Peyronie’s Disease & Intralesional Injection Therapy
Intralesional (IL) injection therapy is a non-surgical therapy for Peyronie’s disease (PD) aimed at treating patients in the acute or chronic stages of the disease with minimal side effects.
IL therapy is designed to work on the basis that interferon α-2B, calcium channel blockers, hyaluronic acid and Botox have the ability to impair the inflammatory and fibrotic problems associated with PD and inhibit fibroblast proliferation amongst others.
So far, many of the IL studies have had mixed results. In some instances, there has been an improvement in penile curvature but not for erectile function or penile pain which are both important factors as far as patients are concerned.
Another issue is the lack of placebo and control groups in the IL studies so that findings can be statistically verified.
IL involves injecting a medical substance called collagenase directly into the scar tissue which has caused the penile curvature. PD sufferers who elect for this treatment are treated as outpatients usually two or three times, seven days apart over a 14 or 21-day period.
During the appointment a consultant will stretch the penis manually and inject Collagenase directly into the scar tissue. Patients normally experience some penile discomfort, swelling and bruising for up to seven days after each injection.
Sexual intercourse is best avoided during the period of treatment as well as for six weeks after the final injection. Most advocates of IL treatment will recommend the use of a penile vacuum pump during and after the treatment.
Verapamil Injections for Peyronie’s Disease
Many urologists recommend these for PD. Patients usually receive six of these injections at fortnightly intervals. You will receive a local anesthetic before the Verapamil Injection as these can be painful. Once your penis is numb, the consultant will inject the Verapamil into the scar tissue in the penis, afterwards they will wrap a bandage around the length of your penis which is best left on for six hours.
Botox for Peyronie’s Disease
Botox is the brand name for the neurotoxic protein called botulinum toxin. It is approved for treating variety of medical conditions such as chronic migraines and certain muscle problems. However, it is best known for its use in the cosmetic industry.
A small study showed benefits of plaque thickness, but the findings need to be confirmed by further research before Botox can be recommended as an IL therapy for PD.
Patients should be made aware that decreased curve does not immediately translate into decreased bother or pain as well as accepting that they might not achieve a perfectly straight penis.
Overall, there is insufficient evidence to currently recommend the use of IL injection therapy.
If you wish to discuss alternative Peyronie’s Disease treatment, please call us or complete the contact form below.