Evaluating the efficacy of intraplaque injection of dexamethasone with oral tadalafil in the chordee patients with Peyronie disease

Abstract

Background: Some studies demonstrated the effect of the combination of modalities in Peyronie's disease (PD) therapy; however, there is no comprehensive study for evaluation of dexamethasone and phosphodiesterase type 5 (PDE5) inhibitors such as tadalafil in the treatment of PD, so the study aimed to evaluate the efficacy of intraplaque injection of dexamethasone with oral tadalafil in the patients with PD. Materials and methods: This double-blinded randomized, controlled trial was conducted on the patients with PD referred to Alzahra and Khorshid hospitals, Isfahan, Iran. Then the patients were randomly divided into two groups as intervention and control groups. In the intervention group, tadalafil (5 mg PO) was administered once daily for 12 weeks and dexamethasone (8 mg) was injected once a week for 12 weeks. In the control group, the verapamil (5 mg: 2 cc) was injected once a week for 12 weeks. Before and after 12 weeks, an ultrasound was performed to assess the size, number and location of the plaque. The degree of penile curvature from the midline, dorsal and lateral curvature was also determined. Results: The means of penis curvature in the intervention and control groups before therapy were 34.09 +/- 7.05 degrees and 31.09 +/- 7.06 degrees, respectively (P=0.097) and also after therapy were 27.3 +/- 7.79 degrees and 24.6 +/- 6.64 degrees, respectively (P=0.13). The means of plaque count in the intervention and control groups before treatment were 2.0 +/- 1.03 and 1.96 +/- 1.06, respectively (P=0.9) and after treatment were 1.22 +/- 0.71 and 1.40 +/- 0.79, respectively (P=0.34). The means of plaque size in the intervention and control groups were 12.31 +/- 4.9 cm and 12.45 +/- 4.12 cm, respectively (P=0.9) and after intervention 7.8 +/- 3.08 and 9.03 +/- 3.46 cm, respectively (P=0.15). Conclusion: According to these findings, there was no significant difference between intervention and control groups regarding the degree of penis curvature, and the count and size of the plaque. Therefore, it seems that tadalafil therapy with dexamethasone did not improve PD compared to verapamil.