Treatment of Peyronie's disease with intralesional verapamil injection

In a previous study, 83% of 14 patients noted that their symptoms of Peyronie's disease had arrested or improved after intralesional injection of verapamil. This nonrandomized, prospective study further investigates the use of verapamil in a larger, thoroughly characterized patient population.

Forty-six men began treatment; 38 completed the study. Using a multiple puncture technique, 10 mg. of verapamil diluted to 10 cc were distributed throughout the plaque every 2 weeks for a total of 12 injections. Response to treatment was evaluated through subjective and objective measurements of pain, plaque size, deformity, duration of disease and sexual function, and with the Kelami classification system based on plaque size and curvature.

Pain resolved in 97% of the patients who presented with pain after a mean of 2.5 injections. After therapy, 76% reported a subjective decrease in curvature, 9.5% noted an increase and 14.5% remained unchanged. Of the treated patients 72% reported an improvement in the ability to engage in coitus. Objective measurements demonstrated that curvature was decreased in 54% of the patients, increased in 11% and remained unchanged in 34%. There were no substantial differences in response to treatment based on duration of disease or within the 3 Kelami classification groups. Other than transient post-injection ecchymosis, there were no significant acute or chronic side effects.

Verapamil injection therapy resulted in a reduction of pain in 97% of the patients, an improvement in sexual function in 72%, a reduction of deformity in 86%, an improvement in distal rigidity in 93% and an objective reduction of curvature in 54%. Further studies are required to determine the effectiveness of this nontoxic, inexpensive, nonsurgical approach to Peyronie's disease.