[80] Injection of verapamil into the plaque of patients with induratio penis plastica (IPP) – Morbus Peyronie

Objective To evaluate the efficacy of treatment based on the direct injection of verapamil into the plaque in patients with induratio penis plastica (IPP). Methods In all, 21 patients with IPP were included. The mean patient age was 65.3 years. The plaques were found at the dorsum of the penis; the mean deviation of the penis when erect was 52° and the mean size of the plaque was 8.5 mm. Erectile function was evaluated using the five-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Results The mean IIEF-5 score was 11.9. The injection itself was reported to be relatively painless by all the patients. The patients rated pain using a visual analogue scale (VAS) with scores of 1 or 2. Two patients (9.5%) reported a haematoma of the penis’ skin after one of a series of injections. There were no severe complications. The efficacy of the therapy was assessed 2 or 3 months after the last injection. Both objective and subjective improvements were found in 14 men (66.6%). The penis deviation was lowered to 26.5° in 48% of cases. The size of the plaque was lowered to 5.2 mm in 33.7% of cases and the IIEF-5 questionnaire scored 15.9 points in 29.3% of cases. Conclusion It is understood that the group of 21 patients is too small to properly evaluate the efficacy of the treatment. The long-term experience at our workplace indicates that treatment using injections of verapamil results in similar efficacy as treatment using extracorporeal shockwaves. Our findings show, that the injection of verapamil is an efficient and safe method. A significant number of patients report an improvement of their sexual health. The method is thus classed as a routine method of conservative treatment for IPP.