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Author Topic: Radial vs Focused ESWT - Does this sound correct?  (Read 1888 times)

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DarrenBent

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Radial vs Focused ESWT - Does this sound correct?
« on: February 23, 2020, 01:25:28 PM »

5 weeks ago I discovered I have Peyronies Disease. 20-30 degree dorsal curvature, no pain, no Erectile Dysfunction. Presumably active phase. Since then I've been taking Vit E, Q10 and L-Argenine daily and have been exploring all non-surgical treatment options in my area (London). Xiapex is no longer distributed in Europe.

One treatment I've been looking at is Shockwave Therapy, but I've also read a lot of studies that state it offers no improvment to curvature or plaque, only for pain (which I don't have...yet). I questioned the practitioner on this, who claimed to have been treating Peyronie's successfully since 2013, and this is what he had to say:

"The paper describes low intensity ESWT (Extracorporeal Shockwave Therapy) but does not specify whether it utilised focus or radial shockwave.

My experience is with using focus shockwave which I generally find superior to radial in most clinical application.

Radial shockwave generates mechanical shockwaves much like a jackhammer.

Focus shockwave generates shockwaves through piezoelectric action and this results increases in Nitric Oxide Synthase (NOS) and subsequent increases in NO

NO is a key mediator in the development and remodelling of fibrosis (scar tissue) in part through inhibition of Transforming Growth Factor B1

This acts to favourably change the collagen ration in the tissue.

It also increases blood supply to penis and improves erectile function. Improving erectile function will also serve to apply a mild stretch to the fibrotic region which aids remodelling.

The piezolectric action also has be shown to reduce nerve pain and aid regeneration, which is also my clinical experience.

With respect to peyronies 100% of my patients have be come pain free after the 6th session.

With respect to curvature all have had improvement in curvature and 70% have resolution of the plaque to the point it is not clinically significant.

My approach also utilises gentle stretching and we can also use oral supplements which have been studied and shown to be of significant benefit in Peyronies.

It is worth mentioning that the focus shockwave equipment is several fold more expensive than radial shockwave device and that I use the device made by the recognised leaders in ESWT, a Swiss company called Storz medical.
"

So...does this sound kosher to you all?


*Out of interest, the other treatment I think sounds promising is PRP. I know a lot of you will immediately shoot this down as useless. But the Doctor I'm talking to sounds very confident about it's success on Active Phase Peyronies Disease. Interestingly I've read he's hosting a series of medical industry lectures and conferences on the subject later this year. I don't know how people think these two treatments compare??*
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TonySa

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #1 on: February 23, 2020, 06:11:55 PM »

I’d ask for him to point to any studies that demonstrate such radical success, to refer you to his successful patients to verify, to offer money back if not successful...
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

DarrenBent

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #2 on: February 24, 2020, 02:31:43 PM »

Patient confidentiality probably excludes him from putting me in contact with former patients but this study seems to show some success using a Storz device that can be used to administer both radial and focussed waves. Although I can't quite tell if it says which it uses - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643174/

"There were improvements in penile curvature (more than 15 degrees in 33% of men), plaque hardness (Av 27% reduction in 60% of men) and penile pain (4 out of 6 men) following LiESWT. There was a moderate improvement in IIEF-5 score (>5 points reported in 20% of men). No complication was reported and the majority of patients were satisfied"

The shockwave adminstrator I'm talking to also discusses Gainswave, which appears to be the most talked about method on here:

"Yes, Gainswave is radial shockwave as their site describes ‘sound waves’

As I have stated my experience is with what I consider to be the superior focus device.

I do have a radial shockwave device by Storz but would not choose to employ it in treating erectile dysfunction and Peyronie’s disease

As mechanical trauma is often involved in the onset of the condition I feel it would be prudent to avoid mechanical shockwaves generated by radial devices especially when focus shockwave is an alternative option."



To me this sounds promising and I think I'm going to go ahead with it. I'll make sure to let you all know of any results.
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TonySa

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #3 on: February 24, 2020, 04:20:11 PM »

I talked to my doc today, he said it can be helpful for Erectile Dysfunction and for painful plaques (not the curve though) unless maybe in conjunction a pentox, traction, etc.
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

KS5495

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #4 on: May 02, 2020, 12:11:14 PM »

Hi woodstorm,                                                                                                                                                                                                                                                                               

I am 24 years old (also in London) and have had peyronie's for a while. I can't remember exactly when or how I got this, but I've definitely had it for many months at least. I have curvature to the left when I am becoming erect which is a  large curvature, however, once my penis gets into a certain position (possibly to allow better blood flow to it from different angles) it does become erect and relatively straight (maybe a minor dorsal curvature) and i am able to have sexual intercourse.

