Low-intensity extracorporeal shock wave therapy for Peyronie's disease: a single-center experience / 亚洲男科学杂志(英文版)

The aim of this article is to assess the outcomes of a low-intensity extracorporeal shock wave therapy (LiESWT) protocol for the treatment of Peyronie's disease (PD). Patients treated for PD were prospectively recorded, and data were retrospectively reviewed. Age, characteristics of fibrous plaques, concomitant treatments, International Index of Erectile Function (IIEF-5), Lue score, and pain score on Likert scale were collected. Patients in acute phase of PD and an angulation of <40° were included. The protocol consisted of 6 weekly sessions of 4000 pulses each, applied from different directions, with a maximal power of 20 W and 8 Hz frequency. We included 39 patients (median age: 56.8 years, interquartile range [IQR]: 35.8-62.2 years). The median number of sessions received per patient was 7.2. After treatment, the median Lue score decreased from 6.8 initially to 3.3 (P = 0.003), the median Likert pain score dropped from 1.8 to 0.7 (P = 0.004), the median plaque size was reduced from 2 cm to 1.2 cm (P = 0.08), and the median penile curvature diminished from 31° to 17° (P = 0.07). On univariate and multivariate analysis, the only predictors of success were younger age (odds ratio [OR] = 0.95, P = 0.03 and OR = 0.91, P = 0.04, respectively) and concomitant use of phosphodiesterase-5 inhibitors (PDE5i; OR = 0.92, P = 0.02 and OR = 0.93, P = 0.01, respectively). LiESWT had a favorable impact on Lue score and notably penile pain, curvature, plaque size, and erectile function in patients treated for PD during the early inflammatory phase, with no side effects. Younger age and concomitant use of PDE5i were the only success predictors.

Evaluation of multidisciplinary team meetings in uro-oncology

The objective of this study was to examine the impact of multidisciplinary team meetings on the management decisions for urological cancers. A prospective study was conducted

Methods: The study population is cases presented to multidisciplinary teams at Notre- Dame de Secours University Medical Center between July 2012 and July 2014. Data was collected by a standard pro forma

Results: 189 cases were presented in multidisciplinary meetings during the study period. Results of this study showed that multidisciplinary team meetings change management decisions in 40.7% of cases. Change in management decisions was mainly significant in testicular cancer [57.1%], prostate cancer [42.7%] and bladder cancer [38.2%], with less important changes in renal cancer [33.3%]. Prostate cancer cases with Gleason score 7 [51.7%] and bladder tumors with TNM >/= T2 [85.7%] were the most modified in their respective groups

Conclusion: Multidisciplinary team meetings have a major impact in therapeutic decisions taken by urologists for newly diagnosed urological cancers