Role of extracorporeal shock wave therapy in management of Peyronie's disease

[skunkworks]

If this one had already been posted I must have missed it:

Role of extracorporeal shock wave therapy in management of Peyronie's disease: A preliminary report. - https://www.ncbi.nlm.nih.gov/pubmed/28057983

Abstract
INTRODUCTION:

Peyronie's Disease (Peyronies Disease) is a disease causing psycho social trauma to the patient. Multiple treatment options are available with variable results. Extra Corporeal Shock Wave Therapy (ESWT) is a new insight into the non invasive modality of management. It focuses on the mechanism of inducing angiogenesis in the penile cavernous tissue.
MATERIALS AND METHODS:

The aim of the study is to determine the role of ESWT in the management of Peyronies Disease. The objectives include demonstrating the improvement in mean International Index of Erectile Function Score (IIEFS), improvement in pain score by Visual Analogue Scale (VAS), change in cavernosal artery flow on colour penile Doppler, reduction in plaque size, and improvement in penile curvature degree after the therapy. 30 patients, between 25-65 years, who were non responders to conservative line of management, were treated with ESWT. The results were evaluated at baseline and 18-24 weeks after the therapy.
RESULTS:

ESWT significantly improves the cavernosal artery velocity, thereby supporting the theory of angiogenesis. ESWT improves all the domains of IIEF including Erectile Function, Sexual Desire, Sexual Satisfaction, Orgasm and Overall Satisfaction. There is a significant improvement in the pain and penile curvature, and reduction in the plaque size. No adverse effects have been recorded.
CONCLUSION:

ESWT offers a safe, minimally invasive, OPD based option to the management of the patients of Peyronies Disease in the stable phase of the disease. Patients who do not respond to the conservative line of management can be really benefited by ESWT.

[Arabia]

It doesn't appear to be of much use for treating the curvature and they did not recruit anyone with large curvatures.  I think only 40% of the subjects had a bend and of those all where listed as mild (1).   Until these studies start to use actual measured curvatures pre and post treatment it is just another modality on the 'to be determined' roster.

[skunkworks]

Ah I didn't notice it linked to the full study there, that must be what you read Arabia.

It is here for everyone else - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100144/

In my opinion it'd be a worthwhile treatment just for "ESWT significantly improves the cavernosal artery velocity" as frequent strong erections tend to make all other treatments work better.

[restore]

What doctors are using shock wave therapy for improving vascularization in the penis?  I don't have curvature any longer or lumps in my shaft from my Peyronies Disease onset six years ago.  However, I would like to restore the quality of my erections.

Are there doctors in the south USA that use these machines to deliver the treatment?

[Tychy]

My time to rise and shine  

I'm in line for this treatment somewhen 2017 and my uro briefed me on this.
They were using ESWT devices originally meant for treating kidney stones and found pain reduction, reduced density in plaques and improvement on vascular velocity, though not much / any improvement in curvature (this paper mentioned here). He basically recommended the treatment for ED and pain reduction to me.

But using larger ultrasound heads for kidney stones isn't optimal, so there are smaller heads available recently which allow better targeting of the plaques / hardened tissue.

ELI5: Shockwaves will pass through flexible tissue, but stick to higher density material, like plaque or hardened tissue. It will then vibrate that tissue and increase blood flow to it / mechanically "shake it loose".

ELI4: Plaque massage

[Arabia]

That is great Tychy and please keep us posted on your outcome and any side effects along the way.

Is your uro part of an academic group which might be publishing their results?  Just curious what is the cost per treatment if you don't mind?

[Arabia]

I found a clinic here in Toronto that is using the Duolith SD1 shockwave therapy machine to treat ED.  They are charging 225 Euro (about $CAD325) per treatment for a series of six recommended treatments. It is run by a uro so I'm sure with the right amount of cash in hand he would gladly also treat cases of Peyronie's disease.

If you go to the Swiss company's website for the above product they actually show a picture of the device treating Peyronie's disease, however they don't use the term Peyronie rather they use the more descriptive name "induratio penis plastica" or IPP.
https://www.storzmedical.com/images/duolith_sd1_ultra_uro/induratio-penis-plastica.jpg

Anyone know how common it is to use the term IPP rather than Peyronie's disease?

[Tychy]

@Arabia:
Will report. Don't know how long it will take. Next appointment is in April. He is a private professor (Priv.-Doz. in Germany) and is located in a urology clinic with around five doctors.

As far as I know my insurance will pay for these sessions as the major goal is pain reduction. They'd have to pay more for any kind of operation, so there's that.

IPP is the common term in Germany / Austria / Switzerland.

[Arabia]

Do you mind telling us your current status now?

