[Is intracavernosal corticosteroid infiltration really useless in Peyronie's disease?].
The value of intracavernosal corticosteroid infiltration remains controversial or may even be contraindicated in Peyronie's disease, as it is considered to be ineffective and a source of morbidity.


OBJECTIVE
To retrospectively analyse the efficacy and safety of intracavernosal corticosteroid infiltration in a selected population only presenting clinical criteria of the acute phase of Peyronie's disease (pain and/or recent onset < 6 months).


METHODS
Intracavernosal corticosteroid infiltration (weekly or twice-weekly) was performed in or around the plaque. Evaluation was based on clinical criteria according to the course of pain, the nodule and curvature and the rates of improvement, resolution, stabilization and deterioration of these criteria were studied.


RESULTS
In a series of 271 patients, 123 presented criteria of the acute phase of Peyronie's disease. Forty five of these patients were treated exclusively by intracavernosal corticosteroid infiltration. The mean age was 52 +/- 8 years. The number of intracavernosal infiltrations was usually less than 10 (n = 40) with less than 8 injections in the majority of patients (n = 36). Follow-up was 6 months. There were no cases of clinical deterioration. The best results were observed on pain, which decreased (13.6%) or totally resolved (61.4%). Curvature was decreased (20.5%), the plaque decreased (25%) or disappeared (9%). When intracavernosal corticosteroid infiltration is ineffective, it appears useless to administer more than 3 injections. No morbidity was observed.


CONCLUSIONS
In our population, the reputation of inefficacy and morbidity of local corticosteroid therapy appears to be unjustified. There were no cases of deterioration, but, on the contrary, stabilization and especially very marked and rapid efficacy on pain, but a lesser efficacy on curvature and plaque. Local steroid therapy appears justified during the acute phase, as the injection allows corticosteroids to exert their anti-inflammatory action in situ in line with the pathophysiology of the disease. A standardized, multicentre, prospective, randomized, placebo-controlled study could confirm our impressions.
Demey
Alexis
A
Fédération d'Urologie-Néphrologie, Hôpital Pasteur Nice, France. demey.a@chu-nice.fr
Chevallier
Daniel
D
Bondil
Pierre
P
Toubol
Jacques
J
Amiel
Jean
J
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000188:drug therapy*; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones