AB131. A meta-analysis of extracorporeal shock wave therapy for Peyronie’s disease

Objective: The efficiency of extracorporeal shock wave therapy (ESWT) for Peyronie’s disease (PD) has been controversial for a very long time. We aim to evaluate the efficiency of ESWT for PD and provide possible evidences on the basis of a meta-analysis of existing comparative studies.

Methods: All controlled studies, including randomized controlled trials (RCT), cohort studies (CS) and case-control studies (CCS), which focused on exploring the efficiency of ESWT for PD, were prospectively identified through comprehensively searches of PubMed, the Cochrane Library and Embase. Following, a meta-analysis of these studies were carried out.

Results: Collectively, six studies, including 3 RCT (level of evidence: 1b), 1 CS (level of evidence: 2b) and 2 CCS (level of evidence: 3b), were selected for meta-analysis, in which 443 patients were included. Pooling data of these studies showed that ESWT could significantly improve the percentage of males with lessening of penile plaques [odds ratio (OR) 2.07, 95% confidence interval (CI), 1.11-3.85, P=0.02], relief of pain (OR 4.46, 95% CI, 2.29-8.68, P<0.0001) and complete remission of pain (OR 5.86, 95% CI, 2.66-12.92, P<0.0001). Though insignificant differences were presented in improvement of penile curvature (OR 1.88, 95% CI, 0.97-3.65, P=0.06) and improving sexual function (OR 2.22, 95% CI, 0.69-7.11, P=0.18), there were evident tendencies of favoring ESWT. Further, similar results were shown for sensitivity and publication bias analysis after excluding all CS and CSS. Though sporadic complications caused by ESWT were reported, there was no special treatment were needed, except observation.

Conclusions: ESWT could be an effective and safe treatment for males with PD. However, more high-quality, well-designed RCT are required to definitely solve this controversy and complete our meta-analysis.

Keywords: Peyronie’s disease (PD); extracorporeal shock wave therapy (ESWT); meta-analysis