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Meta-Analysis
. 2024 Oct 8;24(1):217.
doi: 10.1186/s12894-024-01607-4.

Low-intensity extracorporeal shock wave therapy for Peyroniès disease: a systematic review and meta-analysis

Guizhong Li  1 , Xiao Xu  2 , Libo Man  2
Affiliations
Meta-Analysis

Low-intensity extracorporeal shock wave therapy for Peyroniès disease: a systematic review and meta-analysis

Guizhong Li et al. BMC Urol. .

Abstract

Background: A systematic review of the evidence was conducted to assess the efficacy of low-intensity extracorporeal shock wave therapy (LI-ESWT) for patients with Peyronie`s Disease (PD).

Methods: A comprehensive search of the Cochrane Registry, PubMed and Embase databases was conducted to identify all controlled trials, including randomised controlled trials (RCTs), cohort studies and case-control studies, focusing on the efficacy of LI-ESWT in treating PD, and published before February 2023. The size of plaques, curvature deviation, visual analog scale [VAS] and International Index of Erectile Function (IIEF) were the most commonly used tool to evaluate the treatment effectiveness of LI-ESWT.

Results: There were 7 studies including 475 patients from 1999 to 2023. The meta-analysis of the data revealed that LI-ESWT could considerably enhance the proportion of men experiencing a reduction in penile plaques (RD 0.27, 95% CI: 0.04-0.50, P = 0.02), improvement in penile curvature (RD: 0.13; 95% CI, 0-0.26; p = 0.05), alleviation of pain (RD 0.22, 95% CI: 0.01-0.42, P = 0.04), and complete remission (RD 0.38, 95% CI 0.23-0.52, P < 0.00001). However, there were no significant differences in improvement of sexual function (MD: 1.44; 95% CI, -3.10-5.97; p = 0.53) between LI-ESWT and the placebo group.

Conclusions: According to these studies, LI-ESWT has the potential to decrease plaque size and improve penile curvature or pain in men with PD. The publication of robust evidence from additional well-designed long-term multicenter randomized controlled trials would provide more confidence regarding use of these devices in patients with PD.

Keywords: Controlled trial; Erection; Meta-analysis; Penile deviation; Peyronie’s disease; Plaque; Shock waves.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection. 152 records were identified. After review, 7 controlled trials on LI-ESWT and PD were included in the meta-analysis. LI-ESWT = low-intensity extracorporeal shock wave treatment; RCT = randomized controlled trial
Fig. 2
Fig. 2
Risk of bias summary: review authors’ judgments about each risk of bias item for each included study
Fig. 3
Fig. 3
Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies
Fig. 4
Fig. 4
Forest plot and meta-analysis of lessening of plaque
Fig. 5
Fig. 5
Forest Plot and pooled data about effect of LI-ESWT on plaque size reduction (in mm2) vs. placebo
Fig. 6
Fig. 6
Forest plot and meta-analysis of improvement of penile curvature
Fig. 7
Fig. 7
Forest Plot and pooled data about effect of LI-ESWT on penile deviation angle (in degrees) vs. control
Fig. 8
Fig. 8
Forest plot and meta-analysis of relief remission of pain
Fig. 9
Fig. 9
Forest plot and meta-analysis of completely remission of pain
Fig. 10
Fig. 10
Forest plot and meta-analysis of improvement of sexual function in IIEF5
Fig. 11
Fig. 11
Forest plot and meta-analysis of improvement of sexual function
See this image and copyright information in PMC

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