Skip to main content
SpringerLink
Log in

Injection Therapy for Peyronie’s Disease

  • Chapter
  • First Online:
Contemporary Treatment of Erectile Dysfunction

Part of the book series: Contemporary Endocrinology ((COE))

  • 1048 Accesses

Abstract

Peyronie’s disease (PD) is an underdiagnosed condition that affects up to 9 % of the male population. Intralesional injection therapy (ILI) is one of many modalities in the treatment of PD. Corticosteroids were the first known employed ILI agent but is presently not recommended due to its unproven efficacy. ILI of verapamil, a calcium channel blocker, and interferon have displayed some promising results with regard to improvements in plaque size, penile curvature and erectile function. Their use for the treatment of PD, however, remains off-label. Based on the positive results of the IMPRESS 1 and 2 trials, ILI of collagenase clostridium histolyticum became the first FDA-approved drug for the treatment of PD in 2013. When combined with ILI, penile traction therapy may prevent PD-related loss of penile length, if used diligently. Finally, ILI of stem cells, while still in its infancy, offers hope for a more targeted treatment of the disease in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, et al. Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. J Urol. 2004;171(6):2350–3.

    Article  PubMed  Google Scholar 

  2. Schwarzer U, Sommer F, Klotz T, Braun M, Reifenrath B, Engelmann U. The prevalence of Peyronie’s disease: results of a large survey. BJU Int. 2001;88(7):727–30.

    Article  CAS  PubMed  Google Scholar 

  3. Rhoden EL, Teloken C, Ting HY, Lucas ML, Teodósio da Ros C, Ary Vargas Souto C. Prevalence of Peyronie’s disease in men over 50-y-old from Southern Brazil. Int J Impot Res. 2001;13(5):291–3.

    Article  CAS  PubMed  Google Scholar 

  4. Dunsmuir WD, Kirby RS. Francois de LaPeyronie (1678–1747): the man and the disease he described. Br J Urol. 1996;78(4):613–22.

    Article  CAS  PubMed  Google Scholar 

  5. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. J Urol. 2006;175(6):2115–8. discussion 2118.

    Article  PubMed  Google Scholar 

  6. Russell S, Steers W, McVary KT. Systematic evidence-based analysis of plaque injection therapy for Peyronie’s disease. Eur Urol. 2007;51(3):640–7.

    Article  PubMed  Google Scholar 

  7. Moreland RB, Nehra A. Pathophysiology of Peyronie’s disease. Int J Impot Res. 2002;14(5):406–10.

    Article  CAS  PubMed  Google Scholar 

  8. Taylor FL, Levine LA. Non-surgical therapy of Peyronie’s disease. Asian J Androl. 2008;10(1):79–87.

    Article  CAS  PubMed  Google Scholar 

  9. Furey CA. Peyronie’s disease: treatment by the local injection of meticortelone and hydrocortisone. J Urol. 1957;77(2):251–66.

    PubMed  Google Scholar 

  10. Levine LA. Review of current nonsurgical management of Peyronie’s disease. Int J Impot Res. 2003;15 Suppl 5:S113–20.

    Article  PubMed  Google Scholar 

  11. Teasley GH. Peyronie’s disease; a new approach. J Urol. 1954;71(5):611–4.

    CAS  PubMed  Google Scholar 

  12. Bodner H, Howard AH, Kaplan JH. Peyronie’s disease: cortisone-hyaluronidase-hydrocortisone therapy. J Urol. 1954;72(3):400–3.

    CAS  PubMed  Google Scholar 

  13. Desanctis PN, Furey CA. Steroid injection therapy for Peyronie’s disease: a 10-year summary and review of 38 cases. J Urol. 1967;97(1):114–6.

    CAS  PubMed  Google Scholar 

  14. Toksu E. Peyronie’s disease: a method of treatment. J Urol. 1971;105(4):523–4.

    CAS  PubMed  Google Scholar 

  15. Winter CC, Khanna R. Peyronie’s disease: results with dermo-jet injection of dexamethasone. J Urol. 1975;114(6):898–900.

