I’m Dr. Sébastien Beley, a urological surgeonand andrologist based in Paris, and today I’d like to talk to you about a subject that concerns many men: Lapeyronie’s disease and, more specifically, the role shockwave treatments can play in its management. This pathology, often misunderstood and a source of concern, can be difficult to live with on a day-to-day basis, not least because of its repercussions on sexual and psychological quality of life. In this article, I’ll explain the different facets of this disease, the results of recent scientific studies concerning shockwaves, and what you can reasonably expect from this type of treatment.
Understanding Lapeyronie’s disease
Lapeyronie’s disease is a condition affecting the penis, characterized by the formation of a fibrous plaque in the erectile tissue, known as Lapeyronie’s plaque. This plaque leads to localized hardening, causing the penis to bend during erections, which is often painful. The disease can also lead to visible deformation, pain and sometimes erectile dysfunction. The initial phase is often inflammatory, with pain and progressive curvature, before the disease stabilizes or worsens.
The psychological impact is significant, as affected men can suffer from reduced self-confidence, sexual anxiety and even avoidance of sexual relations. Treatment of this disease is therefore a priority to improve not only sexual function, but also overall quality of life.
Classical treatments for Lapeyronie’s disease
Traditionally, the management of Lapeyronie’s disease has depended on the severity of symptoms, the progressive phase of the disease, and the degree of functional discomfort. Treatment options include:
- Drug treatments: anti-inflammatories, drugs to improve vascularization, or specific treatments such as collagenase from Clostridium histolyticum.
- Physical treatments: stretching, traction devices, sometimes combined with physical therapies.
- Surgical interventions: in severe or stabilized cases, surgery may consist of a plication to correct the curvature, a tissue graft, or the insertion of a penile implant in cases of associated severe erectile dysfunction.
However, many men are reluctant to resort to surgery, not least because of the risks, potential side effects and invasive nature of these procedures. It is in this context that non-invasive treatments, such as shock waves, are attracting growing interest.
What are shockwaves?
Shockwaves are high-energy acoustic pulses used in a number of medical fields, notably to treat kidney stones, certain musculoskeletal pathologies, and more recently, certain urological conditions. In Lapeyronie’s disease, low-intensity shockwaves are generally used to act on fibrous plaque, improve local vascularization, reduce pain and potentially promote tissue remodeling.
The simplicity of the treatment, its non-invasive nature and the low risk of side effects make it an attractive option, especially for patients who wish to avoid surgery or who are unable to undergo it.
What do studies say about the effectiveness of shock waves in Lapeyronie’s disease?
The scientific literature on this subject is particularly extensive, but unfortunately the results are highly heterogeneous and sometimes contradictory. Numerous studies have evaluated the results obtained with shock waves in groups of Lapeyronie patients, with varying sample sizes, which complicates interpretation of the data.
Here are the main conclusions to be drawn:
1. Improvement of penile curvature
Several studies have shown a moderate to significant effect on reducing penile curvature. For example, one study showed a reduction in curvature of over 25% in some patients treated with shockwave therapy. This means that for some men, deformity can be significantly reduced, which can improve sexual function and comfort.
However, other studies found no significant improvement in curvature, and some even reported a worsening of curvature in some patients. These differing results may be due to differences in treatment method, disease stage, or initial severity of deformity.
2. Pain reduction
One point on which almost all studies agree is the significant reduction in disease-related pain, particularly during the inflammatory phase. This reduction in pain is often reported as a major benefit by patients, as it improves their day-to-day comfort and general well-being.
3. Improved erection quality
Another potential benefit of shockwave therapy is improved erectile quality. Several studies have shown that shockwave treatment can contribute to better erectile function, probably thanks to improved local vascularization and reduced pain.
It is important to note that in some studies, an apparent worsening of the curvature was observed in patients with a simultaneous improvement in erectile function. This observation suggests that increasing penile rigidity may make the deformity more visible, without the plaque itself actually worsening.
