Edited by JP Saleeby, MD
Dupuytren’s contracture (also called Dupuytren’s disease) is an abnormal thickening of the skin in the palm of the hand at the base of the fingers. This thickened area may develop into a hard lump or thick band. Over time, it can cause one or more fingers to curl (contract) or pull sideways or in toward the palm.
Peyronie’s disease is a connective tissue disorder of the penis that can be likened to Dupuytren’s contracture of the hand. It is characterized by the triad of bent erections, pain in the penis with erections and palpable penile plaque.
Peyronie’s disease (PD) is a localized, connective tissue disorder characterized by the formation of fibrous tissue plaques within the tunica albuginea of the penis, causing a penile deformity, and a subsequent degree of erectile dysfunction and penile pain. Although its etiology has not been fully elucidated, PD probably results from the presence of a predisposing genetic susceptibility combined with a trauma to the erect penis. PD appears to be more common in northern European Caucasians, its uncommon in African American men and very rare in Asians. Diabetes mellitus also seem to be a potential risk factor for PD.
The true prevalence rate of Peyronie’s disease (PD) may be even higher than that of Dupuytren’s disease (DD) because men are likely to underreport a condition that causes embarrassment. PD is not readily observed (unless you are in a nudist colony) however, DD can be seen quite readily.
The association between PD and DD was first recognized in 1828 and reported by Abernathy in a medical book. According to the literature there is a 3–15% chance that a man with DD will have PD. DD is a fibro-proliferative condition of the palmar fascias in the hand, typically resulting in progressive contracture of one or more fingers. DD is thought to be the most common hereditary connective tissue disorder in Caucasians. The prevalence of DD in different geographical locations is extremely variable (0.2–56%), and it is not fully clear whether this is genetic, environmental or a combination of both.
XIAFLEX® (collagenase clostridium histolyticum) is the only nonsurgical treatment option for appropriate adult men with Peyronie’s disease approved by the Food and Drug Administration (FDA). However, it is moderately invasive requiring injections into the penis which are quite painful and this therapy is very expensive. Of course, surgical interventions are available for both DD and PD but are extremely painful, requiring long recovery periods, moderately successful and very expensive.
Acoustic Wave Therapy (Soft Wave OrthoGold100 tissue regeneration technologies device manufactured by MTS Europe GMBH, Germany) also known as extracorporeal shock wave therapy (ESWT) works well on both DD and PD. It takes time depending on severity. In treating DD a therapy plan would use at least 1000 pulses per session, level 10 or higher unless too painful, then intensity is reduced. The therapist would treat the DD afflicted hand on all the raised areas, as well as any other affected tissue including the carpal tunnel portion of wrist. Twice weekly first few weeks if possible, transitioning to weekly treatments until good results are seen. It often takes at least 12 weeks to see good results. Honestly, about 60% will achieve very good results, 20% of treated will yield poor or no results. If DD is painful, it always seems to help with reducing pain. The more severe the case the harder to get a good result. It is the same pathology as Peyronie’s disease (PD). We ask patient about Peyronie’s as many with Dupuytren’s also have Peyronie’s.
The Acoustic Wave Therapy (Soft Wave by Apollo Wave) is truly a breakthrough treatment for men with Peyronie’s disease and Dupuytren’s disease of all severities. It is a painless, non-surgical, non-pharmacological treatment that can restore normal function, and bring back the fun and spontaneity in one’s relationship. For more information on the treatment of DD and PD visit www.Apollo-Wave.com or www.CarolinaHolisticMedicine.com and speak with Tim Blanc or Dr. JP Saleeby.
References:
Nugteren, H., Nijman, J., de Jong, I. et al. The association between Peyronie’s and Dupuytren’s disease. Int J Impot Res 23, 142–145 (2011). https://doi.org/10.1038/ijir.2011.18
Abernethy J . The Consequences of Gonorrhea. Lecture on Anatomy, Surgery and Pathology: Including Observations on the Nature and Treatment of Local Diseases, Delivered at St Bartholomew’s and Christ’s Hospitals. 1st edn. James Balcock: London (England), 1828 pp. 205.
Knobloch K, Kuehn M, Vogt PM. Focused extracorporeal shockwave therapy in Dupuytren’s disease–a hypothesis. Med Hypotheses. 2011 May;76(5):635-7.
Aykut S, Aydın C, Öztürk K, Arslanoğlu F, Kılınç CY. Extracorporeal Shock Wave Therapy in Dupuytren’s Disease. Sisli Etfal Hastan Tip Bul. 2018 May 21;52(2):124-128.
Sound wave therapy for Peyronie’s disease. Academic Urology & Urogynecology of Arizona. (n.d.). Retrieved January 30, 2022, from http://www.academic-urology.com/soundwave-peyronies-disease.html
