kja Korean Journal of Andrology Korean J Androl 1229-1692 Journal of the Korean Society for Male Gynecology 10.5534/kja.2011.29.2.156 kja-29-156 Original Article Effect of PDE5 Inhibitor in Nonsurgical Management of Peyronie's Disease: Preliminary Study Ham Byeong Kuk Oh Mi Mi Shin Su Hwan Park Tae Yong Kim Sang Woo Park Jong Jin Jeong Seung Min Moon Du Geon Department of Urology, Korea University College of Medicine, Korea University Institute for Regenerative Medicine, Seoul, Korea Correspondence to: Du Geon Moon Department of Urology, Korea University College of Medicine, Korea University Institute for Regenerative Medicine, 80, Guro-dong, Guro-gu, Seoul 152-703, Korea Tel: 02-2626-1320, Fax: 02-2626-1321 E-mail: dgmoon@korea.ac.kr 82011 2282011 292 156160 10082011 22082011 23082011 Copyright © 2011 Journal of the Korean Society for Male Gynecology 2011 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

This study was designed to evaluate the role of PDE5 inhibitors as combination therapy with conventional treatment of Peyronie's disease (PD).

 Materials and Methods

From July 2007 to October 2010, 35 Patients were divided into two groups. Group I (N=14) received PDE5 inhibitors in addition to conventional treatment with tamoxifen and acetyl L-carnitine, while group II (N=21) received only conventional treatment. The follow-up duration was at least 12 weeks after the active therapy of PD. Outcomes were assessed by pain relief, successful attempts for sexual intercourse, resolution of the plaque and any occurring complications.

 Results

In the efficacy of overall treatment of 35 patients, 94.3% patients experienced successful sexual intercourse, while 5.7% experienced pain on erection, and 25.7% showed a decrease in plaque size. The analysis of parameters before treatment showed no significant difference between groups in terms of successful attempt at sexual intercourse (p=0.583) and pain on erection (p=0.445). Furthermore, there was no difference between groups after treatment in terms of successful attempts at sexual intercourse (p=0.766), pain on erection (p=0.766) and change in plaque size (p=0.445). However, successful intercourse and pain relief after treatment showed significant change irrespective of groups (p＜0.05). While the addition of a PDE5 inhibitor did not show any significant improvement in clinical outcome measures, the satisfaction of patient was higher in patients who received combination treatment (p=0.042).

 Conclusions

Although the effect of PDE5 inhibitor for pain relief, successful intercourse and resolution of plaque size was not significant, patients who received PDE5 inhibitors had a more satisfaction of treatment of PD. Further prospective studies on the effect of PDE5 inhibitor in PD will be needed.

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Efficacy of ovearall treatment after treatment in total 35 patients

Variables Before treatment After treatment p-value
Ability of sexual intercourse 85.7% (30/35) 94.3% (33/35) 0.138
Pain on erection 28.6% (10/35) 5.7% (2/35) 0.11
Plaque size (cm) 2.4±1.5 2.1±1.6 0.466

Analysis of group I and II

Variables Group I∗ Group II† Group III‡
Age 54.9±10.2 59.2±8.2 0.194
Number of patients 14 21
Sexual intercourse (＋) before treatment 78.6% (11/14) 90.4% (19/21) 0.583
Pain (＋) before treatment 35.7% (5/14) 23.8% (5/21) 0.445
Sexual intercourse (＋) after treatment 92.9% (13/14) 95.2% (20/21) 0.766
Pain (＋) after treatment 7.1% (1/14) 4.8% (1/21) 0.766
Resolution of plaque after treatment 21.4% (3/14) 33.3% (7/21) 0.445
Satisfaction of patients 85.7% (12/14) 52.4% (11/21) 0.042

Group I patients recieved longterm continuous PDE5 inhibitors (Tadalafil 5 mg once daily) in addition toconventional treatment with tamoxifen 20 mg and acetyl L-carnitine 330 mg twice a day.

Group II patients recived conventional treatment with tamoxifen 20 mg and acetyl L-carnitine 330 mg twicea day.

p-value＜0.05 to be statistically significant.