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

Urology. 2015 Jul;86(1):57-61. doi: 10.1016/j.urology.2015.03.010.

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.

MeSH terms

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

Substances

  • Vasodilator Agents
  • Verapamil