Intralesional hyaluronic acid: an innovative treatment for Peyronie’s disease
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The significantly different effects of several conservative treatments for Peyronie’s disease (PD) led us to conduct this study to evaluate the effectiveness of local treatment with injectable hyaluronic acid (HA) for patients with this disease.
Materials and methods
The study included 83 PD patients who underwent treatment and 81 PD patients who did not (control group). The inclusion criteria were: penile plaque volume <1 cm3; clinical characteristics and ultrasonographic appearance compatible with active inflammation; and penile curvature <45°. The medical history of all PD patients was collected. Patients undertook six tests: routine laboratory tests; penile auto-photography during erection; dynamic penile colour-duplex ultrasound study; penile X-ray (mammography technique); index of erectile function questionnaire (IIEF); and pain intensity questionnaire (visual analog scale). Treated patients received thirty penile infiltrations by injection of 20 mg HA in 6 months. Follow-up checks were conducted at the end of treatment and 12 and 24 months after treatment.
At 12-month follow-up all treated PD patients had experienced three statistically significant outcomes: reduction in plaque size (−93.7 %, p < 0.0001); improvement in penile curvature (−9.01°, p < 0.0001); and improvement in penile rigidity (mean IIEF score +3.8) with an average increase of 21.1 % (p < 0.0001). Furthermore, the improvements remained substantially stable at 24-month follow-up.
Considering the minimally invasive approach in this study, the absence of major side effects, and the significant treatment outcomes achieved, we conclude that intralesional penile injections with HA are effective for treating Peyronie’s disease.
KeywordsPeyronie’s disease Hyaluronic acid Penile curvature
Specific contributions of the Authors
Gennaro Romano: recruitment and treatment of patients, paper writing, research design, and acquisition and analysis of the data. Davide Barletta: recruitment and treatment of patients, research design, and acquisition and analysis of the data. Gianni Paulis: paper revision, interpretation of data, and statistical analysis.
Compliance with ethical standards
Disclosure of potential conflicts of interest
Author Gennaro Romano declares that he has no conflict of interest. Author Davide Barletta declares that he has no conflict of interest. Author Gianni Paulis declares that he has no conflict of interest.
Research involving human participants: Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments, or comparable ethical standards. Specifically, the approval of the Institutional (LILT) Ethics Committee was obtained.
Informed consent was obtained from all individual participants included in the study.
- 1.La Peyronie F (1743) Sur quelques obstacles qui sópposent à l’éjaculation naturelle de la semence. Mem Acad Royale Chir 1:425–439Google Scholar
- 4.Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou XA (2011) Population-based study of Peyronie’s Disease: prevalence and treatment patterns in the United States. Adv Urol. Article ID 282503. Published online 2011. doi: 10.1155/2011/282503. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202120/pdf/AU2011-282503.pdf
- 18.Gelbard M, Goldstein I, Hellstrom WJ, McMahon CG, Smith T, Tursi J et al (2013) Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol 190(1):199–207CrossRefPubMedGoogle Scholar
- 24.Andresen R, Wegner HE, Miller K, Banzer D (1998) Imaging modalities in Peyronie’s disease. An intrapersonal comparison of ultrasound sonography, X-ray in mammography technique, computerized tomography, and nuclear magnetic resonance in 20 patients. Eur Urol 34(2):128–134 (discussion 135) CrossRefPubMedGoogle Scholar