Clinical trial evaluating platelet-rich plasma and extracorporeal shock wave therapy for the treatment of Peyronie's disease

Epifanova M1, Kostin A1, Gameeva E2, Artemenko S3, Epifanov A4

Research Type

Clinical

Abstract Category

Pelvic Pain Syndromes

Abstract 465
On Demand Pelvic Pain Syndromes / Sexual Dysfunction
Scientific Open Discussion Session 29
On-Demand
Clinical Trial Sexual Dysfunction Male Quality of Life (QoL)
1. Department of Urology and Operative Nephrology with Oncourology course of the Medical Institute of Peoples’ Friendship University (RUDN University), Moscow, Russia, 2. P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Research Radiological Centre, Moscow, Russia, 3. Central State Medical Academy of the Business Administration of the President of the Russian Federation, Moscow, Russia, 4. A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
Presenter
M

Maya Epifanova
Links

Abstract

Hypothesis / aims of study 
To investigate the effects of рlatelet-rich plasma (PRP) and low-intensity extracorporeal shockwave therapy (LI-ESWT) in patients with PD.
Study design, materials and methods 
40 patients with PD were included in our trial. Patients were randomly allocated to 2 groups. Group 1 received LI-ESWT (Dornier Aries)  twice weekly for 6 weeks, the median age was 47 years (21-71), the duration of PD was 1.5 years (0.5-5). Group 2 received 2 therapy sessions per week during 6 weeks. 1st session included  LI-ESWT per penile, 2nd session included  LI-ESWT per penile and PRP injections into penile, finally PRP was activated with  LI-ESWT. The median age of group 2 patients was 46 years (29-71), the duration of PD was 1.75 years (0.5-4). Follow-up evaluations were performed at baseline and 2 months after the treatment using the following criteria In both groups (median (IQR%): the Peyronie's Disease Questionnaire (PDQ), a Visual Analogue Scale (VAS) during vaginal intercourse and VAS score during erection,  curvature angle, plaque size and calcifications according to ultrasound data.
Results 
Only one of the patients with an idiopathic form of PD noted the progression of the disease with formation of the hourglass deformity. VAS during erection in group 1 decreased from 1.5 (0-2) to 0 (0-0) (р=0.001). VAS during erection in group 2 decreased from 3 (2-4) to 0 (0-1.5) (р=0.0001). VAS during vaginal intercourse in group 1 decreased from 1 (0-2.5) to 0 (0-1) (р=0.02).  VAS during vaginal intercourse in group 2 decreased from 3 (2.5-4.5) to 0 (0-1) (р=0.000005). PDQ  in group 1 were changed from 9.5 (6.5-14) to 3 (0.5-4.5) (р=0.00004). PDQ  in group 2 were changed from  12 (9-15.5) to 6 (2-8.5) (р=0.0001). The curvature angle in group 1 decreased from 26.7° (19-37) to 18.7° (13.5-23.9) (р=0.02). The curvature angle in group 2 decreased from 27.5° (20-38) to 15° (8.5-23.5) (р=0.007). In group 1 calcification size decreased from 3.5 mm (2.2-7.2) to 1.3 mm (1-4.6) (р=0.05). In group 2 calcification size was changed from 3 mm (2.7-6) to 3 mm (2-4.7) (р=0.5). In group 1 local fibrosis decreased from 207.4 mm2 (136-350) to 76 mm2 (47.5-132) (р=0.001). In group 2 local fibrosis decreased from 96.7 mm2  (65.8-183.6) to 42.9 mm2  (22.8-61.7) (р=0.003). In 3 cases of group 2 local fibrosis was completely resolved according to ultrasound data.
Interpretation of results 
The proposed treatment affects the main links in the pathogenesis of the Peyronie’s disease.
Concluding message 
PRP plus LI-ESWT and LI-ESWT may represent an actual conservative strategy in the PD treatment. Combined treatment is more effectiveness in relation to manage a local fibrosis and pain.
Disclosures
Funding N/a Clinical Trial Yes Public Registry No RCT No Subjects Human Ethics Committee Ethics Committee of the RUDN Medical Institute Helsinki Yes Informed Consent Yes
18/04/2024 08:05:10