    CAS  PubMed  Google Scholar 

  16. Williams G, Green NA. The non-surgical treatment of Peyronie’s disease. Br J Urol. 1980;52(5):392–5.

    Article  CAS  PubMed  Google Scholar 

  17. Levine LA, Merrick PF, Lee RC. Intralesional verapamil injection for the treatment of Peyronie’s disease. J Urol. 1994;151(6):1522–4.

    CAS  PubMed  Google Scholar 

  18. Roth M, Eickelberg O, Kohler E, Erne P, Block LH. Ca2+ channel blockers modulate metabolism of collagens within the extracellular matrix. Proc Natl Acad Sci U S A. 1996;93(11):5478–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Levine LA. Treatment of Peyronie’s disease with intralesional verapamil injection. J Urol. 1997;158(4):1395–9.

    Article  CAS  PubMed  Google Scholar 

  20. Rehman J, Benet A, Melman A. Use of intralesional verapamil to dissolve Peyronie’s disease plaque: a long-term single-blind study. Urology. 1998;51(4):620–6.

    Article  CAS  PubMed  Google Scholar 

  21. Levine LA, Goldman KE, Greenfield JM. Experience with intraplaque injection of verapamil for Peyronie’s disease. J Urol. 2002;168(2):621–6.

    Article  CAS  PubMed  Google Scholar 

  22. Bennett NE, Guhring P, Mulhall JP. Intralesional verapamil prevents the progression of Peyronie’s disease. Urology. 2007;69(6):1181–4.

    Article  PubMed  Google Scholar 

  23. Cavallini G, Modenini F, Vitali G. Open preliminary randomized prospective clinical trial of efficacy and safety of three different verapamil dilutions for intraplaque therapy of Peyronie’s disease. Urology. 2007;69(5):950–4.

    Article  PubMed  Google Scholar 

  24. Shirazi M, Haghpanah AR, Badiee M, Afrasiabi MA, Haghpanah S. Effect of intralesional verapamil for treatment of Peyronie’s disease: a randomized single-blind, placebo-controlled study. Int Urol Nephrol. 2009;41(3):467–71.

    Article  CAS  PubMed  Google Scholar 

  25. Soh J, Kawauchi A, Kanemitsu N, Naya Y, Ochiai A, Naitoh Y, et al. Nicardipine vs. saline injection as treatment for Peyronie’s disease: a prospective, randomized, single-blind trial. J Sex Med. 2010;7(11):3743–9.

    Article  CAS  PubMed  Google Scholar 

  26. Moskovic DJ, Alex B, Choi JM, Nelson CJ, Mulhall JP. Defining predictors of response to intralesional verapamil injection therapy for Peyronie’s disease. BJU Int. 2011;108(9):1485–9.

    Article  CAS  PubMed  Google Scholar 

  27. Berookhim B, Chevinsky M, Jakubowski C, Larish Y, Nelson CJ, Mulhall JP. Ventral intralesional verapamil injections for Peyronie’s disease: feasibility and safety. Abstract accepted for 20th Annual Fall Scientific Meeting of SMSNA, Miami, FL; November 20–23, 2014.

    Google Scholar 

  28. Duncan MR, Berman B, Nseyo UO. Regulation of the proliferation and biosynthetic activities of cultured human Peyronie’s disease fibroblasts by interferons-alpha, -beta and -gamma. Scand J Urol Nephrol. 1991;25(2):89–94.

    Article  CAS  PubMed  Google Scholar 

  29. Wegner HE, Andresen R, Knipsel HH, Miller K. Treatment of Peyronie’s disease with local interferon-alpha 2b. Eur Urol. 1995;28(3):236–40.

    CAS  PubMed  Google Scholar 

  30. Wegner HE, Andresen R, Knispel HH, Miller K. Local interferon-alpha 2b is not an effective treatment in early-stage Peyronie’s disease. Eur Urol. 1997;32(2):190–3.

