[Transdermal iontophoresis with dexamethasone and verapamil for Peyronie's disease].
OBJECTIVE
To evaluate the effects of transdermal iontophoresis with verapamil and dexamethasone in patients with Peyronie's disease of less than one year of evolution.


METHODS
We have treated ten patients twice a week during six consecutive weeks using iontophoresis with a Miniphysionizer dispositive. This device generates a 2mA electric current during 20 min which triggers the transdermal penetration of medication. In every session dexamethasone 8 mg and verapamil 5mg were administered inside a small self-adhesive receptacle on the penile skin overlying the fibrosis plaque. To evaluate the efficacy, penile curvature was measured by Kelami's test, while the plaque size was assessed by penile ultrasound. Other parameters like pain, erectile function and ability for vaginal intercourse were recorded using questionnaires. Safety parameters were also assessed during treatment.


RESULTS
No improvement or progression in penile curvature was evidenced in any of the patients. The hardness of the plaque was reduced in 5 patients, becoming impalpable in 2 of them. Decrease in plaque volume was observed by penile ultrasound in 6. Pain improved in 8 patients, disappearing in 6 of them. One patient recovered his erectile function at the end of the treatment; whereas 3 referred that their ability for intercourse enhanced while 2 reported that treatment improved their sexual life in general. We didn't record any significantly side effects, except for a transitory and slight dermal redness on the site of electrode placement.


CONCLUSIONS
Transdermal iontophoresis is an effective treatment for pain control in early stages of Peyronie's disease. Efficacy in reducing penile curvature seems to be limited. Controlled clinical trials are needed, and perhaps reviewing indications in order to obtain more relevant clinical effects.
Cabello Benavente
R
R
Hospital General Universitario Gregorio Marañón. Madrid. ramirocabello@telefonica.net
Moncada Iribarren
I
I
de Palacio España
A
A
Hernández Villaverde
A
A
Monzó
J I
JI
Hernández Fernández
C
C
D000328:Adult; D000368:Aged; D003907:Dexamethasone / Q000008:administration & dosage*; D004867:Equipment Design; D006801:Humans; D007478:Iontophoresis / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000188:drug therapy*; D014700:Verapamil / Q000008:administration & dosage*
D003907:Dexamethasone; D014700:Verapamil