Presentation Authors: Ali Antar*, Boriss Losso, James Anaissie, Jorge Rivera, Mohit Khera, Houston, TX
Introduction: Botulinum toxin type A (BTA) has revolutionized the treatment of overactive bladder and other neurogenic lower urinary tract disorders. Acting primarily by reducing scar formation, BTA also shows promise as a treatment for other urologic scar-mediated diseases such as urethral stricture. Peyronieâ€™s disease causes curvature due to fibrosis and scar formation, thought to be due to the microtrauma associated with sex. Oral treatments are ineffective and with only one approved intralesional therapy (collagenase clostridium histolyticum)4, there is continued hope for novel treatments. The intent of this study is to determine the clinical efficacy of intralesional botulinum toxin type A injections to treat Peyronieâ€™s disease.
Methods: This study is a randomized, placebo-controlled trial examining the use of intralesional BTA injections for the treatment of Peyronieâ€™s disease. The study included patients in the stable phase of Peyronieâ€™s and excluded patients with active Peyronieâ€™s, with multiple plaques, and calcified plaques. 12 patients were split into two treatment arms: 6 patients in arm 1 received 100 units of intralesional botulinum toxin type A injections and 6 patients in arm 2 received placebo. Both groups received injections every 2 weeks over 16 weeks for a total of 8 injections. Primary endpoints were International Index of Erectile Function (IIEF) scores and percent change in degree of curvature.
Results: IIEF scores were not significantly improved in week 16 compared to week 1. Percent change in curvature was not significant. Full results are shown in the table below.
Conclusions: This study was not able to demonstrate clinically significant improvement in IIEF scores or percent change in degree of curvature. The study was significantly limited by small sample size and limited recruitment of patients with similarly matched degrees of curvature. The treatment modality shows promise and would warrant further investigation if future studies can focus on treating specified subsets of patients with a particular range of degrees of curvature.