Ultrasound & Extracorporeal Shockwave Therapy (ESWT)

[PreZer]

                Last day my wife just takes a check up in the doctor and have some ultrasound in the clinic. I saw our first baby in the 3D ultrasound that is printed. It is a baby boy when It comes out. Ultrasound Repair Training

[newguy]

Why are you so interested in ESWT. There are few if any success stories with this?

If you haven't done so yet you might want to read some of the other topics on the forum that have led to some positive results regarding Peyronies Disease.

Les

It's a cultural thing. For some reason in the UK some doctors seem quite big on ESWT and that filters through to patients perpections of what works and what doesn't. You should get on pentoxifylline michael.. without a doubt (check  out this new study: http://www.peyroniesforum.net/index.php/topic,1004.0.html . And maybe l-arginine and viagra. Aside from that keep doing what you're doing.

[lwillisjr]

Does anyone know of any Urologists in the UK offering ESWT on the NHS or has anyone got any recommendations for private practices in the UK? If it works for some people then I'm prepared to try it, well anything but surgery!!

Thanks in advance. Michael

Why are you so interested in ESWT. There are few if any success stories with this?

If you haven't done so yet you might want to read some of the other topics on the forum that have led to some positive results regarding Peyronies Disease.

Les

[tackarama]

Hi

I was diagnosed in Feb this year, 1cm of plaque on the top = 30 degree (painful) bend upwards. I was on Potaba for 3 months then was taken off and thing started to get worse again about 6 weeks ago. now it's 2cm & 45 degrees, painful when erect and some times when not.

Just saw my Urologist again today, had to wait 6 weeks for an appointment. He says he doesn't do ESWT but a colleague of his may. Back on Potaba & VED now.

Does anyone know of any Urologists in the UK offering ESWT on the NHS or has anyone got any recommendations for private practices in the UK? If it works for some people then I'm prepared to try it, well anything but surgery!!

Thanks in advance. Michael

[newguy]

Yes, ESWT is a tricky one. It's another of of those treatments that appears to work really well acciording to some studies, but not so well according to others. Some of the studies are quite large though, so I do think that it can be useful for certain individuals. There are so many factors though, one of which you wisely point out as the competence or otherwise of those carrying out the procedure. It doesn't seem like it did much for you, so that's a shame.

[Wintercookie]

The 2nd Consultant Urologist I consulted about my Peyronies suggested ESWT and so I agreed.  This was performed in a NHS hospital in the North West of England between April - June 2007.  I had 3 sessions lasting about 20 mins each session, following thay there was only slight reddening or bruising on the surface skin.  I experienced a cessation of aching/pain at the sight of one plaque for about a fortnight but then it seemed to resume.  Other than that I discerned no other benefits as far as plaque reduction or erectile dysfunction was concerned.  However my Peyronies manifests itself as a diffuse scarring around the penis resulting in narrowing and shortening of my penis and so I perhaps was not the best candidate for this treatment.  There was an element of guesswork I felt on the part of the technicians administering the Lithotripsy in locating which part of the penis to focus on given that they could not make out any plaques on the ultrasound monitor.  They were directed by where I indicated the aching/pain.  At the outset of the 2nd session a technician even identified the coronal ridge of my glans penis as being a plaque and proceed to 'zap' me there for all of a minute before I stopped them!  Incompetance indeed.

[newguy]

No, I was trying to get an idea of the geographical boundaries in his search for treatment. ESWT is available in the UK though, so I'd imagine that there must be a few US options.

[Maverick]

Are you looking for treatment in Canada specifically, or would you be able to travel to the US if necessary? If you feel that it helped you, it's a shame that the clinic closed.

Newguy, are you saying that this treatment is being done in the US and if so where and do you know anyone that has done it?
FYI as to my previous post about Nanovibronix, the unit was a little too expensive at 600$+ so I opted for a traditional 1MHz unit and will try it out as soon as it is delivered.

[newguy]

Are you looking for treatment in Canada specifically, or would you be able to travel to the US if necessary? If you feel that it helped you, it's a shame that the clinic closed.

