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Peyronie’s Disease: Treatment Priorities May Guide Intralesional Injection Choice

Currently, four substances are used for intralesional injections: collagenase Clostridium histolyticum (CCH), hyaluronic acid, verapamil, and interferon α-2b. However, the effectiveness of these substances had not been compared using standardized assessment methods.

In the review paper, experts analyzed eight studies involving 1,050 men who had received intralesional injections for Peyronie’s disease. On average, the men’s ages ranged from 52 to 58 years. The research team focused on two outcomes – changes in penile curvature and erectile function – that took place between each study’s beginning and conclusion.

CCH and interferon α-2b appeared to be most effective for reducing penile curvature. But hyaluronic acid seemed to be best for erection problems. While the researchers did not specifically analyze side effects of each medication, they noted that a “low number” were reported.

Because of the ways the studies were designed, the researchers were unable to compare other treatment outcomes, such as pain, plaque size, and satisfaction with treatment. They recommended more clinical trials in this area.

“Urologists should discuss medical therapy with patients before surgical correction, as well as the target of improvement they expect to obtain,” the study authors wrote.

Note: Guidelines provided by the American Urological Association do not support the use of hyaluronic acid or verapamil for treatment of Peyronie’s disease. In addition, use of CCH and interferon α-2b is moderately recommended based on limited evidence.

Resources

The Journal of Sexual Medicine

Russo, Giorgio Ivan, MD, PhD, et al.

“Comparative Effectiveness of Intralesional Therapy for Peyronie’s Disease in Controlled Clinical Studies: A Systematic Review and Network Meta-Analysis”

(Full-text. Published online: January 25, 2019)

https://www.jsm.jsexmed.org/article/S1743-6095(18)31386-9/fulltext

Urology Care Foundation

“What is Peyronie’s Disease?”

https://www.urologyhealth.org/urologic-conditions/peyronies-disease

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