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Peyronies Disease TREATMENT Discussion Boards => Ultrasound and Extracorporeal Shockwave Therapy (ESWT) => Topic started by: wlstet on September 29, 2012, 04:55:25 AM

Title: ultrasound treatment
Post by: wlstet on September 29, 2012, 04:55:25 AM
i found these N.I.C.E. guidelines (ultrasound treatment)for patients/sufferers and was wondering if anyone had the treatment and if they had any success.
Extracorporeal shockwave
National Institute for
Clinical Excellence
NHS
therapy for Peyronie's
disease

Understanding NICE guidance –
information for men considering the
procedure, and for the public

December 2003

Extracorporeal shockwave therapy for Peyronie's disease:

Understanding NICE guidance – information for men considering
the procedure, and for the public

Issue date: December 2003

To order copies

Copies of this booklet can be ordered from the NHS Response Line;
telephone 0870 1555 455 and quote reference number N0389. A
version in Welsh and English is also available, reference number
N0390. Mae fersiwn yn Gymraeg ac yn Saesneg ar gael hefyd, rhif
cyfeirnod N0390. The NICE interventional procedures guidance on
which this information is based is available from the NICE website
(www.nice.org.uk). Copies can also be obtained from the NHS
Response Line, reference number N0388.

National Institute for
Clinical Excellence

MidCity Place
71 High Holborn
London
WC1V 6NA

Website: www.nice.org.uk

ISBN: 1-84257-463-9

Published by the National Institute for Clinical Excellence
December 2003
Typeset by Icon Design, Eton
Printed by Abba Litho Sales Limited, London

© National Institute for Clinical Excellence, December 2003. All rights
reserved. This material may be freely reproduced for educational and
not-for-profit purposes within the NHS. No reproduction by or for
commercial organisations is allowed without the express written
permission of the National Institute for Clinical Excellence.


Contents

About this information 4
About extracorporeal shockwave therapy 5
What has NICE decided? 8
What the decision means for you 9
Further information 10


About this information

This information describes the guidance that the
National Institute for Clinical Excellence (NICE)
has issued to the NHS on a procedure called
extracorporeal shockwave therapy. It is not a
complete description of what is involved in the
procedure – the patient's healthcare team
should describe it in detail.

NICE has looked at whether extracorporeal
shockwave therapy is safe enough and works
well enough for it to be used routinely for the
treatment of Peyronie's disease.

To produce this guidance, NICE has:

• looked at the results of studies on the safety
of extracorporeal shockwave therapy and how
well it works
• asked experts for their opinion
• asked the views of the organisations that
speak for the healthcare professionals and the
patients and carers who will be affected by
this guidance.
This guidance is part of NICE's work on
'interventional procedures' (see 'Further
information' on page 10).

Extracorporeal shockwave therapy for Peyronie's disease


About extracorporeal shockwave
therapy

In Peyronie's disease, a plaque or hard lump
forms in the tissue of the penis. It is not known
what causes the disease. The plaque makes the
penis less flexible, causing pain and making the
penis bend when it is erect. Many men with
Peyronie's disease have sexual problems because
they cannot get or maintain a normal erection.

A small number of men with Peyronie's disease
will get better without treatment but drug
therapy or radiation are normally used. Surgery
is only generally used for men who have not
responded to these or for men with severe
symptoms. The treatments are designed to
improve the symptoms of the disease rather than
to cure it.

Extracorporeal shockwave therapy (ESWT) uses
vibrations caused by sound waves to treat the
affected tissue. The sound waves come from a
device applied to the outside of the body that
generates short bursts of sound, called 'sonic
pulses'. The plaques on the penis are targeted,
normally using ultrasound as a guide. Sometimes
a sedative drug is given to help the man relax.

Extracorporeal shockwave therapy for Peyronie's disease


How well it works

What the studies said

The studies NICE looked at showed that men had
less pain and the curve of the penis was reduced
after having ESWT. In one study of 20 men, half
had a considerable improvement in the bend in
the penis. There was also some improvement in
sexual problems.

What the experts said

The experts were not convinced by the evidence
that this procedure works well enough for men
with Peyronie's disease. The types of studies,
differences between the men having the disease
and the natural progression of the disease meant
the experts were uncertain about its usefulness.

Extracorporeal shockwave therapy for Peyronie's disease


Risks and possible problems

What the studies said

Few complications were reported in the studies.
Short-term problems included bleeding from the
urethra (the tube that carries urine from the
bladder to the end of the penis), bruising,
collection of blood under the skin and small
broken blood vessels. It was not clear, however,
how the dose of ESWT given affected the
complications.

What the experts said

The experts did not have concerns about the
safety of this procedure, although they noted
that superficial bruising and some pain were
possible problems.

Extracorporeal shockwave therapy for Peyronie's disease


What has NICE decided?

NICE has decided that this procedure appears
safe. However, if a doctor wants to carry out
ESWT for Peyronie's disease, he or she should
make sure that the man understands what is
involved and that there are still uncertainties
over how well the procedure works. There
should be special arrangements in place so that
the patient only agrees (consents) to the
procedure after this discussion has taken place.
There should also be special arrangements in
place for monitoring what happens when a
person has ESWT for Peyronie's disease.

Extracorporeal shockwave therapy for Peyronie's disease


What the decision means for you

Your doctor may have offered you ESWT. NICE
has considered this procedure because it is
relatively new. NICE has decided that there are
uncertainties about the benefits of ESWT which
you need to understand before you agree to it.
Your doctor should discuss the benefits and risks
with you. Some of these benefits and risks may
be described above.

Extracorporeal shockwave therapy for Peyronie's disease


Further information

You have the right to be fully informed and to
share in decision-making about the treatment you
receive. You may want to discuss this guidance
with the doctors and nurses looking after you.

You can visit the NICE website (www.nice.org.uk)
for further information about the National
Institute for Clinical Excellence and the
Interventional Procedures Programme. A copy
of the full guidance on ESWT for Peyronie's
disease is on the NICE website
(IPG29 Extracorporeal shockwave therapy for Peyronie's disease: guidance (http://www.nice.org.uk/IPG029guidance)), or you can
order a copy from the website or by telephoning
the NHS Response Line on 0870 1555 455 and
quoting reference number N0388. The evidence
that NICE considered in developing this guidance
is also available from the NICE website.

Date: December 2003

10 Extracorporeal shockwave therapy for Peyronie's disease


National Institute for
Clinical Excellence
NHS
National Institute for
Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
www.nice.org.uk
N0389 1P 5k Dec 03 (ABA)
Title: Re: ultrasound treatment
Post by: james1947 on September 29, 2012, 10:55:19 AM
My uro proposed me this treatment  :) the problem is that the device for ESW is not the same as the one used for kidney stones (much smaller) and is not available here where I am living :(
He stated also that have limited information on the subject regarding results.

James
Title: Re: ultrasound treatment
Post by: wlstet on September 29, 2012, 03:18:16 PM
thanks james, i think its only available on private health care over here at the moment.

wlstet