Here is a research paper that used ultrasound as part of their treatment. Remember, get some training from a professional prior to using ultrasound (even the units purchased from companies selling to the public):
American Journal of Physical Medicine & Rehabilitation: Volume 80(
August 2001 pp 583-585
Physical Treatment of Peyronie Disease
Skenderovic Culibrk, Miroslava; Culibrk, Bogdan
From the Departments of Physical Medicine & Rehabilitation and Rheumatology (MSC) and Urology (BC), Medical Center, Subotica, Yugoslavia.
Abstract
Culibrk MS: Physical treatment of Peyronie disease. Am J Phys Med Rehabil 2001;80:583-585.
Objective:
Peyronie disease is a localized and progressive
fibrosis. It is characterized by a
plaque in the
tunica albuginea, which leads to penile deformity, making sexual intercourse difficult, if not impossible.
Design:
During a 4-yr period, we treated 35 patients, aged 30-62 yr, in different stages of this disease. We applied ultrasound therapy (0.5 W/cm; 10 min), infrared radiation, and
iontophoresis with 8% potassium iodide (0.2 mA; 30 min). The patients were taught to administer therapy by themselves. The patients' diseases were classified into three stages on the basis of subjective symptoms and clinical findings. At the beginning of treatment, 20 patients' diseases were classified as being in the first stage, 13 patients' diseases in the second stage, and 2 patients' diseases in the third stage.
Results:
By the end of treatment, 10 patients were cured, 17 patients' diseases were classified as being in the first stage, 8 patients' diseases were in the second stage, and there were no patients in the third stage.
Conclusions:
The method is simple, safe, painless, and inexpensive. Patients were taught to administer the therapy by themselves. There were no side effects. Functional improvement and the cessation of pain were noted by all the patients. The level of improvement depended on the disease duration, the length of therapy, and the stage of the disease.
Peyronie disease is a localized and progressive
fibrosis that effects the
tunica albuginea of the penis (Fig. 1). Francois de la Peyronie was the first to describe this disease in 1743. 1 The cause of this disease is still unknown. Antigen frequencies of HLA-DR2 and HLA-DQW2 were detected by histocompatibility leukocyte antigen (HLA) typing, 2-4 which suggests a possible autoimmunologic origin. Pathoanatomically, fibrosing plaques are clearly limited to the
dorsal side of the penis. Lateral localization is not common, and
ventral localization is extremely unusual. An excessive deposition of
collagen gives rise to a
plaque, which is initially fibrotic and then becomes calcified. 5 Diagnosis is established on the basis of anamnesis and clinical examination. The symptoms of Peyronie disease include subjective complaints: pain in the penis, distortion of the penis during erection, disturbance during coitus, and occasional impotence.
Figure 1: Peyronie disease is a localized and progressive
fibrosis that effects the
tunica albuginea of the penis.
The indurations are distinctly limited from their surroundings and of a solid consistency. The skin above is free and mobile. The indurations never affect the corpora cavernosa. The size and number of the indurations vary with each individual. The differential diagnosis includes benign and malignant tumors. 6 Causal therapy is not possible because of the unknown origin.
Therapy includes local injections (corticosteroid, anesthetic, hilase preparation, and
verapamil) for local infiltration of the plaques 7 and oral orgotein, 8 tamoxifen, 9 and
collagenase, 10 etc. Roentgen radiation and radiotherapy are also used. 11, 12 Surgical treatment can be used in selected cases. 13-15 Physical therapy includes laser therapy, infrared radiation, ultrasound, and
iontophoresis of various drugs. 16-18
MATERIALS AND METHODS TOP
During 4 yr (1995-1999), 35 patients were included in a prospective study. All patients had been previously treated with local injection therapy (Hilase (Forschunginstitut, Dessau), corticosteroid, and anesthetic) in the
plaque, but without satisfying results. The patients were between 30 and 62 yr (mean age, 50 yr). The duration of the disorder in the patients was more than 6 months. After physical examination and after the stage of illness was determined by the urologist, all patients were sent to the Department of Physical Medicine and Rehabilitation for treatment.
