Benoit Wolff1, Benoit Peyronnet1, Susanna Cattarino1, Pierre Mozer1, Raphaële Renard-Penna1, Véronique Phé1, Marc-Olivier Bitker1, Morgan Rouprêt2. 1. Hopital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Service d'Urologie, Paris, France; UPMC Univ Paris 06, GRC5, ONCOTYPE-Uro, Service d'Urologie, Institut Universitaire de Cancérologie, Paris, France. 2. Hopital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Service d'Urologie, Paris, France; UPMC Univ Paris 06, GRC5, ONCOTYPE-Uro, Service d'Urologie, Institut Universitaire de Cancérologie, Paris, France. Electronic address: mroupret@gmail.com.
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.
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: Maher Abdessater; William Akakpo; Anthony Kanbar; Jérome Parra; Thomas Seisen; Emmanuel Chartier-Kastler; Sarah J Drouin; Morgan Roupret Journal: Asian J Androl Date: 2022 Jan-Feb Impact factor: 3.285