Stage: acute, acute on chronic or chronic?   I guess if you are having pain it is one of the former categories
Curvature:  degree and direction
ED: Y or N
Pain: mild, moderate, or severe

I'm most interested in ESWT to soften the plaque and possibly improve the curvature without surgery.

So what do those Germanic countries have against Monsieur Peyronie?  

[Tychy]

Stage: more towards chronic. A year has passed. No calcification, though. Bombarded myself with Vit-K during acute phase. Pain has moved to the non Peyronie's side due to curvature stretching the healthy tissue
Curvature: Towards right side, 15-20°, around 5° up
ED: On the right side my arterial flow was not detectable. The left side is mainly contributing to erections via arterial cross-paths. Easy to get to 75-80%, from there on it's difficult. I also have CPPS, which contributes to ED and pain. Daily Cialis 2.5mg
Pain: Constant: Mostly mild stinging, depending on stress level. While erection: most pain is gone by now. After ejaculation: moderate stinging and stretching. While doing VED I feel a pulling sensation where the plaques are located.

Daily VED has improved the pain and hard flaccid already. I'm looking forward to softening and better ED quality.

We don't have anything against him. It's just more efficient to call the beast by it's name instead by it's master's

[skunkworks]

Hey Tychy, I am very interested in hearing how it goes for you.

It'd be great if you could make a thread about it, something like 'Tychy's ESWT Journal' or the like?

[Tychy]

I will do a treatment diary (paper form) as soon as I'm on a schedule. No problem posting it in a separate thread here

[projectpd]

has anyone bought or looked into buying an eswt machine
eg
Commercial links deleted by moderator. Please read the forum rules.
although a bit expensive compared to some treatments, it seems should be an easy convenient method to try. would anyone be interested in buying a used model of one of these in the UK.

[Juice]

Has there been any discovery for ESWT for hour glassing ?  The EWST is good for ED, eh for curvature, but I haven't come across anything relatable to hour glassing..
Unfortunately I've been blessed with both.

[JasperTJ]

Guys...
As you all have...Ive been doing tons of research
Ive had some honest doctors tell me that Gainswave seems to help more than many treatments but not in all cases.
After speaking to one in Colorado, he said the Storz machine is very expensive, like $30K to buy one but eluded to being available in China
I looked online and found this.
Link to commercial site deleted by moderator! Read the forum rules!

You can basically buy a machine for roughly the cost of one complete round of treatment from a doc.
Granted, this ain't cheap, but if it's the same as Gainswave and you can do it from home, more often than normally you could afford, it might be worth looking into

[Gabriel]

Hmmmm that is as crazy as interesting! Thanks for the link Jasper!

As far as I'm concerned, after 4 sessions + 2 sessions three months later, I am absolutely positive that shockwave helps a lot at least with pain... for 10 days or so. Remembers of a folk here who said that we should have shockwave once a week for it to be efficient... I couldn't agree more! So if indeed one can possess his own machine at home... that would be wonderful!

[Gabriel]

PS : As i read again the first post about the study, I'm understanding that angiogenesis is actually good for Peyronies Disease (?!!!). For 6 months I have stopped using helichrysum essential oil, which was alleviating my pain, because I had discovered that it encourages angiogenesis, and thus thought that it could encourage the plaque to grow bigger.

BUT, if I'm not getting the study wrong, angiogenesis would be a good thing for us???

[hope794]

Gabriel, angiogenesis accours in the first phases of fibrosis. But that's not the kind of angiogenesis we're talking about.

The angiogenesis which everyone talks about is the one which is related to create new blood vessels, new capillaries veins, and so on. This is really really good for Peyronie's!!!!
VED does exactly this: traction to remodel the plaque + angiogenesis to let the blood flow better and give more oxygen.

So, the angiogenesis is definitely GREAT for our problem.

[Paolo]

Beta-Glucan is very good for angiogenesis (MnSOD) and is derived from Barley, only question is 'does it get past stomach acid', and therefore remains potent???
Paul.

https://core.ac.uk/download/pdf/54924679.pdf
https://www.ncbi.nlm.nih.gov/pubmed/25388628

If you have the time a very interesting article on SOD below;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151424/

[Gabriel]

That's fascinating guys, thanks Hope and Paolo for your answers and valuable informations!

About MnSOD, maybe they could wrap it in gliadin just like they do with SOD alone in order for it to pass the stomach acid barrier ("SOD - Gliadin", = Glisodin, which I've been taking twice a day for 5 months now without any result... I guess)??

