Induratio penis plastica (IPP), also known as Peyronie’s disease, is an acquired and generally progressive condition of the penis. Most men notice the presence of the disease when they feel thickened nodules (so-called plaques) under the skin of the penis. As the disease progresses, pain may occur with or without an erection and the penis becomes curved during an erection, which can make it difficult or impossible to have sexual intercourse.

When treating IPP/Peyronie’s disease, the pain points in the penis are treated with extracorporeal shock waves. In a pilot study , shock waves were delivered to the nonerect penis once a week for a period of five weeks. 18 months after the last shock wave session, the deviation angle had decreased from 59.3° ± 38.1° to 49.3° ± 32.5° (N = 24; P = 0.1496). Pain during erection disappeared in 15 of 17 patients and was reduced in one other patient (P < 0.0001). After shock wave treatment,
15 patients achieved satisfactory sexual intercourse (before treatment: six patients). In 2009, a clinical trial with 100 patients concluded that ESWT leads to resolution of pain and improves both erectile function and quality of life. At 12-week follow-up, mean VAS score, mean IIEF-5 score, and mean QoL score improved significantly in patients receiving shock wave therapy. After 24 weeks, mean IIEF-5 score and mean QoL score were stable in the shock wave group, while the mean VAS score decreased even further. »Interestingly, after 24 wk, mean plaque size and mean curvature degree were significantly higher in the placebo group when compared with both baseline and ESWT values«. The authors of a systematic review published in 2017 also came to the conclusion that ESWT may resolve pain in patients with IPP/Peyronie’s disease.