International Journal of Urology (2002) 9, 110–113 Short Communication Blackwell Science, LtdOxford, UK IJU International Journal of Urology 0919-81722002 Blackwell Science Asia Pty Ltd 92February 2002 430 Extracorporeal shock wave treatment for Peyronie’s disease H Kiyota et al. Short Communication115118BEES SGML Correspondence: Hiroshi Kiyota, 3-25-8, Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan. Email: jpurol@mb.infoweb.ne.jp Received 29 May 2001; revision 11 July 2001; accepted 27 August 2001. Extracorporeal shock wave treatment for Peyronie’s disease using EDAP LT-02; preliminary results HIROSHI KIYOTA, YUKIHIKO OHISHI, KOJI ASANO, NORIO HASEGAWA, JUN MADARAME, KENTA MIKI, NOBUKI KATO, TAKAHIRO KIMURA, TAKEHITO ISHIYAMA, SHIGETAKA MAEDA, TATSUYA SHIMOMURA, YUTAKA SHIONO AND JUN MIKI Department of Urology, Jikei University, School of Medicine, Tokyo, Japan Abstract Background: Peyronie’s disease is an idiopathic fibrosis of the tunica albuginea of the penis, which often causes erectile dysfunction. No effective therapy except surgery has been available for Peyronie’s disease. We investigated the clinical efficacy of extracorporeal shock wave treatment (ESWT) using EDAP LT-02 as an alternative method of treatment for Peyronie’s disease. Methods: Five patients aged 35–65years were treated by ESWT. All patients had undergone unsuccessful medical treatment before ESWT. Each patient was treated by ESWT (7–40 storages at an energy density of 45–96MPa) between three and five times at 4-week intervals. Although no patient needed anesthesia, all were administered diclofenac suppository (50 mg) before ESWT. Results: Of the five patients, four were eligible for evaluation. The penile plaque disappeared in one patient (25%). In the other three patients (75%), the penile plaque did not disappear, but softened. Although no improvement of erectile penile curvature was recognized, erectile penile pain disappeared in all patients. Conclusions: These results indicate that ESWT is a possible alternative to surgery in the treatment of Peyronie’s disease. Key words extracorporeal shock wave treatment, Peyronie’s disease. Introduction Peyronie’s disease is a connective tissue disorder that affects the tunica albuginea of the corpora cavernosa of the penis. 1 It sometimes causes painful penile curvature with erection, often resulting in erectile dysfunction. 1 Because the pathogenesis of Peyronie’s disease is unclear, there has been no effective treatment except the surgical removal of the penile plaque. 1 However, since Butz et al. and Colombo et al. reported the effectiveness of extracorporeal shock wave treatment (ESWT) using Minilith (SL1; Storz Medical, Kreuzlingen, Switzerland) for Peyronie’s disease, several ESWT trials have been published with encouraging results. 2–9 Therefore, we treated Peyronie’s disease with ESWT using EDAP LT- 02 (Techno Medical Systems, Vaulx en Velin, France). Methods Five patients with Peyronie’s disease, aged 35–65years (mean, 52 years), were treated by ESWT at Jikei Uni- versity Affiliated Hospital from March to December 2000. The size of the penile plaque ranged from 15 × 7 × 7 mm to 30 × 8 × 8 mm. All patients had penile curvature (range, 20–40°) with erectile pain and had undergone unsuccessful medical treatment with vitamin E for 6months or longer, before ESWT. This procedure was discussed and approved by the Jikei University Committee (permission 2687). The risks and benefits associated with ESWT as well as the traditional surgical procedures were discussed. Diclofenac sodium suppository (50 mg) was admin- istered 30min before ESWT. The penile plaque was