Regarding angiogenesis, that's changing everything for me: I'm stil making strange experiments with essential oils, some of them encouraging, but had to abandon Helichrysum which is supposed to be one the most valuable... I can now restart testing it along with others, as it has been proven to activate a lot angiogenesis and collagen synthesis: https://dumas.ccsd.cnrs.fr/dumas-00839947/document (sorry guy it's a French thesis, but it is fascinating and very hopeful; try to googletranslate the p. 47 to 55, it's worth it I think)!

SO, before I go back to putting this stuff on my johnson, do we totally agree that 1) Angiogenesis is good and only good; 2) Collagen synthesis (mostly, but not only, type I, as mentioned in the thesis) is good and only good??

[JasperTJ]

Gabriel - I agree..sounds crazy, but compared to the cost of a treatment, you can pretty much buy your own machine and use it every week.
Im not seeing huge results from reading people who did Gainswave, but Im wondering if it just needs more frequency that doing it 4-6 times.
Has anyone one here bought a cheaper shockwave machine ? With all the $ everyone is spending, I dont see why someone shouldn't try it. I don't have a ton of dough but I wish someone who does would consider this.

[Gabriel]

Hey Jasper,

This idea begins to sound not-so-crazy to me you know... I'm still wainting for an improvement in pain after almost a year, tried quite everything but Xiaflex until now, and only shockwave did me some real good... The thing is, this disease is ruining me, and I can't expect any significant pay rise before 2-3 years... But then, if I'm not getting better, YES I will consider these chinese machines! I will ask my uro about them, just in case; pretty sure he's gonna discredit them, but I'll try to make him really justify what he says.

Anyway, could you please PM me the commercial link Jasper, so I can keep it for a potential future :-) ?

[ThrobbingGristle]

Hi, I would also like a link to these Chinese machines. I feel wonderful 2 days after getting a treatment. I'd hate to think it's going to get worse again. Thanks.

Ps, has anyone tried one so far? Thanks.

[Stepone]

Check out this site. This is a guy that bought a shock wave machine and uses it on himself.


Shockwave for Erectile Dysfunction

[jan.schaller1958]

Check out this site. This is a guy that bought a shock wave machine and uses it on himself.


Shockwave for Erectile Dysfunction

Does this really work? I read about it but it sounds too good to be true, unless it's only to treat minimal issues.

[Stepone]

He used to have contact information, so you can contact him.
This technique is available through many urologists. They offer no guarantees and it can be quite expensive, that's why he bought his own equipment.

[TonySa]

There's been very little success in treating peyronies...but fir some in treating ED.

[JustDandy]

What happened to Tychy? Last on just before the shockwave treatment? Was it a success?

[Salah]

Today the doctor asked me to give me collision sessions with plasma injections. Is there any harm in them and will they benefit me?

[pleaseneedhelp]

Hi Salah.

From which country are you writing? What is your doctor's name?

As for me, all the studies I've read on the subject (shockwaves + PRP) have never shown any particular risk or danger.
A few years ago, the topic was debated on the forum, with very mixed opinions — both good and very bad.

I recently shared a link to a study about the use of shockwaves and PRP during the acute phase of Peyronie's disease, and the results were actually very, very encouraging.
Yet, no one really supported the thesis put forward by the researchers behind the study.

Many forum members live in countries where XIAFLEX injections are still available, which may explain the lack of interest...

At what stage of the disease are you, and what symptoms are you experiencing?

[BentKnob]

ESWT and PRP aren't proven to be effective.

I paid £4,000 for 6 sessions of shockwave with no results.

Many on here have done both shockwave and PRP with no results.

Have a search on this forum and you'll find no one has ever had results.

Peyronies disease is hard enough to treat with proven treatments. These treatments you have mentioned will do nothing.

You can take a gamble with your money, chances are you'll be disappointed.

[pleaseneedhelp]

Hello everyone!

Here's another very recent study on the benefits of PRP injections in Peyronie's disease.

I don't know about you, but I give credence to these results.

https://pubmed.ncbi.nlm.nih.gov/40372467/

Courage à tous

[BentKnob]

pleaseneedhelp: You could take a chance and see. I had shockwave and it did absolutely nothing in correcting peyronies disease.

I would be careful with those studies. They are written in a way to make it sound like treatments are more effective than they really are.

[pleaseneedhelp]

Hello BentKnob,

It seems to me that shockwaves are primarily recommended for pain relief, so if you were expecting something else, I understand that you were disappointed.

What did the doctor who prescribed them promise you?

What seems to produce results is the shockwaves combined with PRP injections.

The stage of the disease, the quality of the platelets, the number of sessions, and the injection method chosen by the urologist are all parameters that optimize the results...

Shockwaves and PRP injections are relatively harmless, if at all. The only thing that can happen is being disappointed by the lack of results.

I'm not encouraging anyone to do it or not to do it, but I can't understand why the researchers behind these studies would say anything...