INTRAPLAQUE INJECTIONS OF HYALURONIC ACID IN PATIENTS SUFFERING FROM PEYRONIE’S DISEASE WITH VENTRAL CURVATURES

The aim of this study is to evaluate the safety and the effectiveness of intraplaque hyaluronic acid (HA) injections for the treatment of ventral curvatures in patients suffering from Peyronie’s disease (PD). To the best of our knowledge, ventral curvature were always exclusion criteria in the previous studies, so HA injections have never been tried in this kind of curvature.

From our database we retrospectively collected data of men with ventral curvature with stable-phase PD between June 2018 to August 2024. The curvature assessment after intracavernosal injection of prostaglandin E1, the International Index of Erectile Function (IIEF) and Peyronie’s Disease Questionnaire (PDQ) were completed at baseline and at week 8 (4 weeks after the last injection).

All patients underwent a standard protocol: after a ring block performed with 10 mL of 7,5% Ropivacaine and 10 mL of 2% Mepivacaine a total of three intralesional injections of HA were given at 2-week intervals. HA injections were performed laterally to the plaque, to avoid urethral injuries. In between injections, patients were instructed to perform vacuum device therapy, penile stretching and modeling exercises to mechanically stretch the plaque.

A total of twenty-seven patients with ventral curvature were treated with HA (median age 55 years, median PD duration 21 months, median curvature 55° (IQR = 50-60). Following treatment 17 patients (62.9%) experienced improvements in the penile curvature (median curvature 45°; IQR = 40-50; p < 0.01) and in each of the IIEF questionnaire and PDQ domains.

Ten patients reported no improvements. No major complications such as hematomas or urethral complications were reported. Five patients reported ecchymosis at the base of the penis likely due to the local anesthesia.

Unlike collagenases, which have shown more effectiveness in ventral curvatures than in dorsal ones, HA injections do not seem equally promising in these patients. Certainly, the sample size is small, and the study is retrospective: prospective studies with a larger sample size are needed to confirm the limited effectiveness of hyaluronic acid in ventral curvatures.

The authors declare no conflict of interest.