Treatment of Peyronie’s Disease with ESWT

Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment approach that has been explored for Peyronie’s disease (PD) , a condition characterized by the development of fibrous plaques or scar tissue in the penis. These plaques can cause penile curvature, pain, and difficulties with erections. ESWT involves the use of high-energy shockwaves to target and break down the fibrous tissue responsible for the symptoms associated with Peyronie’s disease.

ESWT is a non-invasive treatment option that may be considered for PD when other treatments are ineffective or surgery is not preferred. It aims to alleviate symptoms, improve penile function, and enhance the quality of life for individuals affected by this condition. However, patient selection, realistic expectations, and ongoing follow-up care are essential aspects of the treatment process. In this article, I will talk about the effectiveness of ESWT in the treatment of Peyronie’s disease, taking into account our own experiences.

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What does in mean acute and chronic phase of Peyronie’s disease

Peyronie’s disease progresses through different phases, and understanding these phases is essential for diagnosing and treating the condition effectively. Here’s what the acute and chronic phases of PD mean:

Acute Phase:

The acute phase of Peyronie’s disease can last for several months, typically ranging from a few months to up to a year or more.
The acute phase of Peyronie’s disease is the initial stage when the condition becomes noticeable and is actively progressing.

During this phase, individuals typically experience symptoms such as penile pain, inflammation, and the development of fibrous plaques or scar tissue within the penis.
Pain during erections and the onset of penile curvature may occur.
The acute phase can last for several months, and the disease is still evolving and changing during this time.
This phase is characterized by active inflammation and the formation of plaques, making it a challenging period for both patients and healthcare providers.

Chronic Phase:

This phase can last indefinitely and may continue for years or even a lifetime.
The chronic phase of Peyronie’s disease occurs after the acute phase, and it is marked by the stabilization of the condition.
In the chronic phase, the acute inflammation and pain typically subside, and the fibrous plaques become more stable.
The penile curvature may remain, but it tends to be less dynamic and changes less over time.
While some symptoms may persist, they are often less severe and more manageable than in the acute phase.
The chronic phase can last for an extended period, and it is during this phase that treatment options are usually considered to address residual symptoms and deformities.

It’s important to note that the transition from the acute phase to the chronic phase varies among individuals. Some people may progress quickly to the chronic phase, while others may have a more prolonged acute phase. The choice of treatment and its effectiveness may also depend on the phase of the disease, with different approaches considered for acute versus chronic PD. Patients should work closely with a urologist or specialist to diagnose their specific phase of Peyronie’s disease and determine the most appropriate treatment plan based on their individual circumstances.

Treatment of Peyronie disease with ESWT in acute phase

Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment approach that has been explored for Peyronie’s disease, a condition characterized by the development of fibrous plaques or scar tissue in the penis. These plaques can cause penile curvature, pain, and difficulties with erections. ESWT involves the use of high-energy shockwaves to target and break down the fibrous tissue responsible for the symptoms associated with Peyronie’s disease.

Extracorporeal Shockwave Therapy (ESWT) is a treatment option that has been explored for Peyronie’s disease, particularly in its acute phase. Peyronie’s disease is a condition characterized by the development of fibrous plaques or scar tissue in the penis, which can cause penile curvature, pain, and difficulty with erections. The acute phase refers to the period when the disease is still actively progressing and causing symptoms. ESWT involves the use of high-energy shockwaves directed at the area affected by Peyronie’s disease. The mechanism of action of ESWT in Peyronie’s disease is not entirely understood, but it is believed to work by breaking down the fibrous plaques and promoting tissue remodeling. Here’s how ESWT may be used in the acute phase of Peyronie’s disease:

Diagnosis and Evaluation: Before initiating ESWT, a thorough evaluation by a urologist or specialist is necessary to confirm the diagnosis of Peyronie’s disease and determine the extent of the condition. This may involve physical examinations, imaging studies, and assessment of penile curvature and function.
Patient Selection: ESWT may not be suitable for all individuals with Peyronie’s disease, and patient selection is crucial. Factors such as the size and location of plaques, the degree of curvature, and the presence of other health conditions will influence whether ESWT is a viable treatment option.
Treatment Sessions: ESWT typically involves a series of treatment sessions, usually performed on an outpatient basis. The exact number of sessions and the energy level of the shockwaves may vary depending on the specific ESWT device used and the patient’s condition.
Anesthesia: Local anesthesia or a topical numbing cream may be used to minimize discomfort during the procedure. We do not give anesthesia..
ESWT Procedure: During the procedure, the shockwaves are delivered to the affected area of the penis using a specialized device. The shockwaves are non-invasive and pass through the skin to target the fibrous plaques. The entire procedure usually takes around 20-30 minutes.
Post-Treatment Care: After each ESWT session, patients may experience some discomfort, bruising, or swelling. It’s essential to follow the post-treatment instructions provided by the healthcare provider, which may include pain management and penile exercises to maintain flexibility.
Follow-Up: Regular follow-up visits with the healthcare provider are essential to monitor progress and determine the need for additional ESWT sessions or other treatments.