4. Psychological impact and quality of life
Beyond objective measurements, one of the notable advantages of shockwave therapy is the improvement in patients’ psychological well-being. The fact of having a treatment underway, of feeling taken care of, and of not putting off indefinitely the decision to treat one’s disease, plays a crucial role. This brings a sense of control and hope, which contributes to a better quality of life.
What are the risks and limitations of shockwave treatment?
One of the great advantages of low-intensity shockwaves is their safety. No studies have reported any major risks or serious side effects associated with this treatment. In this sense, there is no danger in trying this type of treatment, even if results are not guaranteed.
On the other hand, it’s important to bear in mind that :
- Results may vary from patient to patient.
- Treatment does not always replace surgery in the case of severe or stabilized deformities.
- Treatment is most effective in the inflammatory phase, particularly for reducing pain.
- Don’t expect miracles: curvature improvement is not guaranteed in all cases.
For whom is shock wave treatment indicated?
Shock wave treatment is particularly suitable for patients who :
- Suffer from pain associated with Lapeyronie’s disease, particularly in the inflammatory phase.
- Have moderate curvature and wish to avoid or defer surgery.
- Wish to improve the quality of their erection.
- Fear or refuse surgery, but want to manage their disease.
It’s essential to discuss with your urologist whether this treatment is right for you, as each case is unique. Shockwaves are not a one-size-fits-all solution, but they can be part of a personalized management program.
How does a shockwave treatment session work?
Treatment is generally performed on an outpatient basis, without anesthesia, and does not require hospitalization. A session lasts around 15 to 20 minutes, during which a device delivers acoustic pulses targeted at the Lapeyronie plaque and painful areas.
The protocol may vary from one center to another, but it is often recommended to carry out several sessions spaced out over several weeks. The doctor will adapt the number and frequency of sessions according to the patient’s progress and tolerance.
Advice for patients with Lapeyronie’s disease
If you are affected by Lapeyronie’s disease, here are some important tips to keep in mind:
- Consult a specialist: An andrologist is the most qualified professional to assess your condition and suggest a suitable treatment.
- Don’t let the disease go untreated: The inflammatory phase is when treatment is most effective, especially in reducing pain.
- Find out about all the options: Medication, shockwaves, traction devices, surgery – each treatment has its indications and limitations.
- Maintain good communication with your partner: Illness can have an impact on married life, and mutual support is essential.
- Don’t neglect the psychological impact: Don’t hesitate to consult a psychologist or sex therapist if you’re feeling very distressed.
Conclusion: Shockwaves, an interesting option but not a panacea
In summary, shockwave therapy in Lapeyronie’s disease is an attractive treatment option, especially for patients in the inflammatory phase or those wishing to avoid surgery. The literature shows that this treatment can reduce pain, improve erectile quality and, in some cases, reduce penile curvature.
However, results are variable, and a complete cure cannot be expected in all cases. The main advantage remains the safety of the treatment and its non-invasive nature, making it an option to be seriously considered with your doctor.
If you are concerned by Lapeyronie’s disease, I strongly encourage you to discuss with your urologist the possibility of trying shockwaves, especially if you are in the painful phase of the disease and wish to avoid immediate surgery. This treatment can offer you significant relief and improve your sexual and psychological quality of life.
To find out more about this and other tips on male sexual health, check out my other articles and videos. Dealing with Lapeyronie’s disease is a global approach that requires listening, patience and adaptation to each patient.
Finally, remember that there are no major risks in trying shockwaves, and that in the worst case, you won’t get any improvement, but you won’t suffer any serious side effects either. In the best-case scenario, you’ll enjoy a marked improvement in erectile function, a reduction in pain, and perhaps even a reduction in curvature.
Don’t let Lapeyronie’s disease take over your life. Be proactive, get informed, and don’t hesitate to ask a specialist for advice.