[CJinSF]

Hi - I'm new to this site.  I was one of the clients that was treated at the "PainFree ESWT" clinic near Toronto.  The ESWT was extremely effective for me.  I had 3 Peyronie's "symptoms": 1- an hourglass; 2- a sharp bend up to the left; 3- a gentle curve up resulting in an overall shortening.  During the sessions at the clinic, the staff focused on the first 2 as they indicated greater success with specific site treatment.  After my weekend of treatment, both of these symptoms were completely gone.  Plus, my insurance reimbursed me for 80% of the procedure.  Now, almost 2 years later, I am searching for another clinic to try and get treatment for the remaining symptom, to see if I can regain some of my original length.  The clinic in Toronto unfortunately went out of business (I think in 2008) due to lack of clients.  As a former client, they contacted me before they closed to let me know they were doing so.

[Hawk]

I think these were self-proclaimed successful results and not objective, well designed trials.  I have always believed this was likely more hype for business thant it was true results but I wanted to see evidence to the contrary.  I never did.

[Maverick]

Anyone know what happened to that PainFree ESWT clinic in Toronto Canada? Seemed to have posted promising results and then fell off the map...

[Maverick]

It seems to me that ultrasound and/or laser therapy would be the way to go in treating Peyronie. Oral medication can only go so far in reacting with localized scar tissue.
Recently Nanovibronix received preliminary FDA approval on their Pain Shield device. This device is an alternative to the common place high frequency/high intensity ultrasound that has been used for years in helping with muscle tissue healing and various other applications. Pain Shield uses low frequency/low intensity in a portable unit. I've contacted them for a quote and will ask my doctor about which frequency and intensity would be best suited for application in Peyronie.

[Old Man]

Newguy:

Yes, Hawk is right. I had 45 three minute x-ray bombardments done for Peyronies Disease. They were done two times a week until the 45 sessions were completed. It was part of an experiment being done in Birmingham, Alabama.

At the time the urology association was asking certain of their better known urologists to experiment with the treatment. I was selected to participate in the program since my cousin had recommended me for the trials.

My case was followed closely by the urology group and documented very well. However, after the treatment was finished, my Peyronies Disease was just as bad as before. There were no obvious decrease in any of the symptoms. My Peyronies Disease consisted of a 45 degree curve to the right and a 45 degree or more curve downward. Sexual activity was curtailed somewhat, but I could still perform with a few little problems.

Only after I was prescribed a VED for impotency after a radical prostatectomy was I able to see any good results toward return of my penis to somewhat of a "normal" state.

So, bottom line, my radiation therapy proved to be of no actual benefit from it. I don't recommend it for anyone due to the added time and bother of having to make the visits for the treatment with no known good results. Advances in the radiation field may be better now, but I still doubt that x-ray therapy would be any better than it was back then.

Old Man

[Hawk]

I have a dim view of this based only on the fact that it has been tried and seemed to go nowhere.  I am pretty sure Old Man has had radiation therapy for Peyronies Disease many years ago.

It is worth noting that radiation therapy has steadily evolved both in type and in delivery.  Radiation therapy in general is much more precise than even a decade ago so at least tissue outside of the target area is less affected.

[newguy]

Here's a link relating to radiation therapy in those with Dupuytren's. Interestingly, on perhaps the largest Dupuytren's forum it appears to be pretty much the therapy of choice (aside from surgery) with the ability to often "stop the growth of Dupuytren nodules or cords either permanently or for a long time" at least according to the site and a few studies on the http://www.ncbi.nlm.nih.gov/pubmed/ website.

http://www.dupuytren-online.info/radiation_therapy.html

I wonder if these results would be mirrored in those with early stage peyronie's. If so, I suppose it could eventually be considered as a front line treatment for those new to peyronie's. The word "radiotherapy" and typical uses and consequences at high enough doses perhaps mean that not enough study is performed in this area relating to peyronies. As peyronies isn't life threatening it would perhaps be considered a "trivial" use of the technology. I doubt sufferers would agree though.

What's your view of this as a potential treatment?

