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World Journal of Urology

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01-01-2017 | Invited Review

Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain

Authors: Grzegorz Lukasz Fojecki, Stefan Tiessen, Palle Jörn Sloth Osther

Published in: World Journal of Urology | Issue 1/2017

Abstract

Purpose

The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders.

Methods

We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline and PubMed was carried out. The systematic review was performed according to PRISMA guidelines.

Results

We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie’s disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile deviation and plaque size were observed. Four studies on erectile dysfunction (ED) including 337 participants were included. Using International Index of Erectile Function (IIEF-EF) and erectile hardness scale (EHS) data suggested a significant positive effect of ESWT in phosphodiesterase-5 inhibitor (PDE-5i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard to treatment techniques and outcome measures, making it difficult to compare results.

Conclusions

ESWT may resolve pain in PD patients, while evidence for reducing curvature and plaques size is poor. Effects of ESWT on IIEF in ED patients are inconsistent; however, data on EHS does imply that the treatment potentially may recover natural erection in PDE-5i responders. ESWT seems to be able to resolve pain in CPP patients in the short term. In all three disease entities, long-term outcome data are still warranted.

Eisenberger F, Chaussy C (1978) Contact-free renal stone fragmentation with shock waves. Urol Res 6(3):111CrossRefPubMed

Rassweiler JJ, Knoll T, Kohrmann KU, McAteer JA, Lingeman JE, Cleveland RO, Bailey MR, Chaussy C (2011) Shock wave technology and application: an update. Eur Urol 59(5):784–796. doi:10.1016/j.eururo.2011.02.033 CrossRefPubMedPubMedCentral

Wang N, Tytell JD, Ingber DE (2009) Mechanotransduction at a distance: mechanically coupling the extracellular matrix with the nucleus. Nat Rev Mol Cell Biol 10(1):75–82. doi:10.1038/nrm2594 CrossRefPubMed

Frairia R, Berta L (2011) Biological effects of extracorporeal shock waves on fibroblasts. A review. Muscles Ligaments Tendons J 1(4):138–147PubMed

Haupt G, Haupt A, Ekkernkamp A, Gerety B, Chvapil M (1992) Influence of shock waves on fracture healing. Urology 39(6):529–532CrossRefPubMed

Valchanou VD, Michailov P (1991) High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop 15(3):181–184CrossRefPubMed

Larking AM, Duport S, Clinton M, Hardy M, Andrews K (2010) Randomized control of extracorporeal shock wave therapy versus placebo for chronic decubitus ulceration. Clin Rehabil 24(3):222–229. doi:10.1177/0269215509346083 CrossRefPubMed

Saggini R, Figus A, Troccola A, Cocco V, Saggini A, Scuderi N (2008) Extracorporeal shock wave therapy for management of chronic ulcers in the lower extremities. Ultrasound Med Biol 34(8):1261–1271. doi:10.1016/j.ultrasmedbio.2008.01.010 CrossRefPubMed

Yang P, Guo T, Wang W, Peng YZ, Wang Y, Zhou P, Luo ZL, Cai HY, Zhao L, Yang HW (2013) Randomized and double-blind controlled clinical trial of extracorporeal cardiac shock wave therapy for coronary heart disease. Heart Vessels 28(3):284–291. doi:10.1007/s00380-012-0244-7 CrossRefPubMed

10.

Wang Y, Guo T, Cai HY, Ma TK, Tao SM, Sun S, Chen MQ, Gu Y, Pang JH, Xiao JM, Yang XY, Yang C (2010) Cardiac shock wave therapy reduces angina and improves myocardial function in patients with refractory coronary artery disease. Clin Cardiol 33(11):693–699. doi:10.1002/clc.20811 CrossRefPubMed

11.

Hanna M, Pedersen D, Lund M, Marcussen N, Lund L (2012) Low energy ESWT, a novel treatment for diabetic nephropathy (animal study). J Endourol 26:A6CrossRef

12.

Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M (2001) Guidelines on urolithiasis. Eur Urol 40(4):362–371CrossRefPubMed

13.

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012. doi:10.1016/j.jclinepi.2009.06.005 CrossRefPubMed

14.

Schwarzer U, Sommer F, Klotz T, Braun M, Reifenrath B, Engelmann U (2001) The prevalence of Peyronie’s disease: results of a large survey. BJU Int 88(7):727–730CrossRefPubMed

15.

Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, Davis R, Hellstrom W (2004) Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. J Urol 171(6 Pt 1):2350–2353CrossRefPubMed

16.

Bekos A, Arvaniti M, Hatzimouratidis K, Moysidis K, Tzortzis V, Hatzichristou D (2008) The natural history of Peyronie’s disease: an ultrasonography-based study. Eur Urol 53(3):644–650. doi:10.1016/j.eururo.2007.07.013 CrossRefPubMed

17.

Mulhall JP, Schiff J, Guhring P (2006) An analysis of the natural history of Peyronie’s disease. J Urol 175(6):2115–2118. doi:10.1016/s0022-5347(06)00270-9 (discussion 2118) CrossRefPubMed

18.

