Defining predictors of response to intralesional verapamil injection therapy for Peyronie's disease.

摘要

OBJECTIVE: * To assess factors that predict penile curvature responses to intralesional verapamil (ILV) injection therapy for men with Peyronie's disease (PD). PATIENTS AND METHODS: * Men with PD for <1 year were assessed at baseline and after 3 months of bi-monthly ILV-injection therapy. Curvature was assessed at the time of maximum penile rigidity. * Univariate relationships were tested with correlation or chi-square analyses. * Multivariate analyses included logistic and linear regression. * We analysed curvature improvement, defined as a decrease of >/=10 degrees from baseline. Additionally, the relationship between curvature outcomes and patient age and degree of baseline penile curvature were assessed. RESULTS: * Data from 131 men were included and the rates of penile curvature change were:26% improved, 12% worsened, and 62% stable. * Age (r=-0.24, P < 0.01) and larger baseline penile curvature (r= 0.33, P < 0.01) were associated with improved curvature on univariate analysis. * On multivariate analysis (logistic regression), both age [odds ratio (OR) 0.93, P < 0.01, 95%CI 0.89-0.97] and larger baseline penile curvature (OR 1.07, P < 0.01, 95%CI 1.04-1.11) were associated with improvements in curvature after ILV-injection therapy. * Improvements in curvature were associated with age (40 years; OR 0.27, P < 0.05, 95%CI 0.10-0.75) and degree of penile curvature at baseline (30 degrees ; OR 9.12, P < 0.01, 95%CI 1.94-42.84) when dichotomized as indicated. CONCLUSION: * Younger age and larger baseline penile curvature were predictive of favourable curvature outcomes. * Analysis of dichotomized variables suggests that age and baseline curvature thresholds may be important to consider when deciding on ILV as a therapeutic strategy for PD.