title: Defining predictors of response to intralesional verapamil injection therapy for Peyronie's disease.
abstract: OBJECTIVE
  • To assess factors that predict penile curvature responses to intralesional verapamil (ILV) injection therapy for men with Peyronie's disease (PD).
  
  
  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 ° 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 vs >40 years; OR 0.27, P < 0.05, 95%CI 0.10-0.75) and degree of penile curvature at baseline (≤30 ° vs >30 °; OR 9.12, P < 0.01, 95%CI 1.94-42.84) when dichotomized as indicated.
  
  
  CONCLUSIONS
  • 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.
authors: Sexual and Reproductive Medicine Program, Urology Service, Department of Surgery, Department of Psychiatry and Behavioral Services, Memorial Sloan Kettering Cancer Center, New York, NY, USA. mulhalj1@mskcc.org
authors: Daniel J
authors: DJ
authors: Moskovic
authors: Byron
authors: B
authors: Alex
authors: Judy M
authors: JM
authors: Choi
authors: Christian J
authors: CJ
authors: Nelson
authors: John P
authors: JP
authors: Mulhall
mesh_terms: D000367:Age Factors; D005544:Forecasting; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000188:drug therapy*; D012044:Regression Analysis; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D014700:Verapamil