This method ological choice confers to the results a strong clinical relevance as PC has been reported to be one of the major determinants of bother and psychological distress in PD patients [ 2 ] .
Initially , the results in terms of PC were disappointing , probably due to the inadequate dosage and regimen of the drug , or simply because of wrong
In this month 's issue of European Urology , Russo et al. [ 1 ] published the results of a systematic review of the literature about the efficacy of injection therapies , vacuum devices , and penile traction in patients with Peyronie 's disease ( PD ) .
Historically , oral and intralesional therapies have represented the initial conservative option with surgery being considered the definitive gold st and ard therapy in stable disease .
More recently , recommended treatment algorithms have significantly shifted due to the introduction of potential new first-line options .
In this scenario , oral treatments have become less commonly prescribed due to inconsistent or negative outcome data , and intralesional therapies have gained growing interest .
Clinical Efficacy of Injection and Mechanical Therapy for Peyronie's Disease: A Systematic Review of the Literature.
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 . EVIDENCE ACQUISITION An extensive search of Medline , Embase , and Scopus data bases retrieved English- language articles up to 15 May 2018 . The systematic review protocol was registered on PROSPERO ( CRD42017077050 ) . Inclusion criteria were as follows : adults with early or chronic PD receiving treatment with injection therapy , penile traction , or a vacuum device .  EVIDENCE SYNTHESIS Fifty-two articles were selected according to the inclusion criteria -17 comparative studies and 35 cohort studies -analysing the effects of calcium channel blockers ( verapamil , nicardipine ) , collagenase Clostridium histolyticum ( CCH ) , interferon α-2b ( IFNα-2b ) , hyaluronic acid ( HA ) , onabotulinum toxin A , thiocolchicine , penile extender devices , and vacuum devices . 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
This method ological choice confers to the results a strong clinical relevance as PC has been reported to be one of the major determinants of bother and psychological distress in PD patients [ 2 ] .
Initially , the results in terms of PC were disappointing , probably due to the inadequate dosage and regimen of the drug , or simply because of wrong
In this month 's issue of European Urology , Russo et al. [ 1 ] published the results of a systematic review of the literature about the efficacy of injection therapies , vacuum devices , and penile traction in patients with Peyronie 's disease ( PD ) .
Historically , oral and intralesional therapies have represented the initial conservative option with surgery being considered the definitive gold st and ard therapy in stable disease .
More recently , recommended treatment algorithms have significantly shifted due to the introduction of potential new first-line options .
In this scenario , oral treatments have become less commonly prescribed due to inconsistent or negative outcome data , and intralesional therapies have gained growing interest .