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