Long-Term Multimodal Therapy (Verapamil Associated with Propolis, Blueberry, Vitamin E and Local Diclofenac) on Patients with Peyronie's Disease (Chronic Inflammation of the Tunica Albuginea). Results of a Controlled Study

Objective: to demonstrate the possible effectiveness of a long-term multimodal medical therapy in patients with Peyronie’s disease (PD) we carried out a controlled study on 82 patients diagnosed with PD, whereas in the scientific literature the conservative treatment of this disease is much discussed. Methods: 82 patients (mean age=53.6±10.1 years-range 23-68) diagnosed with PD were selected for this study. Of these 41 patients (group A) were treated for 18 months as follows: Verapamil penile injections (12 total injections for six months and subsequently every month for twelve months: total 24 injections) + Iontophoresis with Verapamil/daily + blueberries 160mg/daily + propolis 600mg/daily + Vitamin E 600mg/daily + topical Diclofenac/daily. The other 41 patients spontaneously decided not to receive treatment for several motives and then were introduced as a control group B. All patients were controlled at 6- and 18-month follow up with the same diagnostic tests completed before the therapy (penile ultrasound, photograph documentation, pain scale etc.). Results: In group A, after treatment of 6 and 18 months, the change in plaque volume consisted in volume reduction= - 47.6% and -73.6% respectively, while in group B, the change consisted of an increase in plaque volume= +55.7% and +118.7% respectively (p=0.000). In group A, after treatment of 6 and 18 months, improvement of curvature occurred in 76.3% and 81.5% of the cases respectively, while in group B it occurred in 2.7% and 8.1%, respectively (p<0.0001). Conclusion: Our results showed that a long-term multimodal medical therapy (Verapamil associated with Antioxidants and local Diclofenac) is statistically effective to treat PD patients, if we consider that lower therapeutic outcomes were achieved after 6 months treatment (medium-term treatment). Furthermore, this study confirms that the best treatment modality for PD is a combination therapy.