[newguy]

BACKGROUND: Extracorporeal shock wave therapy (ESWT) is a conservative therapy for patients with Peyronie's disease (Peyronies Disease). OBJECTIVE: To investigate the effects of ESWT in patients with Peyronies Disease. DESIGN, SETTING, AND PARTICIPANTS: One hundred patients with a history of Peyronies Disease not >12 mo who had not had previous Peyronies Disease-related treatments were enrolled in a prospective, randomized, double-blind, placebo-controlled study. Patients were randomly allocated to either ESWT (n=50) or placebo (n=50). Erectile function (EF), pain during erection, plaque size, penile curvature, and quality of life (QoL) were assessed at baseline, at 12 wk, and at 24 wk follow-up. INTERVENTION: Four weekly treatment sessions were administered. Each ESWT session consisted of 2000 focused shock waves. For the placebo group, a nonfunctioning transducer was employed. MEASUREMENTS: EF was evaluated with the shortened version of the International Index of Erectile Function (IIEF-5), pain was evaluated with a visual analog scale (VAS; 0-10), plaque size was measured in cm(2), and penile curvature was measured in degrees. RESULTS AND LIMITATIONS: After 12 wk, mean VAS score, mean IIEF-5 score, and mean QoL score ameliorated significantly in patients receiving ESWT. Mean plaque size and mean curvature degree were unchanged in the ESWT group, while a slight increase was reported in the placebo group (p-value not significant vs baseline). After 24 wk, mean IIEF-5 score and mean QoL score were stable in the ESWT group, while mean VAS score was significantly lower when compared with baseline in both groups. Interestingly, after 24 wk, mean plaque size and mean curvature degree were significantly higher in the placebo group when compared with both baseline and ESWT values. The main limitations were that the QoL questionnaire was not validated, ED was not etiologically characterized, and inclusion criteria were restricted. CONCLUSIONS: In patients with Peyronies Disease, ESWT leads to pain resolution and ameliorates both EF and QoL.

- http://www.ncbi.nlm.nih.gov/pubmed/19473751?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

I have no fixed view of this treatment, but noticed this so thought I'd post it here.

Does anyone have a few on the use of radiotherapy for peyronie's? It appears to have been used to treat Dupuytren's disease, or rather to halt progression.

[Tim468]

Please let us know how it turns out.

Tim

[atchoum]

Hello,
Just to let you know that after thoughts, reading results, statistics and discussions, I have decided to go for the Verapamil  option  (I started yesterday...) so from now on I will be posting on the relevant topic...
atchoum 

[lwillisjr]

atchoum,

Regarding the following:

Hello lwillisjr an thank you for your answers,
You talk about side effects and complications from the Verapamil injections, what could they be ?

Several who post here will tell you that the injections caused more problems for them. Examples would be causing more damage due to the insertion of the needle to the tunica either due to more fibrous tissue or creating additional Peyronies plaque. However....  there are also studies referenced where 70% of patients who did have injections together with Pentox and either VED or traction therapy actually helped to correct their Peyronies bend. To stay on topic look under the "Injections - Verapiml.... " thread on this forum.

[Tim468]

I hope the doctor visit goes well.

You can copy/paste a snippet of the text that you are interested into the google search engine. remember to put it into quotes.

By searching this phrase: "In the study, researchers at the Hôpital Foch in Suresnes, France", I found several links.

Tim

[atchoum]

can anyone comment on this:

In the study, researchers at the Hôpital Foch in Suresnes, France, investigated a technique called extracorporeal shock wave therapy (ESWT), commonly used to split and break up kidney stones, to treat 54 men with Peyronie's.

Of the 35 patients that had pain on erection, 91% noticed relief immediately after treatment. Twenty-nine patients (54%) noticed an improvement in penile angle, and 25 thought the plaque had been smoothed by the procedure. Overall, 61% of patients said their condition had improved after the therapy. Only 9 patients (16%) thought it was inadequate and went on to surgery.

"On the basis of these results, we conclude that ESWT could become a valuable tool in the therapeutic arsenal to successfully treat Peyronie's disease," write the authors in their study, which is published in the current issue Urology.

I am supposed to meet the Hospital Foch Staff (Doctor LEBRET) the 29th of January, the only statistic I found about the treatment is the one I posted (summary), can you tell me where you found yours please?
Regards,
atchoum

[atchoum]

The article on shockwave therapy is from 2003 and I have seen no good followup study published. That usually means that the early data did not pan out with larger numbers of patients, or that the original numbers were not that good to start with.

Tim

  Hello,
Yes I could not find recent studies myself...
Here's the summary from he french study I mentionned before (2000)...

