World Journal of Urology

, Volume 35, Issue 1, pp 1–9 | Cite as

Extracorporeal shock wave therapy (ESWT) in urology: a systematic review of outcome in Peyronie’s disease, erectile dysfunction and chronic pelvic pain

  • Grzegorz Lukasz Fojecki
  • Stefan Tiessen
  • Palle Jörn Sloth Osther
Invited Review



The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders.


We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline and PubMed was carried out. The systematic review was performed according to PRISMA guidelines.


We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie’s disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile deviation and plaque size were observed. Four studies on erectile dysfunction (ED) including 337 participants were included. Using International Index of Erectile Function (IIEF-EF) and erectile hardness scale (EHS) data suggested a significant positive effect of ESWT in phosphodiesterase-5 inhibitor (PDE-5i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard to treatment techniques and outcome measures, making it difficult to compare results.


ESWT may resolve pain in PD patients, while evidence for reducing curvature and plaques size is poor. Effects of ESWT on IIEF in ED patients are inconsistent; however, data on EHS does imply that the treatment potentially may recover natural erection in PDE-5i responders. ESWT seems to be able to resolve pain in CPP patients in the short term. In all three disease entities, long-term outcome data are still warranted.


Extracorporeal shock wave therapy Urology Systematic review Peyronie’s disease Erectile dysfunction Chronic pelvic pain 


Author contribution

G. Fojecki and S. Tiessen contributed to data collection, data analysis and manuscript writing. P. J. Osther helped with data analysis, manuscript writing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Grzegorz Lukasz Fojecki
    • 1
  • Stefan Tiessen
    • 2
  • Palle Jörn Sloth Osther
    • 3
  1. 1.Department of UrologyHospital of Southern Jutland, University of Southern DenmarkSønderborgDenmark
  2. 2.Department of UrologyOdense University Hospital, University of Southern DenmarkOdenseDenmark
  3. 3.Department of Urology, Urological Research Center, Lillebaelt HospitalUniversity of Southern DenmarkFredericiaDenmark

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