Do you think shockwaves are useful...? (Important)

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Joe55s

Dear friends of the forum,

I have recently been diagnosed with Peyronie's disease. In my case I don't still have plaque. As I have pointed out in my profile I have a curvature of 20 per cent right. Two urologists have told me that my problem is Peyronie's but offer me no treatment. Only to wait for three months in the first case and the second the same idea but a year, in which he would tell me if I should be operated or not. A new doctor, in my city (I am sorry but I live in Spain and I can't go to a United States specialist) when I have sent him an email has told me that he can help me with shockwaves treatment to avoid that a plaque is formed.

My question is if the shockwave treatment is useful? I would also like to know if it is worth trying for my case and if it is a very expensive treatment.

(Please if you can help me with this question do it, before I decide what to do...)

Thanks in advance.

Joe
Age:55 Diagnosed with Peyronie's disease(two urologists)Without plaque.Curvature 20 degrees right side.No erectile dysfunction.
Treatment seen on the Internet:propolis, gingko biloba, Vit E, Diclofenac topic,bilberry, magnesium chloride Coq Q10(200mg

GaussRifle

The top specialists,  Dr Landon Trost who is an expert at Peyronies recommended against shockwave therapy. It has not shown any scientific benefit so far. Evidence is lacking.. He has advised to stay away from treatments like these where only goal is to make money and not give you any benefit.
26 year old
45-50 degree downward curve with an indentation on one side when erect.
Using RestoreX and Xiaflex injections
Taking coq10 with daily Cialis 5mg.

PeyroniKirai

This is a good answer from GaussRifle and I would add a little to it from the scientific angle.
First of all, what even are "shock waves"?  They are bursts of sonic energy which are blasted into the affected area.  There are therapists who claim that shock waves can stimulate the regeneration of damaged body parts, but the typical ones are cartilage and ligaments in places like the shoulder rotator cuff.  Here is a passage from a shock wave therapist:

"Stimulation of Collagen Production
The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged myoskeletal and ligamentous structures. Shockwave therapy accelerates procollagen synthesis. The therapy forces the newly created collagen fibers into a longitudinal structure which makes the newly formed tendon fibers more dense and stiff and creates a firmer structure."     (source:  https://www.shockwavetherapy.eu/)

If you read this, you can imagine that this is exactly what you do not want to do to your penis.  Your Peyronie's is caused by a stiff section in the tunica that doesn't expand when the penis becomes erect, like the classic balloon with a piece of tape on it.  That stiff section seems to be caused by a plaque which has formed where it shouldn't have, possibly due to a healing process gone wrong after your penis endured some kind of physical stress.  

As much as all of us would like it to be the case, I can imagine no way by which bombarding the penis with shock waves would selectively break down that plaque without damaging any of the other sensitive tissues in the penis.  As the shock wave therapist says, the shock waves will cause MORE collagen to be produced, which will cause the structure to become more DENSE and STIFF.  If that is even true, it might be great if your shoulder joint is weak, but it's not for your dick.

My suggestion is that you ask the doctor a few questions:
1.  Can you explain exactly how shock waves will fix Peyronie's?  What is the mechanism whereby the offending section of tunica will be made flexible and stretchy again without damaging anything else in the penis?
2.  Do you have any track record of treating Peyronie's patients and can you provide pictures or statistics showing how effective the treatment has been?  
3.  If you do have any such patients, what are the actual stats for
    (a) ratio of successful therapy cases to those in which patients remained the same or got worse,
    (b) actual improvement in Peyronie's expressed in reduction of bend angle, reduction of hourglassing, erection quality, length, girth, etc.
    (c) number of months/years after therapy without relapse or complications

Any REAL doctor will have all these stats at his or her fingertips and will be happy to share them with you.  All doctors must be able to quote the success and failure rates of the procedures they recommend.  Obviously you don't need to know guys' names and phone numbers, but a photograph of a penis does not constitute "personal data" under European GDPR, because you cannot identify a man by his penis alone (unless it's reaaaalllllllly unusual, like he has a red white and blue striped tattoo that turns into the flag of the Netherlands when he gets an erection!)...

Okay, that was a joke, but kidding aside, there is no reason why a good urologist wouldn't be able to at least show you sketches if not actual photos of the penises he has healed.  So please, Joe55s, ask this doctor to show you PROOF in the form of statistics, medical records, and photographs.  And if he really can do that, I will be very surprised but also very happy.

