Abstract Introduction Hyaluronic acid (HA) is a predominant GAG- glycosaminoglycan of the connective tissue and it is present in high concentrations in the tunica albuginea. The current literature shows data on the efficacy of intraplaque injections of HA. At physiological pH, HA is highly polarized and maintains hydration that leads to a reduction in plaque related symptoms. To the best of our knowledge Perovial (IBSA Italia, Institut Biochimique SA, Lodi, Italy) is the first HA approved for Peyronie’s disease (PD). Perovial is composed of a buffered saline solution of hyaluronic acid sodium salt. It contains 0,8% higly purified hyaluronic acid sodium salt with a molecular weight between 800 and 1200 kDalton. Objective The aim of this study is to evaluate the safety and the effectiveness of Perovial injections in patients suffering from PD in both acute and chronic phase. Methods From our database we retrospectively collected data of men with PD between June 2025 to October 2025. 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). The database excluded patients with ventral curvatures or completely calcified plaques. All patients underwent a standard protocol: after a ring block performed with 10mL of 7,5% Ropivacaine and 10 mL of 2% Mepivacaine a total of three intralesional injections of HA were given at 2-week intervals. In between injections, patients were instructed to perform vacuum device therapy, penile stretching and modeling exercises to mechanically stretch the plaque. Results A total of twenty-three patients were treated with HA (mean age 55 years, mean PD duration 15 months, mean curvature 55°). Following treatment 19 patients (82.6%) experienced improvements in the penile curvature mean curvature 43° (p0.01) and in each of the IIEF questionnaire and PDQ domains. Four patients reported no improvements (17,4%). One patient reported penile hematoma; five patients (21,7%) reported ecchymosis at the base of the penis likely due to the local anesthesia. Conclusions Perovial injections seem promising and safe 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 effectiveness and the safety of Perovial. Disclosure No
Zimarra et al. (Mon,) studied this question.