Hatzichristodoulou G, Meisner C, Gschwend JE, Stenzl A, Lahme S (2013) Extracorporeal shock wave therapy in Peyronie’s disease: results of a placebo-controlled, prospective, randomized, single-blind study. J Sex Med 10(11):2815–2821CrossRefPubMed

19.

Chitale S, Morsey M, Swift L, Sethia K (2010) Limited shock wave therapy vs sham treatment in men with Peyronie’s disease: results of a prospective randomized controlled double-blind trial. BJU Int 106(9):1352–1356CrossRefPubMed

20.

Palmieri A, Imbimbo C, Longo N, Fusco F, Verze P, Mangiapia F, Creta M, Mirone V (2009) A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie’s disease. Eur Urol 56(2):363–370CrossRefPubMed

21.

Srirangam SJ, Manikandan R, Hussain J, Collins GN, O’Reilly PH (2006) Long-term results of extracorporeal shockwave therapy for Peyronie’s disease. J Endourol 20(11):880–884. doi:10.1089/end.2006.20.880 CrossRefPubMed

22.

Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Melekos M, Becht E (2006) Extracorporeal shockwave therapy for Peyronie’s disease: an alternative treatment? Asian J Androl 8(3):361–366. doi:10.1111/j.1745-7262.2006.00138.x CrossRefPubMed

23.

Skolarikos A, Alargof E, Rigas A, Deliveliotis C, Konstantinidis E (2005) Shockwave therapy as first-line treatment for Peyronie’s disease: a prospective study. J Endourol 19(1):11–14CrossRefPubMed

24.

Strebel RT, Suter S, Sautter T, Hauri D (2004) Extracorporeal shockwave therapy for Peyronie’s disease does not correct penile deformity. Int J Impot Res 16(5):448–451CrossRefPubMed

25.

Claro JA, Passerotti CC, Figueiredo Neto AC, Nardozza A Jr, Ortiz V, Srougi M (2004) An alternative non-invasive treatment for Peyronie’s disease. Int Braz J Urol 30(3):199–204CrossRefPubMed

26.

Michel MS, Ptaschnyk T, Musial A, Braun P, Lenz ST, Alken P, Kohrmann KU (2003) Objective and subjective changes in patients with Peyronie’s disease after management with shockwave therapy. J Endourol 17(1):41–44CrossRefPubMed

27.

Lebret T, Loison G, Herve JM, Mc Eleny KR, Lugagne PM, Yonneau L, Orsoni JL, Saporta F, Butreau M, Botto H (2002) Extracorporeal shock wave therapy in the treatment of Peyronie’s disease: experience with standard lithotriptor (siemens-multiline). Urology 59(5):657–661CrossRefPubMed

28.

Kiyota H, Ohishi Y, Asano K, Hasegawa N, Madarame J, Miki K, Kato N, Kimura T, Ishiyama T, Maeda S, Shimomura T, Shiono Y, Miki J (2002) Extracorporeal shock wave treatment for Peyronie’s disease using EDAP LT-02; preliminary results. Int J Urol 9(2):110–113CrossRefPubMed

29.

Hamm R, McLarty E, Ashdown J, Natale S, Dickinson A (2001) Peyronie’s disease—the plymouth experience of extracorporeal shockwave treatment. BJU Int 87(9):849–852CrossRefPubMed

30.

Husain J, Lynn NNK, Jones DK, Collins GN, O’Reilly PH (2000) Extracorporeal shock wave therapy in the management of a Peyronie’s disease: initial experience. BJU Int 86(4):466–468CrossRefPubMed

31.

Hauck EW, Altinkilic BM, Ludwig M, Ludecke G, Schroeder-Printzen I, Arens C, Weidner W (2000) Extracorporal shock wave therapy in the treatment of Peyronie’s disease: first results of a case-controlled approach. Eur Urol 38(6):663–670CrossRefPubMed

32.

Mirone V, Imbimbo C, Palmieri A, Fusco F (1999) Our experience on the association of a new physical and medical therapy in patients suffering from induratio penis plastica. Eur Urol 36(4):327–330CrossRefPubMed

33.

Abdel-Salam Y, Budair Z, Renner C, Frede T, Rassweiler J, El-Annany F, El-Magraby H, El-Akkad M (1999) Treatment of Peyronie’s disease by extracorporeal shockwave therapy: evaluation of our preliminary results. J Endourol 13(8):549–552CrossRefPubMed

34.

Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB (1994) Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 151(1):54–61PubMed

35.

Porst H, Vardi Y, Akkus E, Melman A, Park NC, Seftel AD, Teloken C, Wyllie M (2010) Standards for clinical trials in male sexual dysfunctions. J Sex Med 7(1 PART 2):414–444CrossRefPubMed

36.

Jackson G, Boon N, Eardley I, Kirby M, Dean J, Hackett G, Montorsi P, Montorsi F, Vlachopoulos C, Kloner R, Sharlip I, Miner M (2010) Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus. Int J Clin Pract 64(7):848–857. doi:10.1111/j.1742-1241.2010.02410.x CrossRefPubMed

37.

