Multimodal treatments based on Tadalafil during acute phase of Peyronie's disease: experience at two referral academic centers

Ir J Med Sci. 2024 Oct;193(5):2301-2306. doi: 10.1007/s11845-024-03734-1. Epub 2024 Jun 11.

Abstract

Aim: The purpose of this study is to identify the clinical outcomes of patients during acute phase of Peyronie's disease (PD) treated with daily Tadalafil 5 mg associated with non-surgical treatments such as intra-plaque verapamil injections (IVI), vacuum erection devices (VED) or extra corporeal shockwave therapy (ESWT).

Methods: 445 patients with PD in acute stage were treated as it follows: Group 1(G1) 117 men with only Tadalafil 5 mg once a day for 3 months; Group 2(G2) 106 men with IVI plus Tadalafil 5 mg for a period of 12 weeks; Group 3(G3) 124 men that received ESWT for 6 weeks plus Tadalafil with the same protocol of G1; Group 4(G4) 98 men with VED plus Tadalafil 5 mg for 3 months. There were assessed at baseline and follow-up: Erectile dysfunction (ED), presence and severity of painful erections, penile plaque size and penile curvature degree. The results were evaluated at baseline and 3,6,12 months.

Results: Not statistically significant differences emerged between the two groups at baseline, except for higher presence of patients with ED in in G3(7.4%) vs other groups(p < 0.001). Three months after the treatment in G3 men had a significant reduction of penile curvature degrees after 1 year by treatments, whereas pain in an erection or during intercourse was resolved completely in 75% of the patients.

Conclusions: Our study highlights that multimodal therapy has beneficial long-term effects not only in the decrease of ED symptoms, but also in the relief of the penile curvature and the quality of life.

Keywords: Extracorporeal shockwave; Peyronie’s disease; Phosphodiesterase type 5 inhibitors, outcomes; Tadalafil; Vacuum erection device.

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Erectile Dysfunction / drug therapy
  • Extracorporeal Shockwave Therapy / methods
  • Humans
  • Male
  • Middle Aged
  • Penile Induration* / drug therapy
  • Penile Induration* / therapy
  • Phosphodiesterase 5 Inhibitors / therapeutic use
  • Tadalafil* / therapeutic use
  • Treatment Outcome
  • Vacuum
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / therapeutic use
  • Verapamil* / administration & dosage
  • Verapamil* / therapeutic use

Substances

  • Tadalafil
  • Verapamil
  • Vasodilator Agents
  • Phosphodiesterase 5 Inhibitors