As a complementary approach, shockwave therapy may be useful for pain control in selected patients. However, it has not been shown to correct penile curvature or eliminate fibrous plaques.
Among non-surgical options, shockwave therapy for Peyronie’s disease has been studied as an approach generally performed on an outpatient basis. Its usefulness and effectiveness may vary according to the clinical situation and the protocol used.
To understand its role, it is important to distinguish a primary approach from an adjunctive treatment. Shockwave therapy may be considered as a complementary approach in selected situations, but it does not replace other therapeutic options that may be recommended by a urologist.
What Is Shockwave Therapy?
Shockwave therapy consists of applying mechanical stimuli through a specific device.
During a session, the operator positions the device applicator over selected areas, using contact gel to facilitate transmission of the waves.
The number of impulses, intensity, treatment frequency, and number of sessions may vary according to the device and protocol used.
Currently, there is no universally established protocol for using shockwave therapy for Peyronie’s disease.
What Is the Role of This Therapy in Peyronie’s Disease?
In Peyronie’s disease, protocols with different energy levels have been studied and may produce local tissue changes, particularly at vascular and inflammatory levels.
Among the effects studied for shockwave therapy in this condition is possible pain relief during the acute phase of Peyronie’s disease, although the response may vary between patients.
Some clinical recommendations state that shockwave therapy may be considered for penile pain control during this phase, although the strength of this recommendation is limited and consistent improvement in penile curvature or plaque size has not been demonstrated.
Therefore, the therapy should not be presented as a way to straighten the penis or eliminate fibrous plaques. Its use should be complementary and depend on specialist assessment.
What Does the Scientific Evidence Say?
Available studies do not show completely consistent results.
A 2024 meta-analysis published in the scientific journal BMC Urology identified signs of possible improvement in Peyronie’s disease pain and in some plaque- and curvature-related parameters, but definitive conclusions cannot yet be drawn.
Another meta-analysis, published in 2023 in BMC Urology, analyzed four randomized clinical trials involving 301 patients. The results indicated that shockwave therapy may contribute to reducing pain and plaque size. However, no statistically significant benefit was demonstrated for penile curvature or sexual function.
The number of available studies remains limited, and the criteria used to assess outcomes are not homogeneous. Therefore, the results of a particular study cannot automatically be applied to every patient.
When May Shockwave Therapy Be Considered?
Shockwave therapy for Peyronie’s disease may be considered in some cases during the active phase, particularly when significant penile pain is present.
However, the indication depends on specialist assessment and may form part of a multimodal plan selected by the urologist.
What Are the Limitations of the Therapy?
Shockwave therapy is not intended to treat the underlying cause of the disease and has not been shown to consistently correct penile curvature or complex structural deformities. In addition, this therapy does not replace penile surgery when, after specialist assessment, surgery or penile reconstruction is indicated.
Shockwave therapy has not been shown to consistently improve erectile dysfunction associated with Peyronie’s disease.
The results of shockwave therapy vary, and expectations should be realistic.
In addition, pain associated with Peyronie’s disease may decrease spontaneously as the disease progresses from the active phase to the stable phase, making it difficult to attribute improvement exclusively to shockwave therapy.
Frequently Asked Questions
Is the Treatment Painful?
The application is generally well tolerated, although it may cause local discomfort, redness, bruising, or temporary sensitivity. Side effects and the intensity of discomfort may vary according to the device and protocol used.
How Many Sessions Are Usually Needed?
There is no standard number. Treatment is individualized, and the protocol should be defined according to the urologist’s assessment.
Does Shockwave Therapy Eliminate Fibrous Plaques?
It cannot be stated, based on the currently available evidence, that shockwave therapy eliminates fibrous plaques or penile fibrosis. Some studies have identified changes in plaque size, but these results do not mean that the fibrosis has been eliminated.
Can Shockwave Therapy Complement Peyronie’s Disease Treatment?
Shockwave therapy may be useful as a complementary option, particularly for pain control in some patients during the active phase.
Scientific evidence has not demonstrated consistent correction of curvature or elimination of fibrous plaques.
The decision should be individualized and based on specialist assessment, rather than solely on how easy the protocol is to administer.
Whether this approach can form part of a treatment plan should be discussed during a urological assessment, where the available options can be considered in light of the clinical situation and current scientific evidence.