Gallo L, Sarnacchiaro P
Gallo Uro-Andrology Centre, Nápoles, Italia.
Gallo Uro-Andrology Centre, Nápoles, Italia.
Actas Urol Esp (Engl Ed). 2019 May;43(4):182-189. doi: 10.1016/j.acuro.2018.08.005. Epub 2019 Jan 28.
To present our experience with multimodal therapy for Peyronie's disease.
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.
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).
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.
介绍我们在佩罗尼氏病多模式治疗方面的经验。
收集2008年至2017年的回顾性数据。在基线和治疗后评估以下特征:年龄、病程、勃起功能、阴茎勃起弯曲度和阴茎拉伸长度。所有患者均接受相同方案治疗,包括:12次病灶内维拉帕米注射、口服治疗(OT)(L-精氨酸2克单次服用,己酮可可碱400毫克每日3次,共6个月)以及阴茎牵引治疗。评估多模式治疗三个组成部分各自的依从性。
共纳入177例患者。根据依从性等级,我们的调查分为3组。第1组:仅完成口服治疗的患者;第2组:完成口服治疗和病灶内维拉帕米注射的男性;第3组:完成整个方案的患者。分别有76例、45例和56例男性被分配到第1组、第2组和第3组。第1组、第2组和第3组诊断时的平均年龄分别为59±8.4岁、59.1±5.9岁和54.2±4.8岁,而病程的平均时长分别为6.3±3.4个月、4.8±2.9个月和3.9±3.1个月。第1组治疗前后阴茎勃起弯曲度分别为24.2±9°和23.7±8.9°(P<0.36);第2组为25.4±16.8°和24.1±13.6°(P<0.34),第3组为34.3±17.9°和26.1±17.2°(P<0.001)。
单独口服治疗成功阻止了疾病进展。口服治疗加病灶内维拉帕米注射仅带来轻微改善。完整方案显著降低了阴茎勃起弯曲度并改善了勃起功能。