"Extracorporeal shock wave lithotripsy (ESWL) in the treatment of La Peyronie disease. Use of a standard lithotriptor (Siemens Multiline) on «young» plaques (less than 6 months).
Objectives: The treatment of La Peyronie disease is still controversal. 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 kilo-joules 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"...

Regards,
Atchoum
 

[atchoum]

atchoum,
Welcome (unfortunately)....   you will find mixed reactions here regarding the Verapamil injections. Several have had complications just from the injections. But there are documented studies where the injections did help, but I believe it was in conjunction with either VED or traction therapy in addition to the injections. I had 6 of them and didn't notice any improvement at all. I was fortunate in that I did not have any complications or side effects from the injections.

Hello lwillisjr an thank you for your answers,
You talk about side effects and complications from the Verapamil injections, what could they be ?

The ESWT topic has come up several times. It seems there is a lot of interest in it but I'm not aware of anyone on this forum who has had any treatments nor any success with it. But one thing to remember is that there is no single cure that works for everyone, so each person needs to pursue their own choices of therapies to see what works for them.

So no one really on this forum has tryed the ESWT/ESWL so far ?
By looking at statistics of the two treatments, my brother (who's a Dermatologist) said that the results obtained with Verapamil are more significant, he also said to ask my doctor about injecting corticoids into the plaques since he does that with patients who present skin scares that turned fibrous. Has that option ever been tried ? I am not proposing here a treatment. it is only a question a doctor (who's not a specialist in this matter) wants me to ask to another Doctor (who's a specialist in the matter)...
atchoum

[Tim468]

The article on shockwave therapy is from 2003 and I have seen no good followup study published. That usually means that the early data did not pan out with larger numbers of patients, or that the original numbers were not that good to start with.

Tim

[lwillisjr]

atchoum,
Welcome (unfortunately)....   you will find mixed reactions here regarding the Verapamil injections. Several have had complications just from the injections. But there are documented studies where the injections did help, but I believe it was in conjunction with either VED or traction therapy in addition to the injections. I had 6 of them and didn't notice any improvement at all. I was fortunate in that I did not have any complications or side effects from the injections.

The ESWT topic has come up several times. It seems there is a lot of interest in it but I'm not aware of anyone on this forum who has had any treatments nor any success with it. But one thing to remember is that there is no single cure that works for everyone, so each person needs to pursue their own choices of therapies to see what works for them.

[atchoum]

Hello,
I am new here and as you may assume, I am suffering from La Peyronie's disease, I just got diagnosed a couple of weeks ago, thank you for welcoming me...
I am about to start the verapamil injections, but I have heard about the ESWL treatment that stand for  Extracorporeal Shock Wave Lithotripsy   "Using a standard lithotriptor  (Siemens Multiline) on «young» plaques (less than 6 months)."
Have you heard anything about it? Is it related to the topic ESWT
Yours,
atchoum

[gbja]

Sorry for delay of answer: this is the link: http://www.laserpartner.org/lasp/web/en/2000/0006.htm

[PAR]

Pulsed ultrasound is for acute conditions and continuous is for chronic conditions. This is usually regarding inflammation lasting longer than about 72 hours so I would use continuous.

[bodoo2u]

So Tim,

Would you say that I am calcified after more than 3 years of Peyronie's Disease? I have a plaques (it feels more like a cord) that runs along almost the entire right side of my penis, causing a horrible bend to the right, which experts say is worse than bending up or down.

Do you think ESTW is worth trying, assuming I can get a doctor to perform it?

Bo

[Tim468]

I suspect it may have application for those with palpable plaque that is perhaps solidified or calcified, but will prove less helpful for those with dents or smaller scars.

Simply put, it breaks up things that are built up, so if your disease does not include a buildup of something that you can palpate, it will probably not be helped.

Time will tell if this works outside of this hospital - this why multi-center blinded and randomized studies are so important.

Tim

[Iceman]

can anyone comment on this:

In the study, researchers at the Hôpital Foch in Suresnes, France, investigated a technique called extracorporeal shock wave therapy (ESWT), commonly used to split and break up kidney stones, to treat 54 men with Peyronie's.

