(041) IN CLINIC VERAPAMIL INJECTIONS FOR PEYRONIE’S DISEASE: A RETROSPECTIVE STUDY ON PATIENT SEXUAL SATISFACTION

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Abstract Introduction Peyronie’s disease (PD) is an acquired curvature of the penis that affects 5-10% of men and is associated with psychological distress. Intralesional Clostridium collagenase (Xiaflex) and interferon have been removed from Canada, leaving verapamil as the only effective therapy available to our patients. The results of intralesional verapamil (ILV) are variable depending on dosing, injection protocols, and practitioner technique. Surgical treatment of PD endorses substantial risk of penile length loss and erectile dysfunction, which most patients prefer to avoid. Objective We aimed to evaluate our experience with ILV to determine whether off-label ILV provides satisfactory results to men with PD and avoids more invasive interventions. Methods This is a retrospective multicenter cohort study of 224 men who completed ILV treatment between January 1st 2021 and December 31st 2023 performed by three urologists. Dorsal penile block was performed, and verapamil was injected using FAN technique into PD scar. Subjective clinical data was retrieved from initial consultation and follow-up visits through our electronic records. Results Mean age was 57 years old, with a majority of men having an upward curvature (56.7%) between 30-45° (43.8%). Mean onset of the curvature was 20.5 months before the initial consult, with a disease stability of 11.3 months. Risk factors including erectile dysfunction (44.2%), diabetes (19.1%) and active smoking (20.6%) were evaluated. The curvature was initially impairing sexual intercourse for 59% of patients. After ILV treatment protocol, 81.3% of patient’s curvature were subjectively improved, with 94.6% of men being able to engage in sexual intercourse, an increase of 35.6%. Only 14.3% required subsequent surgical treatment for their PD. Conclusions We conclude that our ILV treatment protocol helps men regain their ability to engage in sexual intercourse, provides a subjective lesser degree of curvature and reduces the need to undergo more invasive interventions. Disclosure No.

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