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

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 degrees (+/- 13.3) and 21 degrees (+/- 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. 2015. (C) 2015 Elsevier Inc.