The right half of my penis seems to fill up no problem while my left side stays shortened and struggles to fill itself up at first which subsequently leads to a right angle like shape. In terms of my peyronies plaque, it is predominantly on the left half of my penis (along most of the penis). The tissue along the left side goes from feeling hard/thick sometimes to soft other times (when flaccid). But when my penis is fully erect it does feel very noticeably tough on the left.

This could be from an overuse injury or an injury from sex, of that i am unsure. I, like you am considering all non-surgical treatments, especially shockwave therapy (or possibly the p shot). I have seen studies with mixed results regarding SWT. However, promising treatment has shown that the shockwaves for some patients has helped to break up the scar tissue etc. I like to like I can be positive in a situation like this, and I can find a way to significantly improve the condition, as some others have also. I have enquired to a few Urologists and will also be looking through the NHS as well to see what treatments may be available to me.

How has your situation gone so far if you don't mind me asking? Have you gone ahead with the SWT? I am going to ask the Urologist if I can do this, I am really hopeful that this treatment can help me. I wish you all the best and hope your condition improves. Would be great to hear from anyone else also, who has had shockwave therapy and has any advice/positive results from it?

Thanks.
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DarrenBent

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #5 on: May 30, 2020, 03:26:24 AM »

Hi KS5495,

I’ll message you details separately, but i am currently having the shockwave treatment. I had actually elected for PRP but the appointments were cancelled due to lockdown. The shockwave clinics were still running so I decided I’d rather seek treatment sooner and took it as a...not sign, but fate making my decision for me. Shockwave was cheaper too.

The plaque breaking down theory was also the one sold to me. Sounds good but I’m a little sceptical. Scar tissue isn’t kidney stones.

It’s a course of 8 sessions over 8 weeks with home VED once a day. I’ve had 6 so far (which is when he said most people start seeing results. Unfortunately I am not yet seeing any improvement. If anything - whether natural progression or due to ESWT, VED or stretching - it actually seems 3-4 degrees worse. I measured it at 36 degrees on photos from Feb to April. It now looks almost 40. I can’t see how this could be caused by New trauma so quickly so my presumption is normal progression or the treatment has somehow softened or broken down some of the plaque but not all, which maybe means the other plaque is pulling it at a tighter angle? Who knows!  I am going to have the final two sessions nonetheless. I’ve paid for them. And you never know, it might work at the end.

Weirdly (or normally) it seems almost straight in the VED but natural erections are still curved.

So don’t jump into it just yet. I’ll update once it’s over in a few weeks.
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TonySa

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #6 on: May 30, 2020, 11:09:42 PM »

Thanks for sharing woodstrom, others have had no success w shockwave as well.
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

projectpd

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #7 on: May 31, 2020, 08:11:36 AM »

Very interesting.. Not all studies on eswr are encouraging.  Were there any pains or discomfort afterwards?
It is normal for ved erections to be straight or straighter although I don't know the mechanical reason for it. I believe veds work by increasing fluid rather than blood supply. Scars won't have a good blood supply although i don t know if thats the reason.
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DarrenBent

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #8 on: June 15, 2020, 12:20:07 PM »

UPDATE

I've just had my final ESWT session and there is no change to anything other than my bank balance. I wouldn't reccommend it.

The therapy itself is not terrible but not painless. It feels like small electric shocks and there was usually light bruising afterwards. The radial shockwave machine (which he tried a few times as well) is close to agony and caused worse bruising. 

Onwards an upwards...
(Is the direction my dick still points)
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projectpd

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #9 on: June 15, 2020, 01:28:39 PM »

That's kind of just how I imagined it might feel. Thanks for the update. In the study, they followed up after 6 weeks, so to be on the optimistic side, maybe there is a delayed effect before tissues rebuild.  Do they advise taking anything in relation to the bruising?  I saw a video on it where I think the doctor said they advised not to take any antiinflammatory meds. that's what this page says too. https://www.guysandstthomas.nhs.uk/resources/patient-information/surgery/orthopaedics/extracorporeal-shockwave-therapy.pdf.
That would be tough, it would be the opposite of what I'd be feeling I should do.
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AlterEgo

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #10 on: June 17, 2020, 05:49:04 AM »

Yes it is said to take 6 weeks after final treatment to see results.  Also they are now giving shockwave in erect state as opposed to flaccid state and they say it makes a difference. Don't use gainswave as it is not true shockwave
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melting

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #11 on: June 17, 2020, 05:36:21 PM »

It generates a rather local and micro "shockwave". It 'shakes' the tissue on a micro level.
Never used it but think that focusing it on the plaques directly AND then using other means/help could 'open up' the plaques and allow the body to dissolve the plaque or 'reclaim' the space.
A weaker plaque and healthy errections alone might already help.

