Unit of Quality and Risk Management, University-Hospital of Marche, Ancona, Italy.
Pain Therapy Center, Division of Anesthesia and intensive Care, University-Hospital of Marche, Ancona, Italy.
Urology. 2024 Jan;183:111-116. doi: 10.1016/j.urology.2023.09.037. Epub 2023 Oct 11.
To assess the relationship between baseline total serum testosterone (T) and clinical outcomes in men affected by Peyronie's disease (PD) stable stage and treated by extra corporeal shockwave therapy (ESWT).
In this study, 168 patients affected by PD in stable stage (≥12 months) and treated with ESWT, were divided into 2 groups. Group 1 (G1) counted 71 patients with low T levels (≤ 300 ng/dL); group 2 (G2) consisted of 97 patients with normal T that received ESWT with the same protocol of G1 for 6 weeks. There were assessed at baseline and follow-up: Erectile dysfunction (ED), presence and severity of painful erections, penile plaque size, and penile curvature degree. The results were evaluated at baseline and 3, 6, 12, months after the treatment.
Not statistically significant differences emerged between the 2 groups at baseline, except for higher presence of patients with ED in G1 (90%) vs G2 (52%). Three months after the treatment in G2 pain was resolved completely in 80.4% of the patients, compared with G1 (54.9%). G2 had a reduction of curvature degree after the 3-month treatment (P <.001). Mean plaque size decreased in both groups without statistically differences with baseline values. Mean ± SD International Index of Erectile Function-5 score progressively improved significantly in the eugonadal men.
This study demonstrated greater efficacy for the treatment of PD in men with normal T concentrations compared with men with low T concentrations. The results obtained from this study suggest that may be valuable in considering T therapy in men with PD prior to ESWT.
评估基线总血清睾酮(T)与接受体外冲击波治疗(ESWT)的稳定期 Peyronie 病(PD)男性患者临床结局之间的关系。
本研究纳入了 168 例稳定期(≥12 个月)接受 ESWT 治疗的 PD 患者,将其分为 2 组。G1 组(n=71)有 71 例患者的 T 水平较低(≤300ng/dL);G2 组(n=97)有 97 例患者的 T 水平正常,接受与 G1 组相同方案的 ESWT 治疗,共 6 周。在基线和随访时评估以下指标:勃起功能障碍(ED)、勃起疼痛的存在和严重程度、阴茎斑块大小和阴茎弯曲程度。治疗后 3、6、12 个月评估结果。
除 G1 组患者的 ED 发生率(90%)高于 G2 组(52%)外,两组患者在基线时无统计学差异。治疗 3 个月后,G2 组 80.4%的患者疼痛完全缓解,而 G1 组为 54.9%。G2 组在 3 个月治疗后弯曲程度有明显降低(P<.001)。两组的斑块大小均有减小,但与基线值相比无统计学差异。国际勃起功能指数-5 评分在两组中均逐渐显著改善。
本研究表明,与 T 水平较低的男性相比,T 水平正常的男性接受 PD 治疗的疗效更好。本研究结果提示,在接受 ESWT 治疗之前,考虑对 PD 男性进行 T 治疗可能具有重要价值。