title: Intralesional hyaluronic acid: an innovative treatment for Peyronie's disease.
abstract: OBJECTIVE
  The significantly different effects of several conservative treatments for Peyronie's disease (PD) led us to conduct this study to evaluate the effectiveness of local treatment with injectable hyaluronic acid (HA) for patients with this disease.
  
  
  METHODS
  The study included 83 PD patients who underwent treatment and 81 PD patients who did not (control group). The inclusion criteria were: penile plaque volume <1 cm(3); clinical characteristics and ultrasonographic appearance compatible with active inflammation; and penile curvature <45°. The medical history of all PD patients was collected. Patients undertook six tests: routine laboratory tests; penile auto-photography during erection; dynamic penile colour-duplex ultrasound study; penile X-ray (mammography technique); index of erectile function questionnaire (IIEF); and pain intensity questionnaire (visual analog scale). Treated patients received thirty penile infiltrations by injection of 20 mg HA in 6 months. Follow-up checks were conducted at the end of treatment and 12 and 24 months after treatment.
  
  
  RESULTS
  At 12-month follow-up all treated PD patients had experienced three statistically significant outcomes: reduction in plaque size (-93.7 %, p < 0.0001); improvement in penile curvature (-9.01°, p < 0.0001); and improvement in penile rigidity (mean IIEF score +3.8) with an average increase of 21.1 % (p < 0.0001). Furthermore, the improvements remained substantially stable at 24-month follow-up.
  
  
  CONCLUSIONS
  Considering the minimally invasive approach in this study, the absence of major side effects, and the significant treatment outcomes achieved, we conclude that intralesional penile injections with HA are effective for treating Peyronie's disease.
authors.affiliation: Department of Urologic Oncology, Section of Avellino, Italian League Against Cancer, Avellino, Italy. info@gennaroromano.it.
authors.forename: Romano
authors.initials: R
authors.lastname: Gennaro
authors.affiliation: Department of Urology, San Matteo Hospital - IRCCS, Pavia, Italy. barletta_dave@yahoo.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Barletta
authors.affiliation: Center of Andrology, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy. paulisg@libero.it.
authors.forename: Gianni
authors.initials: G
authors.lastname: Paulis
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010410:Penile Erection; D010411:Penile Induration / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010781:Photography; D011859:Radiography; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D055675:Viscosupplements / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Hyaluronic acid; Penile curvature; Peyronie’s disease