Extracorporeal shock wave lithotripsy (ESWL) in the treatment of La Peyronie disease. Use of a standard lithotriptor (Siemens multiline) on << young >> plaques (less than 6 months).

Objectives: The treatment of La Peyronie disease is still controversal. ESW L has been recently proposed to treat symptomatic plaques. The results, alt hough discordant and often based on subjective assessment criteria, appear to show a certain degree of efficacy on so-called young plaques, i.e. durin g the acute phase of the disease. This study was designed to evaluate the r esults obtained with a classical lithotriptor (Siemens Multiline) on plaque s present for less than 6 months. Material and Method: 26 patients were included in this prospective study. A ll presented a painful plaque on erection. The plaque was palpated under ge neral anaesthesia and 0.5 to 2 ml of contrast agent were injected to allow radiological visualization. All patients received 3000 impacts at a power o f 7 kilojoules in 1 session and all were reviewed 1 months and 3 months aft er the ESWL session. Results: Treatment was perfectly tolerated. Among the 26 patients treated: 19 patients (73%) reported a very marked reduction of pain on erection and 8 (31%) reported a reduction of curvature on erection, but this reduction w as demonstrated objectively (by tracing or photographs) for only 3 patients (11%). Seven patients (27%) experienced softening of the plaque. Six (37%) of the patients suffering from erectile dysfunction reported improvement o f the quality of erection, as reflected by the HEF score. Conclusion: A standard lithotriptor can be used to treat La Peyronie plaque s. ESWL appears to have a marked analgesic effect, but is efficacy on corre ction of curvature of the penis was not demonstrated in this study.