Intralesional Injections for Early Peyronie Disease: Standardized Assessment and Analysis of Predictive Factors for Treatment Response.

Abstract

OBJECTIVE:

To assess the outcomes of a new protocol of intralesional injections of verapamil (ILIV) to treat Peyronie disease (PD) and to look for predictors of response.

METHODS:

Patients followed up for PD in our center were prospectively enrolled between 2007 and 2013. The following data were collected: age, degree of curvature of the penis, Lue score (severity score of PD [0-15]), and pain (analogic Likert scale: 0-5). The protocol consisted of 1 verapamil injection per session (15 mg in 6 mL) in the main plaque using a single-puncture approach. Injections were repeated once every 3 weeks, at least 6 times.

RESULTS:

Sixty men were included. Mean number of injections per patient was 12.6 (±8.9). Average Lue scores before and after ILIV were 9.4 (±2) and 4.5 (±2; P = .05), respectively. Average penile curvatures during erection before and after ILIV were 37.3° (±13.3) and 21° (±13), respectively (P = .02). There were no serious side effects. At the end of follow-up, 47 patients (78%) considered themselves globally improved. Younger age was the only predictor of response to ILIV in univariate (odds ratio = 0.91; P = .04) and multivariate analyses (odds ratio = 0.87; P = .03).

CONCLUSION:

ILIV had a favorable impact reducing PD in 78% of patients with minimal side effects. Most patients required at least 12 injections to obtain optimal improvement. A protocol consisting of repeated courses of 6 injections using a single-puncture approach appears a valid option. Younger age was the only predictor of success.

• Authors: Benoit Wolff, Benoit Peyronnet, Susanna Cattarino, Pierre Mozer, Raphaële Renard-Penna, Véronique Phé, Marc-Olivier Bitker, Morgan Rouprêt
• Journal: Urology (Urology) Vol. 86 Issue 1 Pg. 57-61 (Jul 2015) ISSN: 1527-9995 [Electronic] United States
• PMID: 26142583 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Vasodilator Agents
• Verapamil

Topics

• Dose-Response Relationship, Drug
• Early Diagnosis
• Humans
• Injections, Intralesional
• Male
• Middle Aged
• Penile Induration (diagnosis, drug therapy)
• Prognosis
• Retrospective Studies
• Treatment Outcome
• Vasodilator Agents (administration & dosage)
• Verapamil (administration & dosage)