Dong JY, Zhang YH, Qin LQ (2011) Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol 58(13):1378–1385. doi:10.1016/j.jacc.2011.06.024 CrossRefPubMed

38.

Vardi Y, Appel B, Kilchevsky A, Gruenwald I (2012) Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? short-term results of a randomized, double-blind, sham controlled study. J Urol 187(5):1769–1775. doi:10.1016/j.juro.2011.12.117 CrossRefPubMed

39.

Olsen AB, Persiani M, Boie S, Hanna M, Lund L (2014) Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol 49(4):329–333. doi:10.3109/21681805.2014.984326 CrossRefPubMed

40.

Srini VS, Reddy RK, Shultz T, Denes B (2015) Low intensity extracorporeal shockwave therapy for erectile dysfunction: a study in an Indian population. Can J Urol 22(1):7614–7622PubMed

41.

Yee CH, Chan ES, Hou SS, Ng CF (2014) Extracorporeal shockwave therapy in the treatment of erectile dysfunction: a prospective, randomized, double-blinded, placebo controlled study. Int J Urol 21(10):1041–1045. doi:10.1111/iju.12506 CrossRefPubMed

42.

Chung E, Cartmill R (2015) Evaluation of clinical efficacy, safety and patient satisfaction rate after low-intensity extracorporeal shockwave therapy for the treatment of male erectile dysfunction: an Australian first open-label single-arm prospective clinical trial. BJU Int 115(Suppl 5):46–49. doi:10.1111/bju.13035 CrossRefPubMed

43.

Gruenwald I, Appel B, Vardi Y (2012) Low-intensity extracorporeal shock wave therapy—a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy. J Sex Med 9(1):259–264. doi:10.1111/j.1743-6109.2011.02498.x CrossRefPubMed

44.

Vardi Y, Appel B, Jacob G, Massarwi O, Gruenwald I (2010) Can low-intensity extracorporeal shockwave therapy improve erectile function? a 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol 58(2):243–248CrossRefPubMed

45.

Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, Oberpenning F, de C Williams AC (2010) European Association of Urology, EAU guidelines on chronic pelvic pain. Eur Urol 57(1):35–48. doi:10.1016/j.eururo.2009.08.020 CrossRefPubMed

46.

Marszalek M, Wehrberger C, Hochreiter W, Temml C, Madersbacher S (2007) Symptoms suggestive of chronic pelvic pain syndrome in an urban population: prevalence and associations with lower urinary tract symptoms and erectile function. J Urol 177(5):1815–1819. doi:10.1016/j.juro.2007.01.008 CrossRefPubMed

47.

Turner JA, Hauge S, Von Korff M, Saunders K, Lowe M, Berger R (2002) Primary care and urology patients with the male pelvic pain syndrome: symptoms and quality of life. J Urol 167(4):1768–1773CrossRefPubMed

48.

Tan JK, Png DJ, Liew LC, Li MK, Wong ML (2002) Prevalence of prostatitis-like symptoms in Singapore: a population-based study. Singapore Med J 43(4):189–193PubMed

49.

Moayednia A, Haghdani S, Khosrawi S, Yousefi E, Vahdatpour B (2014) Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis. J Res Med Sci 19(4):293–296PubMedPubMedCentral

50.

Vahdatpour B, Alizadeh F, Moayednia A, Emadi M, Khorami MH, Haghdani S (2013) Efficacy of extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome: a randomized, controlled trial. ISRN Urol 1(1):972601. doi:10.1155/2013/972601

51.

Zimmermann R, Cumpanas A, Miclea F, Janetschek G (2009) Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. Eur Urol 56(3):418–424CrossRefPubMed

52.

Zeng XY, Liang C, Ye ZQ (2012) Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome: a prospective, randomized and sham-controlled study. Chin Med J 125(1):114–118PubMed

53.

Zimmermann R, Cumpanas A, Hoeltl L, Janetschek G, Stenzl A, Miclea F (2008) Extracorporeal shock-wave therapy for treating chronic pelvic pain syndrome: a feasibility study and the first clinical results. BJU Int 102(8):976–980. doi:10.1111/j.1464-410X.2008.07742.x CrossRefPubMed

54.

Khodyreva LA, Dudareva AA, Mudraya IS, Markosyan TG, Revenko SV, Kumachev KV, Logvinov LA (2013) Efficiency assessment of shock wave therapy in patients with pelvic pain employing harmonic analysis of penile bioimpedance. Bull Exp Biol Med 155(2):288–292CrossRefPubMed

55.

Kahan BC, Rehal S, Cro S (2015) Risk of selection bias in randomised trials. Trials 16:405. doi:10.1186/s13063-015-0920-x CrossRefPubMedPubMedCentral

56.

Abraham L, Symonds T, Morris MF (2008) Psychometric validation of a sexual quality of life questionnaire for use in men with premature ejaculation or erectile dysfunction. J Sex Med 5(3):595–601. doi:10.1111/j.1743-6109.2007.00749.x CrossRefPubMed

Title: Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain
Authors: Grzegorz Lukasz Fojecki
Stefan Tiessen
Palle Jörn Sloth Osther
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 1/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1834-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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