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 .
Intralesional Injection of Hyaluronic Acid in Patients Affected With Peyronie's Disease: Preliminary Results From a Prospective, Multicenter, Pilot Study
Introduction Hyaluronic acid has been shown to be efficacious in decreasing scar formation , inflammation , and oxidative stress . Aim To assess the efficacy of intralesional injection of hyaluronic acid in patients affected by Peyronie 's disease . Methods In this prospect i ve , single-arm , self-controlled , interventional , multicenter pilot study , 65 patients underwent a 10-week cycle of weekly intraplaque injections with hyaluronic acid ( 0.8 % highly purified sodium salt hyaluronic acid 16 mg/2 mL ; Sinovial , IBSA , Lodi , Italy ) . Patients were re-evaluated 2 months after the end of therapy . Main Outcome Measures Plaque size ( millimeters ) , penile curvature ( degrees ) , International Index of Erectile Function ( IIEF-5 ) score , visual analog scale ( VAS ) score for sexual satisfaction , and Patient 's Global Impressions of Improvement ( PGI-I ) score . Results Median age was 57 years ( range = 23–70 ) . At baseline , mean plaque size was 10 mm ( range = 3–30 mm ) , mean penile curvature was 30 ° ( range = 0 ° –50 ° ) , and mean IIEF-5 score was 20 ( range = 0–25 ) , with slight to moderate erectile dysfunction ( IIEF score < 21 ) in 36 of 65 patients ( 55 % ) . A median VAS score of 6 ( range = 2–10 ) was found . Mean follow-up was 12 months ( range = 6–24 months ) . Statistically significant post-treatment improvements were detected for plaque size ( before treatment = 10 mm [ 3–30 mm ] , after treatment = 8 mm [ 1–30 mm ] , P < .0001 ) , penile curvature ( before treatment = 30 ° [ 0 ° –50 ° ] , after treatment = 20 ° [ 0 ° –40 ° ] , P < .0001 ) , IIEF-5 score ( before treatment = 20 [ 11–25 ] , after treatment = 21 [ 15–25 ] , P < .0001 ) , and VAS score ( before treatment = 6 [ 2–10 ] , after treatment 8 [ 2–10 ] , P < .0001 ) . After treatment , the rate of patients with an IIEF score lower than 21 decreased from 55 % ( 36 patients ) to 40 % ( 25 patients ) . Overall improvement on the PGI-I question naire was 69 % . Conclusion Intralesional treatment with hyaluronic acid can improve plaque size , penile curvature , and overall sexual satisfaction and seems preferably indicated in the early ( active ) phase of the disease . Furthermore , it is easy to perform and well tolerated
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 .