Abstract
Pentoxifylline (PTX) with other antioxidants, in patients with PD enrolled for a conservative medical management. Methods: We carried out a controlled study on 240 patients diagnosed with Peyronie's Disease (PD). We have divided two treatment groups, which differ from each other only for the association with PTX-penile injection. Two groups (A and B) were totally composed by 160 PD patients (80 patients for each group): Group A=PTX injection (penile and peri-lesional) 100 mg, every two weeks for six months + PTX 400 mg /oral/ twice daily + propolis 600 mg / oral / daily + blueberries 160 mg /oral/ daily + Vitamin E 600 mg / oral / daily + topical Diclofenac sodium 4% gel / twice a day, for a period of 6 months. Group B=the same therapy of group A but without PTX penile injection. Patients who refused treatment, for various reasons, were included in the control group=Group C (80 patients). Results: In groups A and B after 6 months of treatment a reduction of penile plaque volume of 50.3% and 25.9% respectively was observed, while in group C a mean increase in plaque volume of 131% was observed. Furthermore, in groups A and B, the mean curvature decrease was -11.07° and -4.4° respectively, while in group C a mean increase of curvature =+14.09° was observed. Conclusion: Our results showed that multimodal treatment with PTX associated with antioxidants and topical Diclofenac is significantly effective in treating PD. Treatment outcomes obtained in the treatment-group A are statistically more significant than those achieved in group B. Pentoxifylline is more effective when the treatment program includes both routes of administration: oral + perilesional injection.
Highlights
Peyronie's Disease (PD) is a connective tissue disorder that affects primarily the tunica albuginea with the growth of fibrous inelastic plaques in penile corpora cavernosa
A controlled study was carried out to investigate the possible benefits of multimodal treatment, Pentoxifylline (PTX) associated with other Antioxidants, in patients with PD enrolled for a conservative medical management
erectile dysfunction (ED) was present in 95 cases (39, 5% of total 240 cases) and the mean Index of Erectile Function (IIEF) score was 19.78 (±4.49 SD)
Summary
Peyronie's Disease (PD) is a connective tissue disorder that affects primarily the tunica albuginea with the growth of fibrous inelastic plaques in penile corpora cavernosa. These plaques ( improperly called keloid scars), can obstacle the full and complete penile expansion during erection resulting in a possible penile bending. The etiology of PD is not fully understood, in recent years new studies propose the penile trauma as cause of PD [3]. A recent hypothesis suggests that the replicative/tumor-like nature of PD should be regarded as similar to that of keloids [4-8].The disease may occur as a result of traumas or injuries to the penis usually during sexual activity, the majority of PD-patients do not remember a traumatic event. In what follows an activation of Nuclear Factor kappa-light-chain-enhancer of activated B cells (NFκB) with the consequent expression of genes on specific targets (collagen, fibrin, inducible nitric oxide synthase-iNOS, fibroblast growth factor-FGF and TGF-β) [10,11]
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