Of the 35 patients that had pain on erection, 91% noticed relief immediately after treatment. Twenty-nine patients (54%) noticed an improvement in penile angle, and 25 thought the plaque had been smoothed by the procedure. Overall, 61% of patients said their condition had improved after the therapy. Only 9 patients (16%) thought it was inadequate and went on to surgery.

"On the basis of these results, we conclude that ESWT could become a valuable tool in the therapeutic arsenal to successfully treat Peyronie's disease," write the authors in their study, which is published in the current issue Urology.

[Tim468]

No clue regarding that question gbja.

Years ago, when I worked as an ER doctor, during quiet (long quiet) spells during the night, I would use the ultrasound at the same settings that they had used for joints and fasciitis (sp?) and tried it out - no better - though things warmed up while I did it. I do not recall the settings though.

Where did you find the data that you reported?

Tim

[gbja]

I read som articles about the use of ultrasound, and found a dosage of 0,5 W/cm2 for 5 min one place. What is the carrier frequency? ( my apparatus has a choice of 1 MHz and 3 MHz)
Also - should the pulse frecquency be cont. or pulsed ? Grateful for answer

[George999]

Prospective Randomized Controlled Double Blind Trial Of Shock Wave Therapy (SWT) Vs. Sham Treatment In Men With Peyronie's Disease

This study from from the UK may have put to rest the use of extracorporeal shock wave lithotripsy (ESWL) for the treatment of Peyronie's Disease plaques.

And:

Can Extracorporeal Shock Wave Therapy Induce Peyronie's-Like Plaque In Normal Penis?

This study out of Sao Paolo, Brazil showed that shock wave therapy (SWT) can actually induce tissue injury to the tunica albuginea to form a Peyronie's plaque in normal tissue.

[j]

I certainly wouldn't say 'without doubt' but as more studies come out over the years, the conclusion is being reinforced that the cellular changes are identical.  I recall seeing a couple of other study abstracts that were more detailed, but right now I can't Google them up - a lot of that content has been moving to "pay per view".   

I first went to a hand surgeon for Dupuytren's about 10 years ago. He'd seen a lot of Dupuytren's, stated flatly that "Dupuytren's is a disease that affects 3 parts of the body" and told me exactly what to expect.   I didn't have Lederhose or Peyronie's at that point; but within 5 years I had both.  I have to admit that this all too accurate prediction has influenced my thinking.

While the cellular pathology may be similar or identical, there might be multiple causes. If the root cause of this loss of cellular regulation is genetic, it might be fairly intractable; but if some metabolic or 'lifestyle' factor pushes the fibroblasts into this zone, that might be addressed by a drug or supplement.

I have yet to see any convincing evidence that Pentox/Arginine/Viagra even work on Peyronie's, and have never heard of those drugs being tried against Dupuytren's or the other related conditions.  5-fluororacil was tried a few years ago on DC (on a small number of patients) and it failed.  It would be very interesting if someone like Dr. Tom Lue talked to people working on Dupuytren's.

Again, all just my opinions, based on nothing but reading the web over the years.

[Hawk]

J,

On a quick read on the way out the door, that seemed to say there are some common qene expressions and some that are unique.  It concluded based on the common  expressions that they may benefit for common treatments.  Is this how you read it?

This seems like a very reasonable conclusion that I have never doubted.  It seem like you take the position that they would without any doubt benefit from the same treatments.

Would you conclude that the pentox, arginine, viagra combo would be a good treatment attempt for DC or would you conclude that is not a promising treatment for Peyronies Disease?

[j]

Besides being strongly statistically linked, at the cellular level it appears they're essentially the same condition - fibroblasts gone haywire, producing an extracellular matrix of inelastic collagen. None of these therapies has the ability to break the molecular bonds of those collagen molecules in sufficient numbers to make any difference.  It's been hypothesized that verapamil enhances production of collagenase (which lyses collagen) in adjacent cells; however it seems no one can get that to work in the human body.

