Collagenase injections for plaque reduction in Peyronie's

    
      Re: Collagenase injections for plaque reduction in Peyronie's
    


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Posted by HFHS M.D.-MS on March 10, 1998 at 22:21:11:

In Reply to: Collagenase injections for plaque reduction in Peyronie's posted by Fred on March 09, 1998 at 15:20:34:

: I have been diagnosed with Peyronie's disease. I have been taking Vitamin E 400 units 3 times daily for the past six months. The distortions of my penis are definitely improved but not gone. I have read on the internet about collagenase and verapamil injections into the penis to reduce the plaque. I cannot find any information about this procedure. What are the risks and benefits?
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Dear  Fred
Thanks for your question.
Here are a couple of abstracts with their citations.  There are two more titles at the bottom for colchicine and  interferon injections.  All of these therapies are still experimental. and possibly a fad. Surgical correction for severe disease is still the standard of care.  For the risk and complications  you will have to go to a medical library and pull the articles.  You are welcome to make copies but remember to bring money for the photocopier.  Hope these will help.  
Levine LA. Treatment of Peyronie's disease with intralesional verapamil
injection. [Clinical Trial. Journal Article] Journal of Urology.
158(4):1395-9, 1997 Oct.  
Treatment of Peyronie's disease with intralesional verapamil injection.
Journal of Urology. 158(4):1395-9, 1997 Oct.
PURPOSE: 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.
MATERIALS AND METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
Gelbard MK. James K. Riach P. Dorey F .
Department of Surgery, University of California School of Medicine, Los
Angeles.
Collagenase versus placebo in the treatment of Peyronie's disease: a
double-blind study.
Journal of Urology. 149(1):56-8, 1993 Jan.
We investigated 49 men with Peyronie's disease in a prospectively
randomized placebo controlled double-blind study, comparing the effects
on plaque size and penile deformity of intralesional purified
clostridial collagenase and saline placebo. For the group as a whole,
treatment out-performed placebo (p < 0.007). When patients were analyzed
with respect to disease severity, those with lesser deformity responded
more favorably to treatment. The absolute angular change in patients
responding to treatment was small. No significant side effects were
noted within a 3-month followup.
Judge IS. Wisniewski ZS. Intralesional interferon in the treatment of
Peyronie's disease: a pilot study. [Journal Article] British Journal of
Urology. 79(1):40-2, 1997 Jan.  
Akkus E. Carrier S. Rehman J. Breza J. Kadioglu A. Lue TF .
San Francisco
Is colchicine effective in Peyronie's disease? A pilot study.
Urology. 44(2):291-5, 1994 Aug.
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