Akut faz Peyronie hastalığında düşük yoğunluklu ekstrakorporeal şok dalga tedavisi ve trombositten zengin plazma kombinasyonu

Abstract

Amaç: Bu çalışmanın amacı, akut faz Peyronie hastalığında düşük yoğunluklu ekstrakorporeal şok dalga tedavisi ile trombositten zengin plazma kombinasyonunun etkinliğini, güvenliğini ve tolere edilebilirliğini değerlendirmektir.
Gereç ve yöntem: Bu retrospektif tek merkezli çalışmaya, Ocak 2025-Ocak 2026 tarihleri arasında tedavi edilen akut faz Peyronie hastalığı tanılı 42 erkek hasta dahil edildi. Akut faz, semptom süresinin 6 aydan kısa olması olarak tanımlandı. Tüm hastalara günlük tadalafil, altı seans düşük yoğunluklu ekstrakorporeal şok dalga tedavisi ve üç intralezyonel trombositten zengin plazma enjeksiyonu uygulandı. Penis eğrilik açısı, plak boyutu, penil ağrı ve erektil fonksiyon tedavi öncesinde ve tedaviden 3 ay sonra değerlendirildi. Penil ağrı görsel analog skala ile, erektil fonksiyon ise Uluslararası Erektil Fonksiyon İndeksi ile değerlendirildi. Eşleştirilmiş karşılaştırmalar veri dağılımına göre yapıldı.
Bulgular: Ortanca ağrı skoru 7.00’den 3.50’ye anlamlı olarak azaldı (p<0,001). Erektil fonksiyonda da anlamlı iyileşme saptandı ve ortalama skor 16,59±4,51’den 20,88±5,51’e yükseldi (p<0,001). Ortalama penis eğrilik açısı 33,89±10,49 dereceden 31,53±13,26 dereceye geriledi, ancak bu değişiklik anlamlı değildi (p=0,058). Ortalama plak boyutu 1,58±0,45 cm’den 1,56±0,46 cm’ye değişti ve bu fark istatistiksel olarak anlamlı bulunmadı (p=0,594). Majör yan etki gözlenmedi. Minör lokal komplikasyonlar hastaların %11,9’unda hafif ekimoz ve %4,8’inde geçici ödemdi.

Sonuç: Düşük yoğunluklu ekstrakorporeal şok dalga tedavisi ile trombositten zengin plazma kombinasyonu, akut faz Peyronie hastalığında güvenli ve etkili bir konservatif tedavi seçeneği gibi görünmektedir. Bu protokol anlamlı ağrı azalması ve erektil fonksiyonda iyileşme sağlamış, penis eğriliği ile plak boyutunda ise stabilizasyon oluşturmuştur.

Keywords

• Peyronie hastalığı
• trombositten zengin plazma
• şok dalga tedavisi
• erektil disfonksiyon
• penil indürasyon

Supporting Institution

Yazarlar bu makalenin araştırması, yazımı ve/veya yayınlanması için herhangi bir finansal destek almamıştır.

Ethical Statement

Çalışma için Pamukkale Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu'ndan izin alınmıştır (Onay Tarihi ve Numarası: 09.10.2025 E.764107).

Thanks

Yazarlar, bu araştırmaya duydukları güven ve katkılarından dolayı hastalara ve ailelerine minnettardır. Onların katılımı, Peyronie hastalığında rejeneratif tedaviler üzerine yapılan bu çalışmanın tamamlanması için esastı.

Combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma in acute-phase Peyronie’s disease

Abstract

Purpose: To evaluate the efficacy, safety, and tolerability of combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma in patients with acute-phase Peyronie’s disease.
Materials and methods: This retrospective single-center study included 42 men with acute-phase Peyronie’s disease treated between January 2025 and January 2026. The acute phase was defined as a symptom duration of less than 6 months. All patients received daily tadalafil, six sessions of low-intensity extracorporeal shock wave therapy, and three intralesional platelet-rich plasma injections. Penile curvature, plaque size, penile pain, and erectile function were assessed before treatment and 3 months after treatment. Penile pain was evaluated with a visual analog scale, and erectile function was assessed using the International Index of Erectile Function. Paired comparisons were performed according to data distribution.
Results: The median pain score decreased significantly from 7.00 to 3.50 (p<0.001). Erectile function also improved significantly, with the mean score increasing from 16.59±4.51 to 20.88±5.51 (p<0.001). Mean penile curvature decreased from 33.89±10.49 degrees to 31.53±13.26 degrees, but this change was not significant (p=0.058). Mean plaque size changed from 1.58±0.45 cm to 1.56±0.46 cm without statistical significance (p=0.594). No major adverse events were observed. Minor local complications included mild ecchymosis in 11.9% and transient edema in 4.8% of patients.
Conclusion: Combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma appears to be a safe and effective conservative treatment option in acute-phase Peyronie’s disease. The protocol provided significant pain relief and improved erectile function, while stabilizing penile curvature and plaque size

Keywords

• Peyronie's disease
• platelet-rich plasma
• shock wave therapy
• erectile dysfunction
• penile induration

Supporting Institution

The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical Statement

Permission was obtained from Pamukkale University Non-Interventional Clinical Research Ethics Committee for the study (Approval Date and Number: 09.10.2025 E.764107)

Thanks

The authors are grateful to the patients and their families for their trust and contribution to this research. Their participation was essential for the completion of this study on regenerative therapies in Peyronie’s disease.

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