
Peyronie's Disease (PD) is a disease causing psycho social trauma to the patient. Multiple treatment options are available with variable results. Extra Corporeal Shock Wave Therapy (ESWT) is a new insight into the non invasive modality of management. It focuses on the mechanism of inducing angiogenesis in the penile cavernous tissue.
The aim of the study is to determine the role of ESWT in the management of PD. The objectives include demonstrating the improvement in mean International Index of Erectile Function Score (IIEFS), improvement in pain score by Visual Analogue Scale (VAS), change in cavernosal artery flow on colour penile Doppler, reduction in plaque size, and improvement in penile curvature degree after the therapy. 30 patients, between 25-65 years, who were non responders to conservative line of management, were treated with ESWT. The results were evaluated at baseline and 18-24 weeks after the therapy.
ESWT significantly improves the cavernosal artery velocity, thereby supporting the theory of angiogenesis. ESWT improves all the domains of IIEF including Erectile Function, Sexual Desire, Sexual Satisfaction, Orgasm and Overall Satisfaction. There is a significant improvement in the pain and penile curvature, and reduction in the plaque size. No adverse effects have been recorded.
ESWT offers a safe, minimally invasive, OPD based option to the management of the patients of PD in the stable phase of the disease. Patients who do not respond to the conservative line of management can be really benefited by ESWT.
佩罗尼氏病(PD)是一种给患者带来心理社会创伤的疾病。有多种治疗选择,但其效果各不相同。体外冲击波疗法(ESWT)是管理该疾病的一种非侵入性新方法。它专注于诱导阴茎海绵体组织血管生成的机制。
本研究的目的是确定ESWT在PD治疗中的作用。目标包括证明国际勃起功能指数平均得分(IIEFS)的改善、视觉模拟量表(VAS)疼痛评分的改善、阴茎彩色多普勒检查中海绵体动脉血流的变化、斑块大小的减小以及治疗后阴茎弯曲度的改善。对30名年龄在25 - 65岁之间、对保守治疗无效的患者进行了ESWT治疗。在基线以及治疗后18 - 24周对结果进行评估。
ESWT显著提高了海绵体动脉速度,从而支持了血管生成理论。ESWT改善了IIEF的所有领域,包括勃起功能、性欲、性满意度、性高潮和总体满意度。疼痛和阴茎弯曲度有显著改善,斑块大小减小。未记录到不良反应。
ESWT为处于疾病稳定期的PD患者提供了一种安全、微创、基于门诊的治疗选择。对保守治疗无效的患者可真正从ESWT中获益。