Ten-year experience with multimodal treatment for acute phase Peyronie's disease: A real life clinical report

Objectives: To present our experience with multimodal therapy for Peyronie's disease. Methods: Retrospective data were collected since 2008 to 2017. The following features were evaluated at baseline and after treatment: age, duration of disease, erectile function, erected penile curvature, and stretched penile length. All patients were offered the same protocol including: 12 intralesional verapamil injections, oral therapy (0T) ?L-arginine 2 g once and pentoxifylline 400 mg 3 times a day for 6 months?, and penile traction therapy. The adherence to each of the 3 components of multimodal treatment was evaluated. Results: One hundred and seventy-seven individuals were considered. Depending on the grade of adherence our survey was divided into 3 groups. Group 1: patients who only completed OT; group 2: men who accomplished OT and intralesional verapamil injections; group 3: patients who completed the entire protocol. Seventy-six, 45 and 56 men were assigned to group 1, 2 and 3 respectively. The mean age at the diagnosis was 59 +/- 8.4, 59.1 +/- 5.9 and 54.2 +/- 4.8 years, while the mean duration of the disease was 6.3 +/- 3.4, 4.8 +/- 2.9 and 3.9 +/- 3.1 months in group 1, 2 and 3. The erected penile curvature before and after treatment was 24.2 +/- 9 and 23.7 +/- 8.9 in group 1 (P<.36); 25.4 +/- 16.8 and 24.1 +/- 13.6 in group 2 (P<.34), and 34.3 +/- 17.9 and 26.1 +/- 17.2 in group 3 (P <.001). Conclusions: OT alone was successful to block the progression of the disease. The add of intralesional verapamil injections to OT brought only mild improvements. The complete protocol significantly reduced erected penile curvature and improved erectile function. (C) 2018 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.