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 .
The use of intralesional clostridial collagenase injection therapy for Peyronie's disease: a prospective, single-center, non-placebo-controlled study.
INTRODUCTION Peyronie 's disease afflicts at least 3 % of sexually active men over the age of 30 . Many pharmacologic therapies have been tried , but to date , no systemic or local therapy has been proven to provide predictable and lasting results . AIM This study was design ed to assess the efficacy and safety of intralesional clostridial collagenase injection therapy in a series of patients with Peyronie 's disease . METHODS Twenty-five patients aged 21 - 75 years who were referred to a single institution with a well-defined Peyronie 's disease plaque were treated with three intralesional injections of clostridial collagenase 10,000 units in a small volume ( 0.25 cm(3 ) per injection ) administered over 7 - 10 days , with a repeat treatment ( i.e. , three injections of collagenase 10,000 units/25 cm(3 ) injection over 7 - 10 days ) at 3 months . Primary efficacy measures were changes from baseline in the deviation angle and plaque size . Secondary efficacy end points were patient responses to a Peyronie 's disease question naire and improvement according to the investigators ' global evaluation of change . MAIN OUTCOME MEASURE The primary efficacy measures were change in deviation angle and change in plaque size . Secondary end points were patient question naire responses and improvement according to the investigators ' global evaluation of change . RESULTS Significant decreases from baseline were achieved in the mean deviation angle at months 3 ( P = 0.0001 ) and 6 ( P = 0.0012 ) , plaque width at months 3 ( P = 0.0052 ) , 6 ( P = 0.0239 ) , and 9 ( P = 0.0484 ) , and plaque length at months 3 ( P = 0.0018 ) and 6 ( P = 0.0483 ) . More than 50 % of patients in this series considered themselves " very much improved " or " much improved " at all time points in the study , and the drug was generally well tolerated . CONCLUSION The benefits of intralesional clostridial collagenase injections in this trial lend support to prior studies supporting its use in the management of Peyronie 's disease . A double-blind , placebo-controlled study is currently under development
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 .