Hyaluronic acid injection for the management of peyronie's disease

Abstract

To report our findings in terms of safety and efficacy of intralesional injections of hyaluronic acid (IIHA) in the treatment of Peyronie's disease (PD). Data were extrapolated from a single centre prospectively maintained database. 18 patients with PD received IIHA using the same procedure as for collagenase clostridium histolyticum. Penile curvature assessed through Intracavernosal injection of prostaglandin E1, Peyronie's Disease Questionnaire (PDQ) and the International Index of Erectile Function (IIEF) were carried out at baseline and at week 7. The Global Assessment of Peyronie's Disease (GAPD) questionnaire was completed at week 7. No patients received previous local treatment for PD and all had at least 1 year stable disease. IIHA were performed every other week under penile block of 15 mL plain mepivacaine 1% for total number of 3 injections in six weeks; investigator modelling has been fulfilled at the end of each injection. Patients were educated to home modeling, stretching and using daily vacuum device between injections. The median penile curvature at baseline was 55 (IQR= 43.75 - 65). Of the treated patients 16 (88%) showed a decrease in the angle of curvature by a mean of 13.33 ± 8.57 degrees. At 7 weeks the median measured curvature was 40 (IQR = 30 – 50) (p<0.001). A statistically significant improvement in IIEF- Intercourse Satisfaction (from 30,1 ± 7.1 to 34.7 ± 8.1; p<0.001). Hyaluronic acid injections were well tolerated by all patients and no complications were observed. Our preliminary study showed that IIHA may reduce penile curvature in patients affected by Peyronie's Disease in combination with the use of vacuum device, penile modelling and stretching. Considering the safety, the low cost and efficacy, we believe that IIHA may be a promising treatment option. The authors reported no conflict of interest.