[Extra-corporeal lithotripsy in the treatment of Peyronie's disease. Use of a standard lithotriptor (Multiline Siemens) on "young" (less then 6 months old) plaques].

Abstract

OBJECTIVE: The treatment of La Peyronie disease is still controversial. ESWL has been recently proposed to treat symptomatic plaques. The results, although discordant and often based on subjective assessment criteria, appear to show a certain degree of efficacy on so-called young plaques, i.e. during the acute phase of the disease. This study was designed to evaluate the results obtained with a classical lithotriptor (Siemens Multiline) on plaques present for less than 6 months. MATERIAL AND METHOD: 26 patients were included in this prospective study. All presented a painful plaque on erection. The plaque was palpated under general anaesthesia and 0.5 to 2 ml of contrast agent were injected to allow radiological visualization. All patients received 3000 impacts at a power of 7 kilojoules in 1 session and all were reviewed 1 month and 3 months after the ESWL session. RESULTS: Treatment was perfectly tolerated. Among the 26 patients treated: 19 patients (73%) reported a very marked reduction of pain on erection and 8 (31%) reported a reduction of curvature on erection, but this reduction was demonstrated objectively (by tracing or photographs) for only 3 patients (11%). Seven patients (27%) experienced softening of the plaque. Six (37%) of the patients suffering from erectile dysfunction reported improvement of the quality of erection, as reflected by the HEF score. CONCLUSION: A standard lithotriptor can be used to treat La Peyronie plaques. ESWL appears to have a marked analgesic effect, but its efficacy on correction of curvature of the penis was not demonstrated in this study.