title: Tadalafil once daily and intralesional verapamil injection: A new therapeutic direction in Peyronie's disease.
abstract: BACKGROUND
  The aim of this study was to evaluate the combination of intralesional verapamil injection (IVI) therapy with and tadalafil in men affected by Peyronie's disease (PD).
  
  
  METHODS
  In this study, 59 patients diagnosed with PD, were divided into three groups. Group A (GA) counted 23 patients treated with IVI; Group B (GB) treated 19 patients with tadalafil 5 mg once a day, and Group C (GC) treated 17 patients with IVI and tadalafil for 3 months. There were assessed at baseline and follow-up: Erectile function, presence and severity of painful erections, penile plaque size and penile curvature degree.
  
  
  RESULTS
  After 3 months pain resolved completely in 57% cases of GA, 61% of GB and 76% of GC; the final mean curvature degree further decreased in all groups without statistically significant differences; mean plaque size remained stable in GA: 1.57 versus 1.59 at baseline (P = 0.364) and GB: 1.51 versus 1.52 at baseline (P = 0,265), while a further decrease was evident in GC: 1.46 versus 1.58 at baseline (P = 0.03). Mean International Index of Erectile Function-5 score further improved significantly in the group treated with verapamil plus tadalafil: 23.1 versus 14.4 of GA and 18.2 of GB (P ≤ 0.01).
  
  
  CONCLUSIONS
  The association of IVI and tadalafil showed better pain control while reducing penile curvature and erectile function, improving the quality of life.
authors.affiliation: Department of Urology, University Hospital S. Anna, Ferrara, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Dell'Atti
keywords: Erectile dysfunction; Peyronie's disease; phosphodiesterase type 5 inhibitors; verapamil