    CAS  PubMed  Google Scholar 

  31. Judge IS, Wisniewski ZS. Intralesional interferon in the treatment of Peyronie’s disease: a pilot study. Br J Urol. 1997;79(1):40–2.

    Article  CAS  PubMed  Google Scholar 

  32. Ahuja S, Bivalacqua TJ, Case J, Vincent M, Sikka SC, Hellstrom WJ. A pilot study demonstrating clinical benefit from intralesional interferon alpha 2B in the treatment of Peyronie’s disease. J Androl. 1999;20(4):444–8.

    CAS  PubMed  Google Scholar 

  33. Dang G, Matern R, Bivalacqua TJ, Sikka S, Hellstrom WJG. Intralesional interferon-alpha-2B injections for the treatment of Peyronie’s disease. South Med J. 2004;97(1):42–6.

    Article  PubMed  Google Scholar 

  34. Kendirci M, Usta MF, Matern RV, Nowfar S, Sikka SC, Hellstrom WJG. The impact of intralesional interferon alpha-2b injection therapy on penile hemodynamics in men with Peyronie’s disease. J Sex Med. 2005;2(5):709–15.

    Article  CAS  PubMed  Google Scholar 

  35. Hellstrom WJG, Kendirci M, Matern R, Cockerham Y, Myers L, Sikka SC, et al. Single-blind, multicenter, placebo controlled, parallel study to assess the safety and efficacy of intralesional interferon α-2b for minimally invasive treatment for Peyronie’s disease. J Urol. 2006;176(1):394–8.

    Article  CAS  PubMed  Google Scholar 

  36. Trost LW, Ates E, Powers M, Sikka S, Hellstrom WJG. Outcomes of intralesional interferon-α2B for the treatment of Peyronie disease. J Urol. 2013;190(6):2194–9.

    Article  CAS  PubMed  Google Scholar 

  37. Gelbard MK, Walsh R, Kaufman JJ. Collagenase for Peyronie’s disease experimental studies. Urol Res. 1982;10(3):135–40.

    Article  CAS  PubMed  Google Scholar 

  38. Gelbard MK, Lindner A, Kaufman JJ. The use of collagenase in the treatment of Peyronie’s disease. J Urol. 1985;134(2):280–3.

    CAS  PubMed  Google Scholar 

  39. Gelbard MK, James K, Riach P, Dorey F. Collagenase versus placebo in the treatment of Peyronie’s disease: a double-blind study. J Urol. 1993;149(1):56–8.

    CAS  PubMed  Google Scholar 

  40. Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie’s disease: a prospective, single-center, non-placebo-controlled study. J Sex Med. 2008;5(1):180–7.

    Article  PubMed  Google Scholar 

  41. Traynor K. Enzyme product approved for rare hand disorder. Am J Health Syst Pharm. 2010;15:416.

    Article  Google Scholar 

  42. Gelbard M, Goldstein I, Hellstrom WJG, McMahon CG, Smith T, Tursi J, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of Peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190(1):199–207.

    Article  CAS  PubMed  Google Scholar 

  43. Rojo M, Iribarren IM, Rodriguez JC. Experience in the use of collagenase clostridium histolyticum in the management of Peyronie’s disease: current data and future prospects. Ther Adv Urol. 2014;6(5):192–7.

    Article  Google Scholar 

  44. Abern MR, Levine LA. Intralesional verapamil injections with and without penile traction and oral therapies for management of Peyronie’s disease. J Urol. 2008;179(4):408.

    Article  Google Scholar 

  45. Abern MR, Larsen S, Levine LA. Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie’s disease. J Sex Med. 2012;9(1):288–95.

    Article  CAS  PubMed  Google Scholar 

  46. Yafi FA, Pinsky MR, Stewart C, Sangkum P, Ates E, Trost LW, et al. The effect of duration of penile traction therapy in patients undergoing intralesional injection therapy for Peyronie’s disease. J Urol. 2015;194(3):754–8.

