Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
CONTEXT Conservative therapies for Peyronie 's disease ( PD ) aim to treat early-stage disease by improving clinical outcomes such as penile curvature , penile length erectile dysfunction , and pain .
OBJECTIVE To summarise the available evidence regarding injection and mechanical therapies for PD treatment .
Use of intralesional verapamil to dissolve Peyronie's disease plaque: a long-term single-blind study.
OBJECTIVES Multiple conservative therapies for the treatment of Peyronie 's disease have been offered with variable and poor response rates . Calcium channel blockers have been shown in vitro and in vivo to inhibit secretion and synthesis of extracellular matrix , including collagen , glycosaminoglycans , and fibronectin , as well as causing increased collagenase and anti transforming growth factor-beta activity . Calcium antagonists , including verapamil , are effective in stimulating the remodeling and degradation of extracellular matrix in tissue by altering the metabolic pathways of fibroblasts . Recently , a pilot study ( 1994 ) showed preliminary promising results in treating plaque caused by Peyronie 's disease . This r and omized single-blind placebo-based study ( 1994 to 1996 ) was undertaken to confirm the hypothesis . METHODS In this r and omized single-blind study , 14 patients completed the study and were divided into two groups : the verapamil treatment group ( n = 7 ) or the control saline group ( n = 7 ) . Verapamil or saline was injected directly into the Peyronie 's plaque once a week for 6 months . Patients were evaluated before and after treatment with duplex ultrasound to confirm the extent of the lesion and to measure volume of the plaque , and by interview and mailed question naire 3 months after treatment . Patients being treated with oral calcium antagonists were excluded from the study . RESULTS A decreased plaque volume was measured in 57 % of the verapamil-treated men versus 28 % in the control group ( P < 0.04 ) . Penile curvature demonstrated an improvement trend of 37.71 + /- 9.3 degrees to 29.57 + /- 7.3 degrees in the verapamil-treated patients , but the difference was not significant ( P < 0.07 ) . Plaque softening was noted in all patients treated with verapamil . There was significant objective improvement in plaque-associated penile narrowing in all patients in the verapamil group . Subjective plaque-associated erectile dysfunction ( quality of erection ) showed improvement in 42.87 % of the verapamil group versus none in the control group ( P < 0.02 ) . There was no local or systemic toxicity except for an occasional ecchymosis/bruise at the injection site . After a positive clinical response , plaque size , penile angulation , and symptoms continued to improve . Decrease in plaque size was noted in each of the responders in the first 3 months . CONCLUSIONS This r and omized single-blind study suggests that intralesional injection of calcium channel blocker may be a reasonable approach in some selected patients for the treatment of Peyronie 's disease with noncalcified plaque and penile angulation of less than 30 degrees . Patients whose plaque failed to respond to intralesional verapamil therapy within 3 months or whose angulation was greater than 30 degrees at presentation were more likely to benefit from surgery
Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
CONTEXT Conservative therapies for Peyronie 's disease ( PD ) aim to treat early-stage disease by improving clinical outcomes such as penile curvature , penile length erectile dysfunction , and pain .
OBJECTIVE To summarise the available evidence regarding injection and mechanical therapies for PD treatment .