Editorial comment 1

      This paper adds to the increasing data on the use of ESWT in the management of Peyronie’s disease. In this study, 42 patients were studied and were divided into two arms: one group treated on three occasions each separated by 4 weeks and the other group receiving the three treatments on an every-other-day basis. At each session, each patient received 3000 shocks to the plaque, which was localized using ultrasonography. At a 2-month follow-up interval, those patients who reported improvement or wanted to receive additional treatment received another three sessions of ESWT. This noncontrolled study demonstrated that 14% of men had an excellent outcome in symptoms (defined for the purposes of this analysis as curvature and pain), and 50% had a significant improvement in symptoms. Of the men who complained of pain before therapy, 84% reported complete or near-complete relief of pain after therapy. In this small group of patients, it appeared that the magnitude of curvature at baseline was not a predictor of improvement in symptoms, and a longer duration of Peyronie’s disease appeared to be predictive of improvement (responders had a disease duration of an average of 6 months longer than did nonresponders).
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