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Minimally invasive treatment of Peyronie's disease: evidence-based progress.

BJU international (2014-01-23)
Gerald H Jordan, Culley C Carson, Larry I Lipshultz
ABSTRACT

Peyronie's disease (PD) is often physically and psychologically devastating for patients, and the goal of treatment is to improve symptoms and sexual function without adding treatment-related morbidity. The potential for treatment-related morbidity after more invasive interventions, e.g. surgery, creates a need for effective minimally invasive treatments. We critically examined the available literature using levels of evidence to determine the reported support for each treatment. Most available minimally invasive treatments lack critical support for effectiveness due to the absence of randomised, placebo-controlled trials (RCTs) or non-significant results after RCTs. Iontophoresis, oral therapies (vitamin E, potassium para-aminobenzoate, tamoxifen, carnitine, and colchicine), extracorporeal shockwave therapy, and intralesional injection with verapamil or nicardipine have shown mixed or negative results. Treatments that have decreased penile curvature deformity in Level 1 or Level 2 evidence-based, placebo-controlled studies include intralesional injection with interferon α-2b or collagenase clostridium histolyticum.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Colchicine, BioReagent, suitable for plant cell culture, ≥95% (HPLC)
Sigma-Aldrich
Colchicine, ≥95% (HPLC), powder
Sigma-Aldrich
Tamoxifen, ≥99%
Sigma-Aldrich
L-Carnitine inner salt, synthetic, ≥98%
Sigma-Aldrich
(±)-Verapamil hydrochloride, ≥99% (titration), powder
Supelco
(±)-Verapamil hydrochloride, Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Tamoxifen, analytical standard
Colchicine, (European Pharmacopoeia (EP) Reference Standard)
USP
Levocarnitine, United States Pharmacopeia (USP) Reference Standard
Verapamil hydrochloride, European Pharmacopoeia (EP) Reference Standard
Levocarnitine, European Pharmacopoeia (EP) Reference Standard
Tamoxifen citrate, European Pharmacopoeia (EP) Reference Standard
USP
Verapamil hydrochloride, United States Pharmacopeia (USP) Reference Standard
Supelco
4-Aminobenzoic acid, analytical standard
Sigma-Aldrich
Tamoxifen citrate salt, ≥99%
Sigma-Aldrich
4-Aminobenzoic acid, purified by sublimation, ≥99%
Sigma-Aldrich
4-Aminobenzoic acid, ReagentPlus®, 99%
Sigma-Aldrich
4-Aminobenzoic acid, ReagentPlus®, ≥99%
Supelco
Verapamil hydrochloride solution, 1.0 mg/mL in methanol (as free base), ampule of 1 mL, certified reference material, Cerilliant®
Tamoxifen citrate for performance test, European Pharmacopoeia (EP) Reference Standard
4-Aminobenzoic acid, European Pharmacopoeia (EP) Reference Standard