Intralesional hyaluronic acid: an innovative treatment for Peyronie’s disease

Abstract

Considering the minimally invasive approach in this study, the absence of major side effects, and the significant treatment outcomes achieved, we conclude that intralesional penile injections with HA are effective for treating Peyronie's disease.

Evaluation of intralesional injection of hyaluronic acid compared with verapamil in Peyronie's disease: preliminary results from a prospective, double‐blinded, randomized study

“…Currently, Xiaflex it is the only drug available for treatment of Peyronie's disease (Gelbard et al, 2013). Similar results were reported by another study including 83 patients who underwent treatment with HA vs. 81 patients in the control group (Gennaro et al, 2015). In addition, therapy with collagenase is limited by the high cost.…”

“…For this reason novel intralesional agents are strongly needed with better benefit-risk profile. Recent prospective, multicenter, pilot study assessing the efficacy of hyaluronic acid (HA) as intralesional treatment for patients with PD showed encouraging preliminary results for improvement of plaque size, penile curvature, and overall sexual satisfaction (Zucchi et al, 2016) and similar results are reported in other study (Gennaro et al, 2015). Hyaluronic acid is an extracellular matrix glycosaminoglycan that at physiological pH is highly polarized and maintains hydration, turgor, plasticity and viscosity in the amorphous connective tissue matrix.…”

“…These therapeutic options include: oral treatment (potassium para-aminobenzoate, Potaba), vitamin E, colchicine, tamoxifen, carnitine, pentoxifylline, phosphodiesterase type 5 inhibitors); intralesional treatment [steroids, verapamil, collagenase clostridium histolyticum (CCh), interferons]; and topical treatment [extracorporeal shock wave therapy (ESWT), iontophoresis, traction devices and vacuum devices] (Hauck et al, 2006;Safarinejad et al, 2010;Hatzimouratidis et al, 2012;Gelbard et al, 2013;Favilla et al, 2014;Levine et al, 2015;Nehra et al, 2015). Recent prospective, multicenter, pilot study assessing the efficacy of hyaluronic acid (HA) as intralesional treatment for patients with PD showed encouraging preliminary results for improvement of plaque size, penile curvature, and overall sexual satisfaction (Zucchi et al, 2016) and similar results are reported in other study (Gennaro et al, 2015). For this reason, the intralesional therapy with verapamil, for reduced side effects and lower costs, remains the most widely used especially in Europe.…”

2018 Canadian Urological Association guideline for Peyronie's disease and congenital penile curvature

“…Two retrospective studies and a more recent prospective study have shown a reduction in penile plaque size and curvature, as well as improved penile rigidity. [52][53][54] Botulinum toxin has been shown to reduce fibrosis and scarring. A single study evaluated botulinum toxin A as a treatment for PD and has shown a positive response for safety and improvement in penile curvature, while data from further investigations is pending.…”

Nonsurgical Interventions for Peyronie's Disease: Update as of 2016

“…More recently, some research groups have evaluated the potential role of HA as a treatment for PD. In a retrospective study of 83 carefully selected patients, Gennaro et al [46] found a significant reduction in penile plaque size and curvature, as well as improved penile rigidity A more recent prospective study of 65 patients likewise demonstrated improvement across all PD domains and reported no major complications [47]. HA is a promising novel therapy for PD that appears to have some efficacy in improving PD symptoms, but data comparing HA treatment to placebo or alternative therapies are lacking.…”