ABSTRACT
Objetivos: Presentar nuestra experiencia con la terapia multimodal para la enfermedad de Peyronie. Métodos: Los datos retrospectivos se recopilaron entre 2008 y 2017. Las siguientes características fueron evaluadas al inicio y al final del tratamiento: edad, duración de la enfermedad, función eréctil, curvatura del pene erecto y longitud del pene flácido. Todos los pacientes fueron tratados bajo el siguiente protocolo: 12 inyecciones intralesionales de verapamilo, terapia oral (TO) ?L-arginina 2g una vez al día y pentoxifilina 400 mg 3 veces al día durante 6 meses? y terapia de tracción del pene. Se evaluó la adherencia de los pacientes a cada uno de los 3 componentes del tratamiento multimodal. Resultados: Fueron evaluados 177 pacientes. Nuestro estudio se dividió en 3 grupos, de acuerdo con el grado de adherencia al tratamiento. Grupo 1: pacientes que solo completaron TO; grupo 2: pacientes que completaron el tratamiento con TO e inyecciones intralesionales de verapamilo; grupo 3: pacientes que llevaron a cabo todo el protocolo. Setenta y seis, 45 y 56 hombres fueron asignados a los grupos 1, 2 y 3, respectivamente. La media de edad al realizar el diagnóstico fue de de 59±8,4, 59,1 ± 5,9 y 54,2 ± 4,8 años, mientras que la duración media de la enfermedad fue de 6,3 ± 3,4, 4,8 ± 2,9 y 3,9 ± 3,1 meses en los grupos 1, 2 y 3. La curvatura del pene erecto pre y postratamiento fue de 24,2 ± 9 y 23,7 ± 8,9° en el grupo 1 (p < 0,36); de 25,4 ± 16,8 y 24,1 ± 13,6° en el grupo 2 (p < 0,34), y de 34,3 ± 17,9 y 26,1 ± 17, 2° en el grupo 3 (p < 0,001). Conclusiones: La TO en exclusiva bloqueó la progresión de la enfermedad. La combinación de inyecciones intralesionales de verapamilo + TO demostró mejoras leves. El protocolo completo redujo significativamente la curvatura del pene erecto y mejoró la función eréctil
Objectives: To present our experience with multimodal therapy for Peyronie's disease. Methods: Retrospective data were collected since 2008 to 2017. The following features were evaluated at baseline and after treatment: age, duration of disease, erectile function, erected penile curvature, and stretched penile length. All patients were offered the same protocol including: 12 intralesional verapamil injections, oral therapy (OT) ?L-arginine 2 g once and pentoxifylline 400mg 3 times a day for 6 months?, and penile traction therapy. The adherence to each of the 3 components of multimodal treatment was evaluated. Results: One hundred and seventy-seven individuals were considered. Depending on the grade of adherence our survey was divided into 3 groups. Group 1: patients who only completed OT; group 2: men who accomplished OT and intralesional verapamil injections; group 3: patients who completed the entire protocol. Seventy-six, 45 and 56 men were assigned to group 1, 2 and 3 respectively. The mean age at the diagnosis was 59 ± 8.4, 59.1 ± 5.9 and 54.2 ± 4.8 years, while the mean duration of the disease was 6.3 ± 3.4, 4.8 ± 2.9 and 3.9±3.1 months in group 1, 2 and 3. The erected penile curvature before and after treatment was 24.2±9 and 23.7 ± 8.9° in group 1 (P < .36); 25.4 ± 16.8 and 24.1 ± 13.6° in group 2 (P < .34), and 34.3 ± 17.9 and 26.1±17.2° in group 3 (P < .001). Conclusions: OT alone was successful to block the progression of the disease. The add of intralesional verapamil injections to OT brought only mild improvements. The complete protocol significantly reduced erected penile curvature and improved erectile function
Subject(s)
Humans , Male , Middle Aged , Penile Induration/drug therapy , Combined Modality Therapy , Pentoxifylline/therapeutic use , Treatment Adherence and Compliance , Penile Induration/pathology , Retrospective Studies , Penile Induration/therapyABSTRACT
OBJECTIVES: To present our experience with multimodal therapy for Peyronie's disease. METHODS: Retrospective data were collected since 2008 to 2017. The following features were evaluated at baseline and after treatment: age, duration of disease, erectile function, erected penile curvature, and stretched penile length. All patients were offered the same protocol including: 12 intralesional verapamil injections, oral therapy (OT) ?L-arginine 2g once and pentoxifylline 400mg 3 times a day for 6 months?, and penile traction therapy. The adherence to each of the 3 components of multimodal treatment was evaluated. RESULTS: One hundred and seventy-seven individuals were considered. Depending on the grade of adherence our survey was divided into 3 groups. Group 1: patients who only completed OT; group 2: men who accomplished OT and intralesional verapamil injections; group 3: patients who completed the entire protocol. Seventy-six, 45 and 56 men were assigned to group 1, 2 and 3 respectively. The mean age at the diagnosis was 59±8.4, 59.1±5.9 and 54.2±4.8 years, while the mean duration of the disease was 6.3±3.4, 4.8±2.9 and 3.9±3.1 months in group 1, 2 and 3. The erected penile curvature before and after treatment was 24.2±9 and 23.7±8.9° in group 1 (P<.36); 25.4±16.8 and 24.1±13.6° in group 2 (P<.34), and 34.3±17.9 and 26.1±17.2° in group 3 (P<.001). CONCLUSIONS: OT alone was successful to block the progression of the disease. The add of intralesional verapamil injections to OT brought only mild improvements. The complete protocol significantly reduced erected penile curvature and improved erectile function.
