Our experience on the association of a new physical and medical therapy inpatients suffering from induratio penis plastica

Objectives: To check the efficiency of shock waves in the treatment of indu ratio penis plastica. The Minilith SL1, successfully used in orthopedic or salivary stones because of its lithotriptic power, can be used to break pla ques in Peyronie's disease. Methods: A total of 130 patients affected with Peyronie's disease were entered into a prospective trial. Patients with com pletely calcified plaques as determined by ultrasound evaluation were exclu ded. We divided the patients into three treatment groups: (A) shock waves a lone in 21 patients; (B) a combination of shock waves and verapamil (perile sional injection) in 36 patients, and (C)verapamil alone in 73 patients. Fi rst, we treated all groups A and B patients 3 times, 20 min each time, with a Minilith SL1, and then only the patients of the second group received a complete cycle of twelve injections of verapamil (10 mg) every 2 weeks for 6 months. The group of 73 patients (group C) treated during the previous 2 years with a medical therapy (only injection of verapamil) was used as a co ntrol group. Results: Ultrasound evaluation showed a reduction of plaque in 11/21 group A patients and 7/36 group B patients. The treatment was tolera ted very well and only 11 petechiae in some patients were noticed after ESW treatment. Conclusions: The therapeutic association of shock waves with ve rapamil injection is an effective nonoperative treatment for the stabilizat ion of Peyronie's disease.