(299) Patient Sexual Satisfaction of in Clinic Verapamil Injections for Peyronie’s Disease: A Multicentre Retrospective Canadian Cohort Study

Introduction Peyronie’s disease (PD), or acquired penile curvature affects 5-10% of men and can significantly affect a patient’s sexual life and psychological well-being. Intralesional clostridium collagenase (Xiaflex) and interferon are known intralesional injections used to treat PD but are not available in Canada and most countries worldwide. More invasive surgical options carry the risk of erectile dysfunction and penile length loss. Intralesional verapamil (ILV) is an effective alternative for patients seeking nonsurgical treatment of PD. The results of ILV are variable and may depend on dosing, injection protocols, and practitioner technique. Given the lack of Canadian alternatives, we wanted to explore patient outcomes to ensure adequate response to treatment. Objective We aimed to determine whether the use of our ILV protocol in PD patients resulted in measurable improvements in their sexual function and their satisfaction with their curvature correction. Methods This is a retrospective multicenter cohort study of 280 men with PD who received ILV treatment in clinic between January 1st, 2021 and September 30th, 2025. At each session, patients were given a dorsal penile block, followed by the verapamil injection using a fanning technique into the PD scar. Treatment was completed weekly or bi-weekly, with the total number of treatments dependent on patient and surgeon discretion. Clinical data such as PD risk factors, penile curvature, sexual function, and treatment satisfaction were collected. Primary outcomes were patient satisfaction, need for surgery after treatment, and ability to be sexually functional. Results Mean age of patients in the study was 59 years old and the average number of injections per patient was 8 (range: 2-34). The average time since onset of PD was 21.7 months with an average disease stability 14.5 months. Risk factors included smoking (20.3%), diabetes (17.8%), erectile dysfunction (38.9%), Dupuytren’s contractures (3.0%), and tympanosclerosis (1.0%). Most patients presented with a dorsal curvature (54.3%) of 30-45 degrees (40.0%). Notably, the ability to have penetrative sexual intercourse increased from 54.6% prior to treatment to 91.1% at the end of treatment. The majority (77.9%) of patients reported satisfaction with their results endorsing clinically significant subjective improvement in their PD. Only 13.6% of patients desired any additional treatment(s) after completing their course of ILV injections. Conclusions Our ILV treatment protocol improves clinical outcomes of PD by assisting men regain their ability to engage in sexual intercourse and providing them with subjective improvements of their penile curvature. Our results indicate intralesional verapamil injection therapy is an effective option for patients with Peyronie’s disease. Disclosure No