Abstract:

Objective　To analyze the clinical effect of low intensity extracorporeal shock wave therapy for Peyronie's disease. Methods　A total of 22 patients diagnosed with Peyronie's disease at the Department of Urology, the Fifth Affiliated Hospital of Guangzhou Medical University from May 2019 to March 2024 were treated with low intensity extracorporeal shock wave therapy (once a week for 4-12 weeks). After completing the treatment, the induration size, degree of penile curvature, Visual Analogue Scale (VAS) score, International Index of Erectile Function Questionnaire-5 (IIEF-5) score, and complications were recorded. χ² test or Fisher exact probability method were used for statistical analysis. Results　The patients ranged in age from 32 to 55 years old, with an average of 43.5 years old. Among them, 6 cases (27.3%) were under 40 years old, 12 cases (54.5%) were 40 - 50 years old, and 4 cases (18.2%) were over 50 years old. The average course of disease was 16 months, 10 cases (45.4%) within 1 year, 8 cases (36.4%) of 1 - 2 years, and 4 cases (18.2%) over 2 years; 14 cases (63.6%) had only 1 induration, 6 cases (27.3%) had 2 indurations, and 2 cases (9.1%) had 3 indurations. Most of the indurations were nodules, and were long cords in only 4 cases. The maximum induration was 25 mm × 23 mm, and the minimum was 5 mm × 5 mm. The induration was found on both sides of the penis in 8 cases (36.4%) and on the dorsal side of the penis in 14 cases (63.6%). In 18 patients (81.82%), the size decreased or became soft after treatment. Of the 18 patients experiencing pain during penile erection, 14 cases (77.78%) had pain relief. Of the 8 patients with obvious penile curvature during erection, 6 cases (75.00%) were significantly improved after treatment. Of the 9 patients with erectile dysfunction, 7 cases (77.78%) showed significant improvement. No significant complications were observed in all patients. Conclusions　Low intensity extracorporeal shock wave therapy is helpful to relieve the pain caused by penile induration, and improve the penile curvature and quality of life. The findings advocate for its broader implementation in clinical practice.

Key words:

Peyronie's disease, Low-intensity extracorporeal shock wave therapy, Clinical efficacy

摘要：

目的　分析低能量冲击波治疗阴茎硬结症的临床效果。方法　对2019年5月至2024年3月在广州医科大学附属第五医院泌尿外科诊断为阴茎硬结症的22例患者应用低能量冲击波进行治疗（每周1次，疗程4～12周），疗程结束后对患者硬结尺寸、阴茎弯曲程度、视觉模拟评分法（Visual Analogue Scale，VAS）评分、国际勃起功能指数调查问卷表-5（International Index of Erectile Function Questionnaire-5，IIEF-5）评分、并发症等进行记录。采用χ²检验或Fisher确切概率法进行统计学分析。结果　患者年龄32～55岁，平均年龄43.5岁；40岁以下6例（27.3%），40～50岁12例（54.5%），50岁以上4例（18.2%）。平均病程16个月；病程1年内10例（45.4%），1～2年8例（36.4%），超过2年4例（18.2%）。14例（63.6%）仅有1枚硬结，6例（27.3%）有2枚硬结，2例（9.1%）有3枚硬结。硬结大多呈结节状，仅4枚呈长条索状。硬结最大为25 mm × 23 mm，最小为5 mm × 5 mm。硬结分布于阴茎两侧8例（36.4%），分布于阴茎背侧14例（63.6%）。18例患者（81.82%）在疗程结束后出现了尺寸变小或变软的现象；18例有阴茎勃起疼痛的患者中，14例（77.78%）得到减轻；8例阴茎勃起后明显弯曲的患者中，6例（75.00%）治疗后改善；9例有勃起功能障碍的患者中，7例（77.78%）改善。所有患者均未见明显并发症。结论　低能量冲击波治疗有助于缓解阴茎硬结导致的疼痛，改善阴茎弯曲，提高患者生活质量，值得进一步推广应用。

关键词:

阴茎硬结症, 低能量冲击波治疗, 临床效果