Dupuytren's doesn't modify the ligaments, although Dupuytren's tissue may attach to them.  Here's a link to one of several studies I've seen over the years leading to the conclusion (which is actually stated in this abstract) that what works for one should probably work for the other.  Note that AA4500/Xiaflex is effective on both; that's because the tissue is the same.

http://cat.inist.fr/?aModele=afficheN&cpsidt=16035818

[Hawk]

J,

I think you make some good points.  I tend to agree but this time you got my brain activated and I wonder if it has ever even been tried on DC.  I also ask if everything that works on one should just be accepted as working on the other?  One is a ligament and one is specialized tissue.  I think of pentox, arginine, and PDE5 inhibitors.  You could argue they are not known to work or that N.O. is not a factor with DC, but maybe the last point actually addresses my point.  If the fabled Lariche technique works, could it be that ESWT has a similar action of breaking the plaque especially if used in conjunction with traction?

How about the many other related types of fibrosis?

There is no argument that existing technology is a cheaper attempt, but existing technology cannot just be dismissed on those grounds.  New applications for existing technology are found every single day.

Thanks for the thought provoking comments.  I am still thinking....

[j]

There's now a whole group of  therapies - like ESWT, TV, cold laser, and hyperthermia - that are claimed to work on Peyronie's, but no mention is ever made of Dupuytren's.  I think there's a simple reason for that: they don't work, and that would be blindingly obvious if they were tried on Dupuytren's contractures.

They also represent existing products, with no development costs, looking for new markets.  Peyronie's is an easy market to enter because there's currently no effective non-surgical treatment to compete with.

It is true that Easterling's (PDL) web site still refers to Dupuytren's but as I know, no one tries it for DC anymore. A few years ago he spammed the BSTC Dupuytren's message board and a few people tried it. As far as I know it did nothing, and I think Easterling has stopped marketing it for Dupuytren's.



These are just my opinions.  I'm not a doctor.

[Liam]

You can guess my response. 

Where are the objective measures?

Any treatment ever suggested in this forum has had someone who said it helped.  Some of the treatments were not accepted as credible by most members.  Yet some reported improvement.  My point is patient surveys are inherently flawed.  EWST may prove to be the greatest therapy ever.  This report does not prove it, though.

[Hawk]

The following is an abstract of an self-evaluation that the PainFree ESWT clinic in Toronto Canada claims to have achieved.  This was sent directly to me by The PainFree clinic.  I certainly make no claim, or endorsement.  I  have no reason to either accept or reject this data but present it as it was presented to me.

EXTRACORPOREAL SHOCK WAVE TREATMENT (ESWT) FOR PEYRONIE’S DISEASE – SINGLE CENTER CONTINUING EXPERIENCE

Anil Kapoor MD, Michael Asumeng RN, Faten Mitchell BSc.
PainFree ESWT, Toronto, Ontario, Canada
March 2007

INTRODUCTION AND OBJECTIVES: ESWT has been described as a noninvasive
treatment modality for patients with Peyronie’s Disease (Peyronies Disease). Our previous research suggests this treatment is an efficacious and minimal sideeffect method of treating Peyronie’s Disease (Peyronies Disease). To date we have treated over 250 Peyronies Disease patients, and report on our latest experience of 53 Peyronies Disease patients treated with ESWT at a single Canadian institution.

METHODS: 57 patients underwent ESWT for Peyronies Disease from January 2006 to February 2007 at our
center. A prior diagnosis of Peyronies Disease made by a urologist was necessary for referral to our center. Patients were asked to stop all bloodthinners one week prior to procedure. Peyronies Disease assessment was done by the center’s urologist and, if appropriate candidate, proceeded with ESWT. Treatment consisted of 6 treatments of 30005000 shocks to Peyronie’s plaque over four consecutive days at power level 68 using a Siemens Sonocur lithotripter.

Pre and post treatment questionnaires were filled, and the patient contacted 46
Weeks after treatment. Data from the questionnaire was categorized in a conservative manner. Only 'Yes' was counted as an affirmative answer; 'No', 'unsure', 'forgot', 'can't tell' were all counted as a negative response.

Data was collected from 53 of the 57 patients treated at this time. The sample size for each question varies from 17 to 49 respondents, as not all symptoms applied to all patients. For example, only 17 of 53 patients had pain.

RESULTS: Of the 53 patients, all underwent successful ESWT. There were no procedure related
complications. Average age was 54 years and 8 months, and patients had the disease for an average of 2.6 years. 75.5% (37 of 49) of patients reported improvement in the Peyronie’s plaque, characterized by decrease in size and thickness of the plaque. 63% (31 of 49) of patients reported improvement in the degree of penile curvature. 82% (14 of 17) patients reported decreased pain with erections and intercourse.