    Article  PubMed  Google Scholar 

  47. Cerruto MA, DElia C, Molinari A, Cavicchioli FM, D’Amico A, Artibani W. Animal experimental model of Peyronie’s disease: a pilot study. Arch Ital Urol Androl. 2013;85(1):28–33.

    Article  PubMed  Google Scholar 

  48. Davila HH, Ferrini MG, Rajfer J, Gonzalez-Cadavid NF. Fibrin as an inducer of fibrosis in the tunica albuginea of the rat: a new animal model of Peyronie’s disease. BJU Int. 2003;91(9):830–8.

    Article  CAS  PubMed  Google Scholar 

  49. El-Sakka AI, Hassan MU, Nunes L. Histological and ultrastructural alterations in an animal model of Peyronie’s disease. Br J Urol. 1998;81(3):445–52.

    Article  CAS  PubMed  Google Scholar 

  50. Gokce A, Abd Elmageed ZY, Lasker GF, Bouljihad M, Kim H, Trost LW, et al. Adipose tissue-derived stem cell therapy for prevention and treatment of erectile dysfunction in a rat model of Peyronie’s disease. Andrology. 2014;2(2):244–51.

    Article  CAS  PubMed  Google Scholar 

  51. Albersen M, Kendirci M, Van der Aa F, Hellstrom WJG, Lue TF, Spees JL. Multipotent stromal cell therapy for cavernous nerve injury-induced erectile dysfunction. J Sex Med. 2012;9(2):385–403.

    Article  CAS  PubMed  Google Scholar 

  52. Castiglione F, Hedlund P, Van der Aa F, Bivalacqua TJ, Rigatti P, Van Poppel H, et al. Intratunical injection of human adipose tissue-derived stem cells prevents fibrosis and is associated with improved erectile function in a rat model of Peyronie’s disease. Eur Urol. 2013;63(3):551–60.

    Article  CAS  PubMed  Google Scholar 

  53. Lin C-S, Lin G, Lue TF. Allogeneic and xenogeneic transplantation of adipose-derived stem cells in immunocompetent recipients without immunosuppressants. Stem Cells Dev. 2012;21(15):2770–8.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Huang Y-C, Ning H, Shindel AW, Fandel TM, Lin G, Harraz AM, et al. The effect of intracavernous injection of adipose tissue-derived stem cells on hyperlipidemia-associated erectile dysfunction in a rat model. J Sex Med. 2010;7(4 Pt 1):1391–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, et al. Peyronie’s disease. J Urol. 2015;194(3):745–53.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Tulane Medical Center, 1430 Tulane Avenue, 86-42, New Orleans, LA, 70112, USA

    Eric Shaw MD, Faysal A. Yafi MD & Wayne J. G. Hellstrom MD, FACS

  2. Department of Urology, Ramathibodi Hospital, 270 Rama VI Road, Bangkok, 10400, Thailand

    Premsant Sangkum MD

Authors
  1. Eric Shaw MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Faysal A. Yafi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Premsant Sangkum MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wayne J. G. Hellstrom MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wayne J. G. Hellstrom MD, FACS .

Editor information

Editors and Affiliations

  1. Southern Illinois University School of Medicine, Springfield, Illinois, USA

    Tobias S. Köhler

  2. Division of Urology Department of Surgery, Southern Illinois University School of Medicine Hospital Affiliates, Springfield, Illinois, USA

    Kevin T. McVary

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Shaw, E., Yafi, F.A., Sangkum, P., Hellstrom, W.J.G. (2016). Injection Therapy for Peyronie’s Disease. In: Köhler, T., McVary, K. (eds) Contemporary Treatment of Erectile Dysfunction. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31587-4_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31587-4_22

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-31585-0

  • Online ISBN: 978-3-319-31587-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation