Intralesional verapamil prevents the progression of Peyronie's disease

Objectives To define the impact of intralesional verapamil injection therapy on penile deformity in men with Peyronie's disease. Methods Patients underwent a total of 6 intralesional injections of verapamil. Penile deformity was assessed at baseline and 3 months after the last intralesional injection of verapamil during penile erection after the administration of intracavernosal medication. Measurement was recorded using a goniometer at maximum penile rigidity. Endpoints included change in magnitude of curvature, stretched penile length, penetration ability, and resolution of pain. Results Ninety-four consecutive patients met all inclusion criteria. Mean (+/- standard deviation) patient age and duration of Peyronie's disease at time of baseline deformity assessment were 44 +/- 18 years and 5.2 +/- 2.7 months, respectively. At baseline 86% had dorsal and 14% lateral curvature. The mean Curvature and stretched flaccid length were 50 degrees +/- 28 degrees and 12.6 +/- 3.1 cm, respectively. At the follow-up evaluation, patients were 5.2 +/- 1.8 months after their last ILV injection and were 11.7 +/- 4.2 months after the onset of Peyronie's disease. Eighteen percent of patients had improvement of curvature, 60% were unchanged, and 22% worsened. Pain resolved in 100% of patients. Conclusions In response to intralesional verapamil, a minority of men experienced improvement in penile deformity; however, the majority of patients had stabilization of their deformity. This information may permit clinicians to give realistic expectations to patients considering intralesional verapamil therapy.