The patient's disease was classified into one of three stages on the basis of subjective symptoms and clinical findings. The most important criteria for determining the stage of the illness was the presence of pain during erection with the possibility of coitus: stage I-periodic and spontaneous pain in the penis, less penile pain during erection, no curvature of the penis, intercourse possible; stage II-spontaneous pain during erection, penile curvature during erection, intercourse painful (mostly impossible); stage III-penile curvature expressive, decreased erection, intercourse impossible.
If the patient's disease was between two stages, his disease was classified as being at the heavier stage. During examination, which was compulsory after every series of physical procedures, the level of improvement and possible change of the illness stage were determined. Every series consisted of ten ultrasound therapies, ten infrared radiations, and ten
iontophoresis with 8% potassium iodide. The time interval between the series was 6 wk at least. All patients underwent all three kinds of therapies in the series. The patients were taught to use the therapy themselves (Fig. 2).
Figure 2: The patients were taught to administer the therapy themselves.
We started every treatment with ultrasound therapy. The continual insonation lasted 10 min (intensity 0.5 W/cm2), according to the principles of ultrasound, in the series of ten procedures.
A further series of ten radiation treatments of the penis with infrared rays, lasting 15 min at a distance of 50 cm, followed as an introductory procedure of
iontophoresis (Fig. 3).
Figure 3:
Iontophoresis.
As the active electrode for
iontophoresis with 8% potassium iodide, we used a cathode (7 × 5 cm) on the induration of the penis and a different electrode (3 × 3 cm) on the front side of the upper leg (duration, 30 min).
RESULTS TOP
At the beginning of treatment, 20 patients were classified with diseases in the first stage, 13 patients with diseases in the second stage, and 2 patients with diseases in the third stage (Fig. 4).
Figure 4: Beginning of treatment.
By the end of treatment, 10 patients were cured, 17 patients were classified as having first-stage disease, 8 patients as having second-stage disease, and no patients had third-stage disease (Fig. 5).
Figure 5: End of treatment.
The sharp line to normal
tunica albuginea disappears during therapy. Induration
plaque is divided into several smaller plaques, which are separated by normal tunica of different consistencies. Pain during erection disappears after one or two series in 80% of the patients. The series was repeated, depending on the results of the treatment, two to ten times (mean, 4 times). If the stage of illness was lower, fewer series were required. The treatment was finished when the patient was satisfied with the results of the treatment.
By the end of treatment, ten patients were cured (no traces of illness in morphologic and functional forms). Two patients with stage III illness of long duration had their diseases classified to a milder disease stage, stage II (penis curvature was less, erection was possible with less pain; however, coitus was not possible).
Six patients' diseases remained at the same stage (stage II). Although the improvement that appeared in all of these patients was both subjective and objective (diminishing pain and softening
plaque), the main criterion for the first stage of illness was not fulfilled, the possibility of coitus.
Seven patients' diseases were reclassified from stage II to stage I because after therapy, they satisfied all the criteria of that stage. Ten patients' diseases remained at stage I. Although their objective problems disappeared and their functional status was satisfying, the
plaque traces were still present, so we did not consider them cured.
CONCLUSION TOP
The results of this study may be summarized as follows. After 4 yr of using this therapy, we can conclude that this method is simple, safe, painless, and inexpensive. Patients are taught to administer the therapy by themselves, which they tolerate well, and there were no side effects. Functional improvement and the loss of pain were noted with all patients, but the level of improvement depended on disease duration, the length of using the therapy, and the stage of the disease. If the stage of illness was lower, fewer series were needed.
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Hope this helps someone
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Topic: Ultrasound & Extracorporeal Shockwave Therapy (ESWT) (Read 103018 times)
December 14, 2015, 11:03:53 PM