Journal of Andrology
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Published-Ahead-of-Print August 14, 2009, DOI:10.2164/jandrol.109.008029

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Severe, Disabling, and/or Chronic Penile Pain Associated with Peyronie's Disease: Management with Subcutaneous Steroid Injection

Rian J Dickstein , Jayant Uberoi , and Ricardo Munarriz *

* To whom correspondence should be addressed. E-mail: ricardo.munarriz{at}bmc.org.

Penile pain is one of the most distressing, limiting, and difficult to treat manifestations of Peyronie's Disease. The use of steroid injections for penile deformities associated with Peyronie's Disease has been ineffective. However, use of steroid injections in managing penile pain has been poorly investigated. The aim of this study was to examine the efficacy and safety of subcutaneous, nonintralesional steroid injections in patients with severe, disabling, and/or chronic penile pain associated with Peyronie's Disease. This is a single institution, retrospective study of 16 patients with severe, disabling, and/or chronic penile pain associated with Peyronie's Disease who underwent subcutaneous, nonintralesional injection of Triamcinolone (50 mg) between 2004 and 2006. Pre- and postinjection analog pain scales were used to assess treatment efficacy. All 16 patients, (mean age 47.6 ± 11.1 years) had penile pain associated with erections for an average of 13.9 months (range 3-36) prior to injections. Mean pre- and postinjection penile pain scores were 6.6 ± 2.1 and 0.5 ± 0.5 respectively. On average, patients were pain free at follow up visits within 10.6 ± 7.6 weeks. The mean pain-free duration was 23.8 months (range 3-52). The mean cumulative dose of Triamcinolone was 75.0 mg (range 50-200) with a mean of 1.5 injections (range 1-4). Of the 16 patients, all had overall improvement in pain scores. There were no adverse events or geometric penile changes after injections. In conclusion, subcutaneous, nonintralesional injection of Triamcinolone is an effective, safe, and durable means of managing severe, disabling, and/or chronic penile pain in patients with Peyronie's Disease. Future studies are needed to validate these findings.


Key words: Penis • Pain • Peyronie's Disease • Steroids






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