It’s important to note that while ESWT may be considered as a treatment option for Peyronie’s disease in the acute phase, its effectiveness varies among individuals, and not all patients may experience significant improvement. Therefore, it is crucial for individuals with Peyronie’s disease to consult with a qualified urologist or specialist to discuss the most appropriate treatment plan for their specific condition.

How is the success rate of ESWT in the acute phase of Peyronie’s disease:

The success rate of Extracorporeal Shockwave Therapy (ESWT) for Peyronie’s disease in the acute phase can vary among individuals, and its effectiveness may depend on several factors, including the severity of the condition, the size and location of the plaques, and the specific ESWT protocol used. Success rates are generally reported based on improvements in penile curvature, pain reduction, and overall symptom relief.

Research and clinical studies have produced varying results regarding the effectiveness of ESWT for PD. Some studies suggest that ESWT may provide significant benefits in the acute phase, while others have reported more modest or inconsistent outcomes. Here are some key points to consider:

Degree of Curvature: ESWT may be more effective in cases of mild to moderate penile curvature in the acute phase. Severe curvature may be less responsive to ESWT.
Plaque Size and Location: The location and size of the fibrous plaques can influence the success of ESWT. Plaques that are accessible and amenable to shockwave treatment may respond better than those in challenging locations.
Treatment Protocol: The specific ESWT protocol used, including the energy level, number of sessions, and interval between treatments, can impact outcomes. There is no standardized protocol, and different healthcare providers may have varying approaches.
Patient Selection: Proper patient selection is crucial. Not all individuals with Peyronie’s disease in the acute phase may be suitable candidates for ESWT. Factors such as overall health and the presence of comorbidities can influence the treatment’s success.
Combination Therapy: In some cases, ESWT may be used in conjunction with other treatments, such as medications or penile traction therapy, to optimize results.
Follow-Up: Regular follow-up assessments with a healthcare provider are essential to monitor progress and determine the need for additional ESWT sessions or alternative treatments.
Expectations: Patients should have realistic expectations about the outcomes of ESWT. While it may improve penile curvature, reduce pain, and enhance erectile function for some individuals, it may not completely eliminate Peyronie’s disease or achieve the desired results for everyone.

Overall, the success rate of ESWT for PD in the acute phase is variable, and its effectiveness is a subject of ongoing research and clinical investigation. Before considering ESWT, individuals should consult with a urologist or specialist who can assess their specific condition, discuss treatment options, and provide personalized recommendations based on their unique circumstances. It’s also essential to discuss potential risks, benefits, and alternative treatments during this consultation.

Treatment of Peyronie disease with ESWT in chronic phase

Extracorporeal Shockwave Therapy (ESWT) is a treatment option that has been explored for Peyronie’s disease, even in its chronic phase when the condition has stabilized. Peyronie’s disease is characterized by the development of fibrous plaques or scar tissue in the penis, which can cause penile curvature, pain, and difficulty with erections. ESWT involves the use of high-energy shockwaves directed at the area affected by Peyronie’s disease, and it may have potential benefits in the chronic phase as well.

Here’s how ESWT may be used in the chronic phase of Peyronie’s disease:

Evaluation and Diagnosis: Before considering ESWT or any other treatment for Peyronie’s disease, a thorough evaluation by a urologist or specialist is necessary to confirm the diagnosis and assess the extent of the condition. This may include physical examinations, imaging studies, and assessment of penile curvature and function.
Patient Selection: ESWT may be considered for individuals with Peyronie’s disease in the chronic phase who have stable symptoms and are not experiencing active progression. The decision to use ESWT will depend on factors such as the size and location of plaques, the degree of curvature, and the patient’s overall health.
Treatment Sessions: ESWT typically involves a series of treatment sessions, usually performed on an outpatient basis. The number of sessions and the energy level of the shockwaves may vary depending on the specific ESWT device used and the patient’s condition.
Anesthesia: Local anesthesia or a topical numbing cream may be used to minimize discomfort during the procedure. We do not give anesthesia for our patients.
ESWT Procedure: During the procedure, shockwaves are directed at the fibrous plaques in the penis using a specialized device. The shockwaves are non-invasive and pass through the skin to target the affected area. Each session usually takes around 20-30 minutes.
Post-Treatment Care: After each ESWT session, patients may experience some discomfort, bruising, or swelling. It’s essential to follow the post-treatment instructions provided by the healthcare provider, which may include pain management and penile exercises to maintain flexibility.
Follow-Up: Regular follow-up visits with the healthcare provider are essential to monitor progress and determine the need for additional ESWT sessions or other treatments.

