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Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie's disease.

Abstract

Introduction. There is no current consensus as to the most effective non-surgical therapy for Peyronie's disease (PD).
Aim. To assess the benefit of penile traction therapy (PTT) when added to intralesional verapamil injections (IVI) combined with oral L-arginine 1g bid and pentoxifylline 400 mg tid in men with PD.Methods. 74 men with PD completed 12 IVI. Patients electing to add PTT were advised to wear the device for 2-8 hours daily, and no longer than 2 hours per session. Subjective responses were measured using patient questionnaires. Stretched penile length (SPL) and erect penile curvature (EPC) using penile duplex ultrasound (DU) were measured. Response to therapy was defined as at least a 10 degree reduction in EPC.Main Outcome Measures. Change in SPL (cm), change in EPC (degrees).
Results. 39 patients in the PTT group (I) vs. 35 patients in group (II) completed the protocol. 54% of men in group I responded to therapy vs. 46% in group II (p = 0.75). Responders had a mean EPC improvement of 26.9 degrees in group I vs. 20.9 in group II (p = 0.22). Mean PTT use was 3.3 hours per day, and men with >3 hours per day use gained 0.6 cm in SPL vs 0.07 cm using less than or equal to 3 hours per day (p= 0.09), while men in group I on lost 0.74 cm of SPL on average. Multivariate analysis revealed that duration of PTT use significantly predicts length gain (0.38 cm gain for every additional hour per day of PTT use, p = 0.007).
Conclusion. There was a trend toward measured curvature improvement, and a significant gain in SPL in men using the combination therapy protocol. Length improvement is related to duration of use of the traction device [corrected].

Links

  • Publisher Full Text

    • Authors

    Abern MR, Larsen S, Levine LA

    Institution

    Department of Urology, Rush University Medical Center, Chicago, IL 60612, USA.

    Source

    The journal of sexual medicine 9:1 2012 Jan pg 288-95

    MeSH

    Administration, Oral
    Age Factors
    Combined Modality Therapy
    Humans
    Injections, Intralesional
    Male
    Middle Aged
    Patient Satisfaction
    Penile Induration
    Questionnaires
    Traction
    Treatment Outcome
    Vasodilator Agents
    Verapamil

    Pub Type(s)

    Clinical Trial
    Journal Article

    Language

    eng

    PubMed ID

    22024053