title: Long-term multimodal therapy (verapamil associated with propolis, blueberry, vitamin E and local diclofenac) on patients with Peyronie's disease (chronic inflammation of the tunica albuginea). Results of a controlled study.
abstract: OBJECTIVE
  to demonstrate the possible effectiveness of a long-term multimodal medical therapy in patients with Peyronie's disease (PD) we carried out a controlled study on 82 patients diagnosed with PD, whereas in the scientific literature the conservative treatment of this disease is much discussed.
  
  
  METHODS
  82 patients (mean age=53.6±10.1 years-range 23-68) diagnosed with PD were selected for this study. Of these 41 patients (group A) were treated for 18 months as follows: Verapamil penile injections (12 total injections for six months and subsequently every month for twelve months: total 24 injections) + Iontophoresis with Verapamil/daily + blueberries 160mg/daily + propolis 600mg/daily + Vitamin E 600mg/daily + topical Diclofenac/daily. The other 41 patients spontaneously decided not to receive treatment for several motives and then were introduced as a control group B. All patients were controlled at 6- and 18-month follow up with the same diagnostic tests completed before the therapy (penile ultrasound, photograph documentation, pain scale etc.).
  
  
  RESULTS
  In group A, after treatment of 6 and 18 months, the change in plaque volume consisted in volume reduction= - 47.6% and -73.6% respectively, while in group B, the change consisted of an increase in plaque volume= +55.7% and +118.7% respectively (p=0.000). In group A, after treatment of 6 and 18 months, improvement of curvature occurred in 76.3% and 81.5% of the cases respectively, while in group B it occurred in 2.7% and 8.1%, respectively (p<0.0001).
  
  
  CONCLUSIONS
  Our results showed that a long-term multimodal medical therapy (Verapamil associated with Antioxidants and local Diclofenac) is statistically effective to treat PD patients, if we consider that lower therapeutic outcomes were achieved after 6 months treatment (medium-term treatment). Furthermore, this study confirms that the best treatment modality for PD is a combination therapy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Paulis
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cavallini
authors.forename: Giovanni De
authors.initials: GD
authors.lastname: Giorgio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Quattrocchi
authors.forename: Tommaso
authors.initials: T
authors.lastname: Brancato
authors.affiliation: Andrology Center, Regina Apostolorum Hospital, Via San Francesco, 50 - CAP 00041, Albano Laziale, Rome, Italy. paulisg@libero.it.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D029798:Blueberry Plants; D016022:Case-Control Studies; D004008:Diclofenac / Q000008:administration & dosage*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000188:drug therapy*; D011429:Propolis / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage*; D014810:Vitamin E / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014810:Vitamin E; D004008:Diclofenac; D011429:Propolis; D014700:Verapamil