Comparative study between intralesional verapamil and triamcinolone for the management of peyronie’s disease
Abstract
Background: Peyronie's disease (PD) is a wound healing disorder in which fibrotic plaque found in the tunica albuginea
of penis. It affects the men worldwide and may be associated with pain, erectile dysfunction and penile deformity
including shortening. The condition has significant debilitating effects on quality of life, self-esteem and psychological
wellbeing in addition to sexual function. Surgical results add further dissatisfaction with various aspects of outcomes.
Materials and Methods: Patients with symptomatic PD presented at outpatient department of a tertiary hospital from
January 2017 to December 2018 were included in the study. Details history and physical examination done. They were
purposively divided into two groups. Out of 62 patients, 30 patients enrolled in group A (Verapamil) and 32 patients in
group B (Triamcenolone). Results: Plaque size improvement was found 24(80.0%) in group A and 24(75.0%) in group B.
It was stable in 6(20.0%) of group A and 8(25.0%) of group B (p>0.05). Improvement of penile curvature was 22(73.33%)
in group A and 18(56.25%) in group B and stable in 8(26.67%) and 14(43.75%) respectively. Though the results was a bit
higher in group A than group B, but that was not statistically significant (p>0.05). Conclusion: both verapamil and
triamcinolone is effective in reducing the penile curvature and plaque size in PD when compared with baseline. When
compared among them, percentage of improvement was a bit high in Verapamil group.
Keywords
Early pregnancy Maternal weight
Pregnancy weight gain
Maternal outcome and fetal Outcome.
Introduction
Peyronie’s disease (PD) is characterized by a fibrous, inelastic lesion of the tunica albuginea, is estimated to affect approximately 3-9% of men worldwide and may be associated with pain, erectile dysfunction and penile deformity including shortening. It has significant debilitating effects on quality of life, self-esteem and psychological wellbeing in addition to sexual function. The pathophysiology of this disorder is poorly understood. Surgery results further dis-satisfaction with various aspects of outcomes'”. Multiple non-surgical treatment options are available. Oral therapy includes vitamin E, colchicine, carnitine, potassium amino benzoate, pentoxyfylline and omega 3 fatty acids. Intralesional therapy includes steroids, calcium channel blockers, interferon, collagenase clostridium histolyticum (CCh) and stem cell therapy.* The therapy for PD depends on the disease severity, patient preference and physician’s expertise. Each therapies has its own pros and cons. Numerous trials have been done to determine the significant benefits in treatment of PD. FDA approved intralesional therapy is CCh. This is very expensive medication with moderately efficacious for men with chronic phase rather than acute phase.*® No such study done with intralesional Verapamil and Triamcenolone for the management of PD in Khulna region, south-western part of the Bangladesh.