Most single measure ways for peyronies are not sufficient to create positive change.combinations seem to help.
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Daily Transdermals and Traction/VED solved my Peyronies Disease https://www.peyroniesforum.net/index.php/topic,12587.0.html (DMSO+X)

AlterEgo

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #12 on: June 24, 2020, 05:54:43 AM »

Shockwave will be the next level of treatment modification in Erectile Dysfunction and Peyronies Disease. 
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melting

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #13 on: June 25, 2020, 08:06:13 PM »

It's just one more way to attack the plaques.
I think just using 1 treatment and then if it doesn't work 1 other treatment and so on has a low chance of working.
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Daily Transdermals and Traction/VED solved my Peyronies Disease https://www.peyroniesforum.net/index.php/topic,12587.0.html (DMSO+X)

TonySa

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #14 on: June 25, 2020, 09:42:53 PM »

Shockwave has not shown success w Peyronie’s and perhaps some improvement with Erectile Dysfunction...not much future in that...
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

AlterEgo

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #15 on: June 30, 2020, 06:13:40 AM »

Shockwave has not shown success w Peyronie%u2019s and perhaps some improvement with Erectile Dysfunction...not much future in that...
  Shockwave is experimental and a lot is being learned about it as we speak and in past year.  for example it is now best to be given in erect state rather than flaccid.  It's all about finding the right energy density, applicator head they use and how many treatments and at what intervals, all these factors need to be sorted out.  I suggest watching this video it's more current https://www.youtube.com/watch?v=JLI6CY_NxAo&feature=emb_logo  There was also a study that came out after this for best methods to use for peyronies
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DarrenBent

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #16 on: August 03, 2020, 03:53:52 AM »

More than 6 weeks after shockwave with continued VED and recently Potaba. No results. Curve worse than when started shockwave.

When I decided to try it I was hopelessly hopeful and chose to believe the salesman rather than the science, which all says good for Erectile Dysfunction and pain but does [email protected]< all for plaque and curvature. I wanted to believe this charlatan had worked out some unique method with his particular machine. But I think I was just another Rolex to him.

Feel free to hopelessly hope like me. But I really would try to find someone else, anyone real, who’s has genuine success with this before believing any private practitioners promises.
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projectpd

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #17 on: August 03, 2020, 07:28:23 AM »

thanks for keeping us updated.  most of the studies are at least somewhat positive so you were not being unreasonable to be hopeful.
what I noticed was you had two types of treatment though, one was only like an mild electric shock but the other was agonizing? i wonder if the agonizing one did some damage and made the curve worse, then the other type might have been benign or positive..
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DarrenBent

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #18 on: August 18, 2020, 11:34:38 AM »

I only had the painful radial shockwaves treatment twice. It's apparently more surface based which would explain why it was painful on the skin. It may have done but I don't believe I had enough of it to cause trauma in that manner, and I think the curve had maybe started to worsen before then.

I think with medical reports you believe what you want to believe, and inevitably we want to hope for a cure. So you doubt the 9 reports saying it does nothing for curvature and pin hope on the 1 that says it does. Especially when that one is supported by all those nice, smiling doctors driving Ferraris.

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AlterEgo

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Re: Radial vs Focused ESWT - Does this sound correct?
« Reply #19 on: September 15, 2020, 06:50:29 AM »

I only had the painful radial shockwaves treatment twice. It's apparently more surface based which would explain why it was painful on the skin. It may have done but I don't believe I had enough of it to cause trauma in that manner, and I think the curve had maybe started to worsen before then.

I think with medical reports you believe what you want to believe, and inevitably we want to hope for a cure. So you doubt the 9 reports saying it does nothing for curvature and pin hope on the 1 that says it does. Especially when that one is supported by all those nice, smiling doctors driving Ferraris.
Was your shockwave administered in erect or flaccid state?
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