Maiti Krishnendu, Srivastava Swadeep Kumar, Pal Dilip Kumar
Department of Urology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India.
Indian J Urol. 2023 Jul-Sep;39(3):209-215. doi: 10.4103/iju.iju_22_23. Epub 2023 Jun 30.
Efficacy of low-intensity extracorporeal shockwave therapy (LiESWT) in Peyronie's disease (PD) has not been studied in an Indian population. Here, we studied the effect of LiESWT in Indian PD patients.
This prospective study was conducted on 25 patients who completed weekly sessions of LiESWT for 6 weeks with a follow-up of 6 months. Patients were evaluated using International Index of Erectile Function (IIEF)-5 questionnaire for erectile dysfunction and visual analog scale for pain. Baseline and follow-up examinations included measurement of plaque size and curvature. The primary outcome was to assess remission of pain and reduction of plaque size along with improvement of penile curvature and erectile function as the secondary outcome.
Primary goal of pain reduction and ≥50% reduction of plaque size was achieved in 64% and 20% of patients, respectively. Improvement in vaginal penetration during sexual intercourse and IIEF-5 score increase of ≥3 was achieved 20% and 36% cases, respectively. The mean reduction of penile curvature was more with plaque calcification (PC), but the difference was not statistically significant ( = 0.26). The difference in mean visual analog scale reduction was more in noncalcified plaque ( = 0.002). The mean reduction of plaque size in patients with PC was significant ( = 0.03).
Shockwave therapy is a probable alternative treatment option. A significant improvement was observed in pain and plaque size in patients treated by LiESWT. The presence of PC may affect the outcome of LiESWT in PD.
低强度体外冲击波疗法（LiESWT）治疗佩罗尼氏病（PD）在印度人群中的疗效尚未得到研究。在此，我们研究了LiESWT对印度PD患者的影响。
本前瞻性研究对25例患者进行，这些患者每周接受一次LiESWT治疗，共6周，并随访6个月。使用国际勃起功能指数（IIEF）-5问卷评估患者的勃起功能障碍情况，使用视觉模拟量表评估疼痛情况。基线和随访检查包括测量斑块大小和弯曲度。主要结局是评估疼痛缓解和斑块大小减小情况，次要结局是阴茎弯曲度改善和勃起功能改善。
分别有64%和20%的患者实现了疼痛减轻和斑块大小减小≥50%的主要目标。分别有20%和36%的患者在性交时阴道插入情况得到改善且IIEF-5评分增加≥3。伴有斑块钙化（PC）的患者阴茎弯曲度平均减小幅度更大，但差异无统计学意义（P = 0.26）。非钙化斑块患者视觉模拟量表评分平均降低幅度的差异更大（P = 0.002）。伴有PC的患者斑块大小平均减小具有统计学意义（P = 0.03）。
冲击波疗法可能是一种替代治疗选择。接受LiESWT治疗的患者在疼痛和斑块大小方面有显著改善。PC的存在可能会影响LiESWT治疗PD的效果。
