Tadalafil once daily and intralesional verapamil injection: A new therapeutic direction in Peyronie's disease

Introduction: The aim of this study was to evaluate the combination of intralesional verapamil injection (IVI) therapy with and tadalafil in men affected by Peyronie's disease (PD). Materials and Methods: In this study, 59 patients diagnosed with PD, were divided into three groups. Group A (GA) counted 23 patients treated with IVI; Group B (GB) treated 19 patients with tadalafil 5 mg once a day, and Group C (GC) treated 17 patients with IVI and tadalafil for 3 months. There were assessed at baseline and follow-up: Erectile function, presence and severity of painful erections, penile plaque size and penile curvature degree. Results: After 3 months pain resolved completely in 57% cases of GA, 61% of GB and 76% of GC; the final mean curvature degree further decreased in all groups without statistically significant differences; mean plaque size remained stable in GA: 1.57 versus 1.59 at baseline ( P = 0.364) and GB: 1.51 versus 1.52 at baseline ( P = 0,265), while a further decrease was evident in GC: 1.46 versus 1.58 at baseline ( P = 0.03). Mean International Index of Erectile Function-5 score further improved significantly in the group treated with verapamil plus tadalafil: 23.1 versus 14.4 of GA and 18.2 of GB ( P ≤ 0.01). Conclusions: The association of IVI and tadalafil showed better pain control while reducing penile curvature and erectile function, improving the quality of life.