Multimodal treatments based on Tadalafil during acute phase of Peyronie's disease: experience at two referral academic centers.

Abstract

The purpose of this study is to identify the clinical outcomes of patients during acute phase of Peyronie's disease (PD) treated with daily Tadalafil 5mg associated with non-surgical treatments such as intra-plaque verapamil injections (IVI), vacuum erection devices (VED) or extra corporeal shockwave therapy (ESWT). 445 patients with PD in acute stage were treated as it follows: Group 1(G1) 117 men with only Tadalafil 5mg once a day for 3months; Group 2(G2) 106 men with IVI plus Tadalafil 5mg for a period of 12weeks; Group 3(G3) 124 men that received ESWT for 6weeks plus Tadalafil with the same protocol of G1; Group 4(G4) 98 men with VED plus Tadalafil 5mg for 3months. There were assessed at baseline and follow-up: Erectile dysfunction (ED), presence and severity of painful erections, penile plaque size and penile curvature degree. The results were evaluated at baseline and 3,6,12months. Not statistically significant differences emerged between the two groups at baseline, except for higher presence of patients with ED in in G3(7.4%) vs other groups(p < 0.001). Three months after the treatment in G3 men had a significant reduction of penile curvature degrees after 1year by treatments, whereas pain in an erection or during intercourse was resolved completely in 75% of the patients. Our study highlights that multimodal therapy has beneficial long-term effects not only in the decrease of ED symptoms, but also in the relief of the penile curvature and the quality of life.