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Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie's disease. The journal of sexual medicine [J Sex Med] Journal article

TitleCombination of penile traction, intralesional verapamil, and oral therapies for Peyronie's disease.
Author(s)Abern MR, Larsen S, Levine LA 
InstitutionDepartment of Urology, Rush University Medical Center, Chicago, IL 60612, USA.
SourceJ Sex Med 2012 Jan; 9(1):288-95.
MeSHAdministration, Oral
Age Factors
Combined Modality Therapy
Humans
Injections, Intralesional
Male
Middle Aged
Patient Satisfaction
Penile Induration
Questionnaires
Traction
Treatment Outcome
Vasodilator Agents
Verapamil
AbstractIntroduction. 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].
Languageeng
Pub Type(s)Clinical Trial
Journal Article
PubMed ID22024053