World J Mens Health.  2021 Apr;39(2):352-357. 10.5534/wjmh.190108.

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

  • 1Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
  • 2Urology Section, Villa Donatello Clinic, Sesto Fiorentino, Italy.
  • 3Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy.
  • 4Department of Urology, University of Turin, Turin, Italy.
  • 5Department of Urology, University of Verona, Verona, Italy.
  • 6The Institute of Urology, University College of London Hospital, London, UK.


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.
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).
Intralesional HA injections could represent a reliable treatment option for the conservative management of patients with acute phase of PD.


Hyaluronic acid; Penile curvature; Penile induration; Peyronie disease; Verapamil
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