Multiple treatment options have been used for Peyronie's disease (PD) including intralesional injection of the calcium antagonist verapamil. The use of verapamil is based on its capacity to alter fibroblast function at several levels, including cell proliferation, extracellular matrix protein synthesis and secretion, as well as collagen degradation. Consequently, calcium antagonists may have the capacity to slow, prevent, or even reverse plaque formation and the progression of PD. The multicenter international experience with intralesional verapamil injection suggests that the majority of men with PD that receive treatment demonstrate durable reduction in pain, decrease in curvature, and improved sexual function. We review the scientific rationale, published literature, clinical experience, and technique of intralesional injection of verapamil.
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de La Peyronie F . Sur quelques obstacles qui s'opposent a l'ejaculation naturelle de la semence Mem de l'Acad Roy de Chir 1743 1: 425–434
Abdel-Salam Y et al. Treatment of Peyronie's disease by extra corporeal shockwave therapy: evaluation of our preliminary results Journal of Urology 1997 13: 549–552
Bittard H, Schraub S, Bittard M . Treatment of Peyronie's disease by a combination of radiotherapy and surgery. Apropos of 51 cases Annales d Urologie 1988 22: 67–69
Stojic M, Negrojevic M, Josic P, Stojic S . Conservative therapy of Peyronie's disease using vitamin E Medicinski Pregled 1987 40: 133–135
Akkus E et al. Is colchicine effective in Peyronie's disease? A pilot study Urology 1994 44: 291–295
Teloken C et al. Tamoxifen vs placebo in the treatment of Peyronie's disease Journal of Urology 1999 162: 2003–2005
Carson CC . Potassium para-aminobenzoate for the treatment of Peyronie's disease: is it effective? Techniques in Urology 1997 3: 135–139
Riedl CR et al. Iontophoresis for treatment of Peyronie's disease Journal of Urology 2000 163: 95–99
Treffiletti et al. Iontophoresis in the conservative treatment of Peyronie's disease: preliminary experience Archivio Italiano di Urologia, Andrologia 1997 69: 323–327
Gelbard MK, James K, Riach P, Dovey F . Collagenase vs placebo in the treatment of Peyronie's disease: a double-blind study Journal of Urology 1993 149: 56–58
Cipollone G et al. Betamethasone vs placebo in Peyronie's disease Archivio Italiano di Urologia, Andrologia 1998 70: 165–168
Primus G . Orgetein in the treatment of plastic induration of the penis (Peyronie's disease) International Urology and Nephrology 1993 25: 169–172
Ahuja S et al. A pilot study demonstrating clinical benefit from intralesional interferon alpha 2B in the treatment of Peyronie's disease Journal of Andrology 1999 20: 444–448
Levine LA . Treatment of Peyronie's disease with intralesional verapamil injection Journal of Urology 1997 158: 1395–1399
Kelly RB . Pathways of protein secretion in eukaryotes Science 1985 230: 25–32
Aggeler J, Frisch SM, Werb Z . Changes in cell shape correlate with collagenase gene expression in rabbit synovial fibroblasts Journal of Cell Biology 1984 98: 1662–1671
Askey DB et al. The effect of weak electric fields and verapamil on exocytosis in human fibroblasts Journal of Cell Biology 1988 107: 336a abstract 1905
Lee RC, Ping JA . Calcium antagonists retard extracellular matrix production in connective tissue equivalent J Surg Res 1990 49: 463–466
Kappas AM, Barsoum GH, Ortiz JB, Keighly MR . Prevention of peritoneal adhesions in rats with verapamil, hydrocortisone sodium succinate, and phosphatidylcholine European Journal of Surgery 1992 158: 33–35
Steinleitner A, Kazensky C, Lambert H . Calcium channel blockade prevents postsurgical reformation of adnexal adhesions in rabbits Obstetrics and Gynecology 1989 74: 796–798
Johnson H, Parham M, Davis E, Wise L . Preliminary study of the protective effect of the calcium channel blocker, nifedipine, on adriamycin-induced tissue injury J Invest Surg 1991 4: 313–322
Lee RC, Doong H, Jellema AF . The response of burn scars to intralesional verapamil. Report of five cases Arch Surg 1994 129: 107–111
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 1996 93: 5478–5482
Stetler-Stevenson WG . Dynamics of matrix turnover during pathologic remodeling of the extracellular matrix Amer J Path 1996 148: 1345
Wolf JS Jr, Soble JJ, Ratliff TL, Clayman RV . Ureteral cell cultures II. Collagen production and response to pharmacological agents J Urol 1996 156: 2067
Rodler S, Roth M, Nauck M, Tamm M, Block LH . Ca(2+)-channel blockers modulate the expression of interleukin-6 and interleukin-8 genes in human vascular smooth muscle cells J Mol Cell Cardiol 1995 27: 2295
Anderson MS, Shankey TV, Lubrano T, Mulhall JP . Inhibition of Peyronie's plaque fibroblast proliferation by biologic agents International Journal of Impotence Research 2000 Suppl. 3 S25–S31
Levine LA, Merrick PF, Lee RC . Intralesional verapamil injection for the treatment of Peyronie's disease J Urol 1994 151: 1522–1524
Arena F . Clinical effects of verapamil in the treatment of Peyronie's disease Acta Biomed Ateneo Parmense 1995 66: 269–272
Teloken C et al. Objective evaluation of non-surgical approach for Peyronie's disease J Urol 1996 155: 633A abstract 1290
Lasser A, Vandenberg TL, Vincent MJ, Hellstrom WJ . Intraplaque verapamil injection for treatment of Peyronie's disease Journal of the Louisiana State Medical Society 1998 150: 431–434
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: 620–626
Levine LA, Goldman KE . Updated experience with intralesional verapamil injection treatment for Peyronie's disease J Urol 2000 163: 170 abstract 751
Shadish WR, Cook TD, Campbell DT . Experimental and quasi-experimental designs for generalized causal inference Houghton-Mifflin: Boston 2002
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Levine, L., Estrada, C. Intralesional verapamil for the treatment of Peyronie's disease: a review. Int J Impot Res 14, 324–328 (2002). https://doi.org/10.1038/sj.ijir.3900917
- intralesional injection
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