Intralesional low‐dose methylprednisolone for the treatment of active phase Peyronie’s disease: A single‐centre, preliminary prospective non‐randomised study

Abstract

Aim There are a few types of drugs that can be used in the active phase of Peyronie's disease. Methylprednisolone is a corticosteroid with a strong anti‐inflammatory effect. In this study, we aimed to evaluate the effect of intralesional low‐dose methylprednisolone treatment on patients in the active phase of Peyronie's disease. Patients and Methods Forty‐eight patients suffering from Peyronie's disease active phase symptoms were included in the study. Methylprednisolone was administered intralesionally for 8 weeks, once per week, at a dose of 40 mg. The injection was applied to the plaques, which causes maximum curvature. Patients were evaluated before and after treatment for plaque size, angle of curvature, and erectile dysfunction according to the International Index of Erectile Function‐5 and Peyronie's Disease Questionnaire. Results The mean age of the patients was 61.1 (43‐78) years. The mean duration of the symptoms was 3.4 (0‐9) months. The average plaque size before treatment was 13.6 mm (7.1‐16.8) and after treatment, this value decreased to 10.8 mm (4.3‐14.6) (P: .025). The average scores of Peyronie's Disease Questionnaire elements; symptom severity, penile pain, and bother/discomfort were 12.3, 19.1, and 6.2, respectively, before the treatment. These scores were decreased to 8.9, 9.6, and 4.4, respectively, after treatment. All subgroups of Peyronie's Disease Questionnaire scores were significantly improved after treatment (P: .001, P < .001, P: .045, respectively). No adverse events were observed during or after treatment. Conclusion In order to recover the symptoms and signs, new and easily accessible drugs are required for use in the acute period of Peyronie's disease. In this context, treatment with intralesional low‐dose methylprednisolone in acute phase Peyronie's Disease is a promising and safe treatment option.

Current trends in non‐surgical management of Peyronie's disease—A narrative review

“…A preliminary prospective single‐arm study including 48 patients treated in an acute phase of PD with low‐dose methylprednisolone injections has shown a significant decrease in plaque size (mean 13.6–10.8 mm) and improvement in PDQ elements. The authors did not report any side effects of the treatment 51 . The conclusions are limited by the lack of a comparator, and the use of dexamethasone and methylprednisolone is currently discouraged by European Association of Urology (EAU) guidelines 19…”

“…The authors did not report any side effects of the treatment. 51 The conclusions are limited by the lack of a comparator, and the use of dexamethasone and methylprednisolone is currently discouraged by European Association of Urology (EAU) guidelines. 19…”

Pathological Significance of Macrophages in Erectile Dysfunction Including Peyronie’s Disease

“…Various novel treatment strategies and agents have been suggested and used for PD [ 124 , 138 , 139 , 140 , 141 ]. Furthermore, several studies have analyzed the usefulness of treatments according to disease phases [ 140 , 141 , 142 ].…”

“…Various novel treatment strategies and agents have been suggested and used for PD [ 124 , 138 , 139 , 140 , 141 ]. Furthermore, several studies have analyzed the usefulness of treatments according to disease phases [ 140 , 141 , 142 ]. However, the study populations in most pre-clinical and clinical studies vary widely in disease duration from the disease onset, and molecular mechanisms under pathological conditions are dependent on the disease phase.…”