Comparison of Intralesional Hyaluronic Acid vs. Verapamil for the Treatment of Acute Phase Peyronie's Disease: A Prospective, Open-Label Non-Randomized Clinical Study

PURPOSE: To compare the efficacy and safety of intralesional hyaluronic acid (HA) as compared with verapamil injection in patients with Peyronie's disease (PD). MATERIALS AND METHODS: Between January 2015 and December 2018, men in PD acute phase were prospectively recruited. This open-label, prospective study included 2 different protocols. Group A: 8-week cycle of weekly intraplaque injections with HA; Group B: 8-week cycle of weekly intraplaque injections with verapamil. Penile curvature, plaque size, International Index of Erectile Function (IIEF)-15 score and visual analogue scale (VAS) were assessed at baseline and after 3 months. RESULTS: Two-hundred forty-four patients were enrolled. Of these, 125 received intralesional HA (Group A), 119 received intralesional verapamil (Group B). At enrollment, median age was 56.0 years (interquartile range [IQR]=47.0–63.0 years), median curvature 35.0° (IQR=25.0°–45.0°), median IIEF-15 score 19.0 (IQR=16.0–23.0), median VAS 4.0 (IQR=4.0–5.0). Median difference for IIEF-15 was 1.0 (95% confidence interval [CI]=1.12–1.94) in Group A and 0.0 (95% CI=−0.04–0.14) in Group B (p<0.05) and median difference for VAS score was −4.0 (95% CI=−4.11–−3.65) in Group A and −1.0 (95% CI=−0.50–2.01) in Group B (p<0.05). Plaque size decreased by −1.50 mm (IQR=1.60–2.10 mm) in Group A and −1.20 in Group B (p=0.10), while penile curvature decreased by −9.50° (IQR=4.50°–13.00°) in group A and −4.50 (IQR=2.50–7.50) in Group B (p<0.01). CONCLUSIONS: Intralesional HA injections could represent a reliable treatment option for the conservative management of patients with acute phase of PD.