To compare the efficacy and safety of intralesional hyaluronic acid (HA) as compared with verapamil injection in patients with Peyronie's disease (PD).
Between January 2015 and December 2018, men in PD acute phase were prospectively recruited. This open-label, prospective study included 2 different protocols. Group A: 8-week cycle of weekly intraplaque injections with HA; Group B: 8-week cycle of weekly intraplaque injections with verapamil. Penile curvature, plaque size, International Index of Erectile Function (IIEF)-15 score and visual analogue scale (VAS) were assessed at baseline and after 3 months.
Two-hundred forty-four patients were enrolled. Of these, 125 received intralesional HA (Group A), 119 received intralesional verapamil (Group B). At enrollment, median age was 56.0 years (interquartile range [IQR]=47.0-63.0 years), median curvature 35.0° (IQR=25.0°-45.0°), median IIEF-15 score 19.0 (IQR=16.0-23.0), median VAS 4.0 (IQR=4.0-5.0). Median difference for IIEF-15 was 1.0 (95% confidence interval [CI]=1.12-1.94) in Group A and 0.0 (95% CI=-0.04-0.14) in Group B (p<0.05) and median difference for VAS score was -4.0 (95% CI=-4.11--3.65) in Group A and -1.0 (95% CI=-0.50-2.01) in Group B (p<0.05). Plaque size decreased by -1.50 mm (IQR=1.60-2.10 mm) in Group A and -1.20 in Group B (p=0.10), while penile curvature decreased by -9.50° (IQR=4.50°-13.00°) in group A and -4.50 (IQR=2.50-7.50) in Group B (p<0.01).
Intralesional HA injections could represent a reliable treatment option for the conservative management of patients with acute phase of PD.
The world journal of men's health. 2020 Jan 20 [Epub ahead of print]
Andrea Cocci, Fabrizio Di Maida, Gianmartin Cito, Pierangelo Verrienti, Nicola Laruccia, Riccardo Campi, Andrea Mari, Marina Di Mauro, Marco Falcone, Giovanni E Cacciamani, Giulio Garaffa, Andrea Minervini, Giorgio Ivan Russo
Department of Urology, Careggi Hospital, University of Florence, Florence, Italy., Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. ., Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy., Department of Urology, University of Turin, Turin, Italy., Department of Urology, University of Verona, Verona, Italy., The Institute of Urology, University College of London Hospital, London, UK.