Intra-plaque injection of betamethasone and verapamil using a new plunger mechanism syringe with ergonomic leverage handling for the treatment of Peyronie's disease

We report a review of the literature and our experience in the intra-lesional therapy (medical therapy) for the treatment of Peyronie’s Disease. We use, since 1997, a plunger mechanism syringe with ergonomic leverage handling named Citoject. This syringe develops a high hydraulic pressure, exerting both a pharmacological and a mechanical effect on plaques. The main endpoints of this study is to compare our results with all the data reported in the recent literature about this issue. From June 2002 to December 2007, we treated 67 men with Peyronie’s disease by administering 10 weekly intra-lesional injections, alternating between betamethasone (4 mg) and verapamil (5 mg). 50 patients (89%) reported plaque-related symptoms during erection. Palpable plaque was present in all patients. Recurvatum was present in 45 patients (80%). At a mean follow-up of 30 months, we observed rapid resolution of the symptoms in 48/50 patients (96%). A significant reduction in plaque size was noted in 43% of cases (24/56; p = 0.001). Recurvatum improved only in a small percentage of cases (26.6%), with no progression of recurvatum. This device represents a good choice for intra-lesional drug administration in Peyronie’s disease. Minimal side effects or adverse reactions were reported by patients, and there was minimal involvement of the normal tissue surrounding the plaque