Best regards,
PK
Age 64, Peyronie's history 4 years, left side hourglass, 20-degree bend to left, no ED

Joe55s

Dear Gaussrifle and Peyronikirai,

I feel really grateful for both of your answers. I am going to say "no" to shockwave treatment. It is not only what you convincingly say about this therapy, it is also that in all the Peyorinie's replies in the forum there is no-one who says that this technique is useful in our case. Your joke about the tattoo in the penis has make me laugh, Peyronikirai . I am living in a country where there are not many opportunities in life to make a living. For me it would be a great economic effort to have to go through this "therapy". I should have gone to the US when I was young, as I have both Spanish and US citizenship, but I decided to remain in Spain where my family was.

Instead I have bought from Amazon, Coq 10. I haven't bought the most expensive one, the one with ubiquinol but the oral one with ubiquinone (200mgs). I was going to buy Acetil L Carnitine and L arginine but in my case I don't practice sports or go to a gym.

I don't have erectile dysfunction yet. I don't know if things will go better or worse in future. Sometimes I am scared about that.

Thanks!

Joe  
Age:55 Diagnosed with Peyronie's disease(two urologists)Without plaque.Curvature 20 degrees right side.No erectile dysfunction.
Treatment seen on the Internet:propolis, gingko biloba, Vit E, Diclofenac topic,bilberry, magnesium chloride Coq Q10(200mg

Heallingway

I am suspecting peyronise with the many doctors I have seen and the trauma I micro trauma I had

I was wondering if ESWT can alleviate the pain ? As I only have pain and a minimal curvature natrual and added post trauma (only while flaccid) ...

Any experience with pain alleviation?  
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knowledge81

Quote from: GaussRifle on October 01, 2021, 10:02:00 PM
The top specialists,  Dr Landon Trost who is an expert at Peyronies recommended against shockwave therapy. It has not shown any scientific benefit so far. Evidence is lacking.. He has advised to stay away from treatments like these where only goal is to make money and not give you any benefit.

I found this trial that suggests promising results (I've also had this treatment myself): https://pubmed.ncbi.nlm.nih.gov/19473751/
Age: 42
Diagnosed: July 2020
Shape: 45° up (plaque on sides & top)
Treatments: ESWT
Supplements: L-Citrulline, French Maritime Pine Bark Extract.

jj21

knowledge - did you find it effective?

Im on week 2 of the theray and now freaking out after what other users said!
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm +1cm RTE, Partial revision 27th June 23 (fix pump, remove 10ml reservoir).

FlatteningTheCurve

Feeling like a broken record sometimes but I find these recommendations from the urology associations in the US and Europe really useful. They basically look at all the scientific evidence at hand for different forms of treatments and make an overall assessment and recommendation.

For ESWT, the European one says:

The mechanical shear stress provoked by low-intensity extracorporeal shock wave treatment (LI-ESWT) on the treated tissue was deemed to induce neovascularisation and to enhance local blood flow [1016]. The mechanism of action involved in ESWT for Peyronies Disease is still unclear, but there are two hypotheses: (i) SWT works by directly damaging and remodelling the penile plaque; and (ii) SWT increases the vascularity of the area by generating thermodynamic changes resulting in an inflammatory reaction, with increased macrophage activity causing plaque lysis and eventually leading to plaque resorption [1067,1068].

Four RCTs and one meta-analysis [1069-1073] assessed the efficacy of ESWT for Peyronies Disease. Three were sham-controlled trials while one compared ESWT with the combination of ESWT and PDE5I (tadalafil) [1067].

All trials showed positive findings in terms of pain relief, but no effect on penile curvature and plaque size. Inclusion criteria varied widely among studies and further investigation is needed.


Source: https://uroweb.org/guideline/sexual-and-reproductive-health/#8

The American one says:

14. Clinicians should not use extracorporeal shock wave therapy (ESWT) for the reduction of penile curvature or plaque size. (Moderate Recommendation; Evidence Strength Grade B)

15. Clinicians may offer extracorporeal shock wave therapy (ESWT) to improve penile pain. (Conditional Recommendation; Evidence Strength Grade B)


Source: https://www.auanet.org/guidelines/guidelines/peyronies-disease-guideline

There is more information on each of the websites if you want to know more about the studies and the specific effects on the patients. Hope you find this helpful.
Early 30s, diagnosed with Peyronies in 2017 after trauma during sex. ca 15 degrees upward curvature. Restorex, VED, 5mg Cialis, Pentox, L-arginine, Coq10, Propolis, Vitamin E. Underwent 12 rounds of Verapamil injections 2021-22