Author/Authors :
Munoz-Rangel، Carlos Arturo نويسنده Department of Urology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico. , , Fernandez-Vivar، Elieser نويسنده Department of Urology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico. , , Banuelos-Gallo، Ruben Alejandro نويسنده Department of Banuelos Radiologos, Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Gonzalez-Ojeda، Alejandro نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Macias-Amezcua، Michel Dassaejv نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Chavez-Tostado، Mariana نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Ramirez-Campos، Kenia Militzi نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Ramirez-Arce، Anais del Rocio نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Cortes-Lares، Jose Antonio نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico , , Fuentes-Orozco، Clotilde نويسنده Department of Research Unit in Clinical Epidemiology Medical Unit of High Specialty, Specialties Hospital of the Western Medical Center, Mexican Institute of Social Security, Guadalajara 44349, Jalisco, Mexico ,
Abstract :
Purpose: To determine the effectiveness of intralesional administration of onabotulinumtoxinA in patients with Peyronie’s
disease (PD).
Materials and Methods: A prospective therapeutic cohort study was undertaken in patients aged ? 18 years with
stable PD. Intervention included one-time intralesional application of 100 U of onabotulinumtoxinA. We included 22
patients who attended the urology clinic from October 1, 2011 to June 30, 2012. Primary outcome measure was degree
of curvature. Secondary outcome measures were thickness of the fibrous plaque, improvement in erectile function
and pain. Erectile function was evaluated using the International Index of Erectile Function (IIEF-5) questionnaire.
The Visual Analog Scale (VAS) was used to measure pain during an erection. Statistical analyses were performed by
Pearson’s chi-squared test for categorical variables and student’s t-test for quantitative variables. Any P value < .05
was considered statistically significant.
Results: The size of the fibrous plaque was reduced from 0.34 ± 0.20 to 0.27 ± 0.13 cm after treatment (P = .014). The
curvature initially averaged 32.95 ± 9.21°, and improved to 25 ± 9.38° (P = .025). According to the Kelami classification,
the curvature was < 30° in 14 cases (63.6%) and was 30°-60° in eight cases (36.4%). At 16 weeks, the curvature
was < 30° in 19 cases (86.4%) and 30°-60° in three cases (13.6%). The IIEF-5 score was 16.18 ± 4.46 before treatment
and 18.22 ± 4.55 after treatment (P = .002). Pain was reduced from 3.36 ± 3.48 before treatment to 1.14 ± 1.58 after
treatment (P = .001).
Conclusion: The administration of onabotulinumtoxinA may improve the clinical manifestations of PD resulting from
fibrosis, thus improving sexual function in patients.
