Cabello Benavente R, Moncada Iribarren I, de Palacio España A, Hernández Villaverde A, Monzó J I, Hernández Fernández C
Hospital General Universitario Gregorio Marañón. Madrid.
Actas Urol Esp. 2005 Nov-Dec;29(10):955-60. doi: 10.1016/s0210-4806(05)73376-3.
To evaluate the effects of transdermal iontophoresis with verapamil and dexamethasone in patients with Peyronie's disease of less than one year of evolution.
We have treated ten patients twice a week during six consecutive weeks using iontophoresis with a Miniphysionizer dispositive. This device generates a 2mA electric current during 20 min which triggers the transdermal penetration of medication. In every session dexamethasone 8 mg and verapamil 5mg were administered inside a small self-adhesive receptacle on the penile skin overlying the fibrosis plaque. To evaluate the efficacy, penile curvature was measured by Kelami's test, while the plaque size was assessed by penile ultrasound. Other parameters like pain, erectile function and ability for vaginal intercourse were recorded using questionnaires. Safety parameters were also assessed during treatment.
No improvement or progression in penile curvature was evidenced in any of the patients. The hardness of the plaque was reduced in 5 patients, becoming impalpable in 2 of them. Decrease in plaque volume was observed by penile ultrasound in 6. Pain improved in 8 patients, disappearing in 6 of them. One patient recovered his erectile function at the end of the treatment; whereas 3 referred that their ability for intercourse enhanced while 2 reported that treatment improved their sexual life in general. We didn't record any significantly side effects, except for a transitory and slight dermal redness on the site of electrode placement.
Transdermal iontophoresis is an effective treatment for pain control in early stages of Peyronie's disease. Efficacy in reducing penile curvature seems to be limited. Controlled clinical trials are needed, and perhaps reviewing indications in order to obtain more relevant clinical effects.
评估维拉帕米和地塞米松经皮离子导入疗法对病程少于一年的佩罗尼氏病患者的疗效。
我们使用Miniphysionizer设备，连续六周每周两次对10名患者进行离子导入治疗。该设备在20分钟内产生2毫安电流，促使药物经皮渗透。每次治疗时，将8毫克地塞米松和5毫克维拉帕米置于覆盖纤维化斑块的阴茎皮肤上的一个小自粘容器内。为评估疗效，通过凯拉米试验测量阴茎弯曲度，同时通过阴茎超声评估斑块大小。使用问卷记录疼痛、勃起功能和阴道性交能力等其他参数。治疗期间还评估了安全性参数。
所有患者的阴茎弯曲度均未改善或进展。5名患者的斑块硬度降低，其中2名患者的斑块变得触诊不到。阴茎超声显示6名患者的斑块体积减小。8名患者的疼痛有所改善，其中6名患者的疼痛消失。1名患者在治疗结束时恢复了勃起功能；3名患者表示性交能力增强，2名患者称治疗总体上改善了他们的性生活。除电极放置部位出现短暂轻微皮肤发红外，未记录到任何明显的副作用。
经皮离子导入疗法是佩罗尼氏病早期控制疼痛的有效治疗方法。在减少阴茎弯曲度方面的疗效似乎有限。需要进行对照临床试验，或许还需审查适应症以获得更相关的临床效果。
