Allameh Farzad, Razzaghi Mohammadreza, Rayegani Seyed Mansoor, Fallah-Karkan Morteza, Ranjbar Arash, Rahavian Amirhosein, Javadi Atefeh, Ghiasy Saleh, Razzaghi Zahra
Center of Excellence in Training Laser Application in Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Lasers Med Sci. 2019 Fall;10(Suppl 1):S37-S42. doi: 10.15171/jlms.2019.S7. Epub 2019 Dec 1.
The management of Peyronie's disease (PD) has remained a therapeutic dilemma for physicians and there is no gold standard treatment. In this paper, we decided to investigate the beneficial effect of the intralesional administration of verapamil compared with the intralesional administration of verapamil plus a low-intensity laser (LIL). Research was activated from May 2016 to May 2018 and a total of 38 men aged 18 years and older completed the investigation. The subjects were randomly divided into 2 groups. Group 1 was composed of 22 patients that were treated only by verapamil (5 mg) plus a sham laser weekly for 6 weeks, and group 2 consisted of 22 patients that received a laser, using the BTL-6000 HIGH-INTENSITY LASER 12 W machine and the same protocol of intralesional verapamil injection. The visual analogue scale (VAS) was used to evaluate pain during an erection, penile ultrasonography was used to measure plaque size, the penile curvature angle degree was measured using the photographs taken during an erection, and the International Index of Erectile Function questionnaire was used to assess erectile function. The follow-up treatment lasted for nine months, with visits performed in the 3rd and 9th months. All study parameters decreased significantly after treatment in both arms, but the reduction in pain and penile curvature improvements in combination therapy revealed more significant changes in 3 months (p = .035, p=.032). Nevertheless, these improvements were not seen in the follow-up session after 9 months. A laser appears to be safe treatment modality in carefully-selected patients with PD. It has moderate efficacy in the short term.
佩罗尼氏病（PD）的治疗一直是医生面临的治疗难题，且尚无金标准治疗方法。在本文中，我们决定研究维拉帕米病灶内注射与维拉帕米联合低强度激光（LIL）病灶内注射相比的有益效果。研究于2016年5月至2018年5月开展，共有38名18岁及以上男性完成了调查。受试者被随机分为2组。第1组由22名患者组成，他们仅接受维拉帕米（5毫克）加每周一次的假激光治疗，共6周；第2组由22名患者组成，他们使用BTL - 6000高强度激光12瓦机器，并采用相同的病灶内维拉帕米注射方案接受激光治疗。采用视觉模拟量表（VAS）评估勃起时的疼痛，阴茎超声检查测量斑块大小，使用勃起时拍摄的照片测量阴茎弯曲角度，并用国际勃起功能指数问卷评估勃起功能。后续治疗持续9个月，在第3个月和第9个月进行随访。两组治疗后所有研究参数均显著下降，但联合治疗在3个月时疼痛减轻和阴茎弯曲改善方面显示出更显著的变化（p = 0.035，p = 0.032）。然而，在9个月后的随访中未观察到这些改善。对于精心挑选的佩罗尼氏病患者，激光似乎是一种安全的治疗方式。它在短期内具有中等疗效。
