ESWT Experience after 10 sessions and some insight about studies

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blex

I have suffered peyronies for about 1.5 years now.
First half year was pain only, then curvature, hourglass and shortening began.

As a lot of studies show pain reduction with ESWT and almost every doctor recommending it, I tried it with multiple doctors in Germany.

1st session was in 02.22 with a local urologist, was cheap (80€/treatment), I stopped treatment because he used the applicator/strength for Erectile Dysfunction and not the one for Peyronies Disease.
2nd-4th session was in 04.22 with a peyronies specialist, more expensive (240€/treatment) and correct applicator/strength.
5th-10th session was in 06.22 with another specialist, part of combined treatment with ultrasound and iontophoresis, (2000€/6 treatments). Wrong applicator/strength again.

The result of all this, half a year after the last treatment:
Absolutely nothing, no decrease in pain, no reduction of curvature, no stop in progress.
In fact my curvature, hourglass and loss of length got worse, but as it did so with a constant rate of about 5° per month since the beginning, I doubt ESWT is to blame.

Why do I write about "wrong" and "right" applicator/strength?
Manufactures of ESWT devices advertise bigger applicators and less strength for Erectile Dysfunction, and smaller applicators and more strength for targeting Peyronies Disease.
As it shows, not every doctor is aware of this, which shows how bad the average knowledge about this disease is.

This is of course only anecdotally evidence, but it also shows in studies.
There are a lot of them floating around, showing improvements with ESWT.
But studies are of vastly varying quality, even without assuming ulterior motives.
Natural progression is still not clear and varies from case to case.
Sample sizes are small and results may be biased by not using double blind, RCT and so on.

What we want to look at are meta-analysis, which are reviews of multiple studies. I made an effort and collected some results:

Gao 2016:
QuoteESWT may be an effective and safe treatment for lessening of penile plaques and relieving pain for men with Peyronies Disease, but not for improving of penile curvature and sexual function.

Krieger 2019:
QuoteRandomized controlled trials examining the efficacy of ESWT in Peyronie's disease do not show a statistically significant benefit in curvature reduction, plaque size, or erectile function, although a recent meta-analysis demonstrates a benefit in plaque size reduction. A statistically significant reduction in penile pain has been observed across multiple studies.

Bakr 2021:
QuoteThe current data suggest that ESWT fails to improve penile curvature or pain in men with Peyronies Disease. Although ESWT may reduce plaque size, this remains of questionable clinical significance, and further studies are required to confirm findings

So even these meta-reviews dont totally agree with each other, but the results seem to be, that ESWT does not improve Peyronies Disease.
At least few ill side effects are mentioned, so if you have time and money left, you may as well try.
Note that some members claim they got worse, their experience can be found in this board elsewhere, please do not repeat it here.
36 years old, married
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Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
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Nothing helped, looking for surgery now

takit

Thanks for the insight. Your points are in line with those of the doctors I have asked about this treatment method.
Peyronies Disease: since October 2021 . 45° dorsal 10° sideways [active]
Medication: Tadalafil, L-Arginin, L-Carnitin, Coenzym Q10 and vitamins [canceld]
Physical therapy: PeniMaster Pro 4h daily [canceld]
Personal: 35, single