背景:佩罗尼病(PD)与阴茎疼痛有关,偏差,和性功能障碍。直到现在,PD没有保守的标准治疗。然而,体外冲击波疗法(ESWT)的作用越来越受到人们的关注。
目的:为了评估ESWT对阴茎偏离的影响,斑块大小,勃起功能,疼痛量表,和PD患者的并发症发生率。
方法:PubMed数据库搜索2000年1月至2020年11月发表的文章,使用相关关键词,仅包括随机对照试验(RCT)。使用RevMan进行了Meta分析和森林地块,结果由2名作者独立审查。本文使用PRISMA指南来实现数据的定量和定性综合。
结果:阴茎偏差的变化,斑块大小,勃起功能,疼痛量表,和ESWT相关并发症的发生率。
结果:搜索产生了73篇文章。三个RCT,包括ESWT组的117名患者和安慰剂组的121名患者,被审查了。ESWT与斑块大小减小相关(OR=2.59,95%CI(1.15-5.85),P=.02)。与安慰剂相比,ESWT后组的阴茎偏角减少或瘀伤率没有显着差异。没有证据表明ESWT对勃起功能或疼痛量表有影响。
结论:根据可用的RCT,ESWT不能改善患有PD的男性的阴茎弯曲或疼痛。虽然ESWT可以减少斑块大小,这仍然具有值得怀疑的临床意义。
■RCT使用不同的度量来报告相同的结果。缺失的数据被估算以符合荟萃分析的要求。然而,还有很多数据无法估计。
结论:目前的数据表明ESWT不能改善男性PD患者的阴茎弯曲或疼痛。虽然ESWT可以减少斑块大小,这仍然具有可疑的临床意义,需要进一步的研究来确认发现。
BACKGROUND: Peyronie\'s disease (PD) is associated with penile pain, deviation, and sexual dysfunction. Up till now, there is no conservative standard treatment for PD. However, the role of Extracorporeal Shock Wave Therapy (ESWT) is gaining increasing interest.
OBJECTIVE: To evaluate the effect of ESWT on penile deviation,
plaque size, erectile function, pain scale, and the rate of complications in PD patients.
METHODS: PubMed database was searched for articles published from January 2000 to November 2020, using related keywords and including randomized controlled trials (RCTs) only. Meta-analysis and forest plots were carried out using RevMan, and outcomes were reviewed by 2 authors independently. PRISMA guidelines were used in this article to achieve the quantitative and qualitative synthesis of data.
RESULTS: Changes in penile deviation,
plaque size, erectile function, pain scale, and the rate of ESWT related complications.
RESULTS: The search yielded 73 articles. Three RCTs, including 117 patients in the ESWT group and 121 patients in the placebo group, were reviewed. ESWT is associated with reduction in
plaque size (OR = 2.59, 95% CI (1.15-5.85), P= .02). No significant difference in reduction of penile deviation angle or rate of bruises were detected in post ESWT group when compared to placebo. No evidence was found to show an effect of ESWT on erectile function or pain scale.
CONCLUSIONS: Based on the available RCTs, ESWT fails to improve penile curvature or pain in men with PD. Although ESWT may reduce
plaque size, this remains of questionable clinical significance.
UNASSIGNED: RCTs used different metrics to report the same outcome. Missed data were imputed to match the requirements of meta-analysis. However, there is still much data that cannot be estimated.
CONCLUSIONS: The current data suggest that ESWT fails to improve penile curvature or pain in men with PD. Although ESWT may reduce
plaque size, this remains of questionable clinical significance, and further studies are required to confirm findings.