title: Severe, disabling, and/or chronic penile pain associated with Peyronie disease: management with subcutaneous steroid injection.
abstract: Penile pain is one of the most distressing, limiting, and difficult to treat manifestations of Peyronie disease. The use of steroid injections for penile deformities associated with Peyronie disease has been ineffective. However, use of steroid injections in managing penile pain has been poorly investigated. The aim of this study was to examine the efficacy and safety of subcutaneous, nonintralesional steroid injections in patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease. This was a single-institution retrospective study of 16 patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease who underwent subcutaneous, nonintralesional injection of triamcinolone (50 mg) between 2004 and 2006. Preinjection and postinjection analog pain scales were used to assess treatment efficacy. All 16 patients (mean age, 47.6 ± 11.1 years) had penile pain associated with erections for an average of 13.9 months (range, 3-36 months) prior to injections. Mean preinjection and postinjection penile pain scores were 6.6 ± 2.1 and 0.5 ± 0.5, respectively. On average, patients were pain free at follow-up visits within 10.6 ± 7.6 weeks. The mean pain-free duration was 23.8 months (range, 3-52 months). The mean cumulative dose of triamcinolone was 75.0 mg (range, 50-200 mg), with a mean of 1.5 injections (range, 1-4 injections). All 16 patients had overall improvement in pain scores. There were no adverse events or geometric penile changes after injections. Subcutaneous, nonintralesional injections of triamcinolone is an effective, safe, and durable means of managing severe, disabling, and/or chronic penile pain in patients with Peyronie disease. Future studies are needed to validate these findings.
authors.affiliation: Center for Sexual Medicine, Department of Urology, Boston University School of Medicine, Boston, MA 02118, USA.
authors.forename: Rian
authors.initials: R
authors.lastname: Dickstein
authors.forename: Jayant
authors.initials: J
authors.lastname: Uberoi
authors.forename: Ricardo
authors.initials: R
authors.lastname: Munarriz
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D010147:Pain Measurement; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology*; D010411:Penile Induration / Q000150:complications*; D010413:Penis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D014221:Triamcinolone