While ESWT may be considered as a treatment option for Peyronie’s disease in the chronic phase, it’s important to note that its effectiveness can vary among individuals, and not all patients may experience significant improvement. Patients should consult with a qualified urologist or specialist to discuss the most appropriate treatment plan for their specific condition and to assess whether ESWT is a suitable option in the chronic phase of Peyronie’s disease.

How is the success rate of ESWT in the chronic phase of Peyronie’s disease?

The success rate of Extracorporeal Shockwave Therapy (ESWT) for PD in the chronic phase is variable and can depend on several factors, including the specific patient, the characteristics of the Peyronie’s disease, and the chosen ESWT protocol. Success in this context is typically measured by improvements in penile curvature, reduction in pain, and overall symptom relief.

Here are some key factors that can influence the success rate of ESWT in the chronic phase of Peyronie’s disease:

Duration of the Disease: ESWT may be more effective when used in the chronic phase of Peyronie’s disease, as the condition is usually stable at this stage. The acute inflammation and pain have typically subsided, making it a potentially more suitable time for treatment.
Plaque Characteristics: The size, location, and composition of the fibrous plaques can impact the success of ESWT. Plaques that are accessible and responsive to shockwave treatment may yield better results.
Patient Selection: Proper patient selection is crucial. ESWT may be more effective for individuals with milder or more localized penile curvature and those who are otherwise healthy. Patients with severe deformities or extensive plaques may have less predictable outcomes.
ESWT Protocol: The specific ESWT protocol used, including the energy level, number of sessions, and interval between treatments, can influence outcomes. Different healthcare providers may use varying approaches, and the optimal protocol may not be standardized.
Combination Therapy: In some cases, ESWT may be used in combination with other treatments, such as medication or penile traction therapy, to achieve better results.
Patient Expectations: Patients should have realistic expectations about the outcomes of ESWT. While it may improve penile curvature, reduce pain, and enhance erectile function for some individuals, it may not completely resolve Peyronie’s disease or achieve the desired results for everyone.
Follow-Up: Regular follow-up assessments with a healthcare provider are essential to monitor progress and determine the need for additional ESWT sessions or alternative treatments.

It’s important to note that the success rate of ESWT for Peyronie’s disease in the chronic phase can vary among individuals, and research on its effectiveness is ongoing. The available evidence suggests that ESWT may provide benefits for some patients by reducing curvature, improving penile function, and decreasing pain. However, it may not be a suitable or effective treatment for everyone, especially those with severe or extensive plaques.

Before considering ESWT or any other treatment for PD in the chronic phase, individuals should consult with a urologist or specialist who can assess their specific condition, discuss treatment options, and provide personalized recommendations based on their unique circumstances. Discussion of potential risks, benefits, and alternative treatments is essential during this consultation.

Summary of the success rate of ESWT in the chronic and acute phase of PD

The success rate of Extracorporeal Shockwave Therapy (ESWT) for PD varies depending on the phase of the disease and individual factors. Here is a summary of the success rates in both the acute and chronic phases:

Acute Phase:

In the acute phase, where the disease is actively progressing and causing symptoms, the effectiveness of ESWT can be variable.
ESWT may be more beneficial for individuals with mild to moderate penile curvature and less severe symptoms.
Success rates are measured by improvements in penile curvature, pain reduction, and overall symptom relief.
Some patients may experience significant improvements, while others may see more modest or inconsistent results.
Proper patient selection, the specific ESWT protocol used, and realistic patient expectations are critical factors in determining success.

Chronic Phase:

In the chronic phase, when PD has stabilized and inflammation has subsided, ESWT may be more suitable and potentially effective.
Success rates may be higher in the chronic phase compared to the acute phase.
ESWT can help reduce penile curvature, improve erectile function, and decrease pain in some individuals.
Patient selection, plaque characteristics, ESWT protocol, and the possibility of combining ESWT with other treatments are factors that influence outcomes.
Realistic patient expectations and regular follow-up assessments are essential.

Overall, while ESWT can be considered for PD in both the acute and chronic phases, success rates can vary widely among individuals. It is crucial for patients to consult with a urologist or specialist to assess their specific condition, discuss treatment options, and receive personalized recommendations based on their unique circumstances. Additionally, patients should be informed about potential risks, benefits, and alternative treatments when considering ESWT for Peyronie’s disease.

According to our experience, reduction in pain, improvement in curvature and improvement in erection are more evident in the acute phase and in small-sized lesions. Plaque growth has stopped or completely disappeared. In the chronic phase, a similar improvement was observed depending on the degree of curvature, improvement in erection and disappearance of plaques in small lesions.

Prof. Dr.Emin ÖZBEK

Urologist

Istanbul- TURKEY