Patients were also asked subjective questions about the quality of their erection. 45% and 39% of
respondents felt that some penile length, and girth had been improved. 60% reported improvement in hardness, and 75% (30 of 40) felt penetration had been enabled, or improved. The baseline was lower as some patients were not sexually active, or did not answer the question.
Approximately 19% of patients reported no change in condition after treatment.

CONCLUSIONS: ESWT is a reasonable noninvasive option for the treatment of Peyronie’s
Disease. Complications and side effects are minimal. Results to date indicate 75% of patients report
decrease in plaque size, 63% report decrease in penile curvature, and 82% decrease in penile pain. Longer term followup is necessary to evaluate efficacy.

Disclosure: All authors have received financial support from PainfreeESWT

[kenno]

Tim, do you have any more information on the ultrasound therepy?  I would assume that this is something you would have to continue doing on an intermittent basis, since the cause of Peyronie's is probablly still present.  Any news?

[hopeful]

Could you please have some of your 200 plus patients join the Forum- and post their reults? This would be hepful to anyone who is considering this treatment.
Hopeful

So far, from about 200 men treated, we haven't had trauma, just some minor tenderness/bruising in a few cases.  We do not agree that treatment is mor effective on older plaques.  Our Urologist will consider ESWT after more conservative treatments have bee tried (eg. waiting 6-12 months for spontaneous remission, treatment with Vitamin E)

Hawk is correct that there is no standardized treatment yet among researchers/therapists.  However a search of MedLine or similar European engines does return quite a bit of research. 

[Liam]

British Journal of Dermatology
Volume 154 Page 755  - April 2006
doi:10.1111/j.1365-2133.2005.07074.x
Volume 154 Issue 4
 
 
CASE REPORT
Cutaneous granulomatous reaction to injectable hyaluronic acid gel
M. Ghislanzoni, F. Bianchi, M. Barbareschi and E. Alessi
 Summary

Injectable hyaluronic acid (HA) derivatives are the most used reabsorbable dermal fillers for soft tissue augmentation today and their utilization is considered safe. We report a cutaneous granulomatous reaction that developed in a woman 5 weeks after the first treatment with a nonanimal HA derivative for the correction of facial wrinkling. We describe the clinicopathological findings and course of the cutaneous reaction. The adverse reaction showed clinical and histopathological characteristics comparable to the few previously reported cases. All cutaneous lesions spontaneously disappeared without scars within 3 months. We conclude that even nonanimal injectable HA derivatives can be associated with delayed granulomatous reactions. The patient should be informed of this potential long-term complication.


Dermatologic Surgery
Volume 27 Page 185  - February 2001
doi:10.1046/j.1524-4725.2001.00248.x
Volume 27 Issue 2    
 
Human Anti-Hyaluronic Acid Antibodies: Is it Possible?
Patrick Micheels, MD
Background. Although hyaluronan has been acknowledged as being free of species and organ specificity, for 4 years I have encountered a variety of adverse reactions to injectable hyaluronic acid as used in aesthetic medicine.

Objective. I have tried to prove that some of those side effects may be allergic reactions to the commercial preparations of injectable hyaluronic acid.

Methods. I began with intradermal tests to the reactive patients and to 2 witnesses; then lymphocyte transforming tests were performed at the University of Geneva (Switzerland). Histology was performed on the skin tests and on reactive treated areas of the face of different patients. A serum analysis was then done by Pr. Sainte Laudy of Laboratoire Pasteur—Cerba (France).

Results. The skin tests were positive for one or the other or both of the injectable hyaluronic acid preparations used in aesthetic medicine. The different biopsies have shown for some a chronic inflammatory reaction, even 11 months after the treatment or a severe granulamatous reaction to foreign bodies. Serum analysis revealed positive antibodies against Restylane and/or Hylaform and even IgG and E anti-hyaluronic acid.

Conclusion. Since 1995, I have 8 patients with adverse reactions to injectable hyaluronic acid, which after several tests, may be allergic to those products. Isn't it time to introduce intradermal tests before any injection of this type, as done with injectable bovine collagen?
 


Link to 1,785 matches for hyaluronic acid:

http://www.blackwell-synergy.com/action/doSearch?type=simple&target=simple&restrict=all&searchText=hyaluronic+acid+&filter=all&journal=abac&discipline=-1&group=-1&searchbuttonmain.x=38&searchbuttonmain.y=9

[Rico]

What I'm reading is that the infrasonic is suppose to increase the hyaluronic acid in the area, which only healthy tissue can survive, this is why the scar tissue dissolves and promotes the healthy tissue to rebuild. So read the articles. Any thoughts on this Brothers?

[George999]

I also read somewhere (forgot where) that ultrasound can be used to drive topical medication into tissue (sort of like DMSO I suppose).  Anyone else ever heard or read anything about that aspect?

[Liam]

Stating the obvious.

Ultrasound  is very high frequency.

Infrasound is very low frequency.

How they are supposed to work is opposite as well.

[Tim468]

Several points in responses to other posts:

The four years period in the study (post below on ultrasound) refers to a period of time during which data wre collected. As not all patients walk in on the same first day, but rather trickle in over time, one needs to look at a group of patients over time to see trends. If one looks at enough patients in four years, then that is when you collate data and write it up. The problem with a 30 year study like that is that other therapies change a lot, so cause and effect is harder to see.

As ultrasound therapy becomes more sophisticated - hopefully as any therapy becomes more sophisticated - we will see more clearly how it might help us (or not). I am unsure of the data presented - like many that have come before, it is not really controlled or blinded.

Tim

[Liam]

   Found this about infrasound healing.  PRRRRRRRR




 
 News Source: Townsend Letter for Doctors & Patients 
Date Released: April, 2003 
 Website: www.tldp.com
 
 
 
CHI Institute Presents Conclusive Studies Proving Healing Effect of Sound
by Staff Writer
 
Location Text Here - Recent studies are revealing how purring may be the secret to cats' nine lives. CHI Institute is the first to release studies that conclusively corroborate the healing results from infrasonic sound waves on humans and other animals.

Recent unreleased studies from the Fauna Communications Research Institute in Hillsborough, North Carolina have given evidence of the healing effect of purring in cats. Scientists there have determined that the frequency at which many cats purr, between 27 and 44 hertz for house cats, matches the frequency that seems to help human bones strengthen and grow. Biologists still don't know what generates purring in felines. They do know that cats purr, not only when they are happy, but also when injured. They heal quickly from bone and tissue injuries caused by impact of falling great distances.

Cats are not the only creatures that use sound for healing. Even humans have been measured emitting varying degrees of low-frequency sound waves. The Beijing Acoustics Institute found that Qi-Gong healers emit up to 100 times the level of infrasonic waves as the average person emits, and up to 1,000 times greater than those emitted by the infirmed. Chinese researchers built a device that replicated the patterns and frequencies of the Qi-gong healers. After they discovered clinical evidence of healing from the devices, CHI Institute founder, Richard Lee, teamed up with the Chinese engineer, Lu Yan Fang, to create a more precisely tuned device for improved reliability and effectiveness.

Twelve years later, CHI Institute is the first organization to present conclusive evidence proving the healing effect of sound from several independent research studies. The studies show that infrasound therapy improves measurements in EEG, EKG, thermogram, and AST/CPK diagnostic enzyme levels. In April 2002, a serological study performed by Ronald Riegal, DVM, showed improvement in the form of an increase in hyaluronic acid quality and concentration in joint lubrication after using CHI Institute's Equisonic QGM on joints in horses.

In addition to the scientific studies, thousands of medical doctors have already observed first-hand the results of therapeutic infrasound. Merle Janes, MD states, "I am using the machine in daily practice. I tried it on my cat, and she immediately flopped down, curled up and half-closed her eyes and purred away. Must've seemed to her like her momma cat had come back."

While 35% of CHI Institute's customers report near-miraculous results in improving their acute and chronic ailments, 96% of users report satisfactory to excellent benefits from infrasound therapy for reducing pain and and inflammation, improving circulation and accelerating the healing process.

source - http://www.healingmusic.org/Library/Newsroom/CHIInstitutePresentsConclusiveStudiesProvingHealingEffectofSound.asp