human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose We aim ed to assess the effect of intralesional verapamil on the treatment of Peyronie ’s disease . Material s and methods This r and omized study involved 80 patients . First , they were divided into two groups . The first group ( case : 40 patients ) received intralesional verapamil and the second group ( control : 40 patients ) local saline injection . They were followed about 24 weeks and evaluated for the size of plaques , plaque softening , reduction of pain and amelioration of penile deformity and erectile dysfunction ( estimated by the International Index of Erectile Function ) before and after treatment . Results Reduction of plaque size was seen in 17.5 % of the case group and 12.8 % of the control group ( P : 0.755 ) . Pain was reduced in 30 % of the case group and 28.2 % of the control group ( P : 0.99 ) . Curvature was decreased in 17.5 % of the case group and 23.1 % the control group ( P : 0.586 ) . Plaque softening was seen in 30 % of the case group compared with 25.6 % improvement in the control group ( P : 0.803).Also we found 5 % and 2.6 % improvement in sexual dysfunction in the case and control groups , respectively . ( P : 0.985 ) . Conclusion Although in some studies verapamil has been found to be effective in the treatment of Peyronie ’s disease , we did not find any improvement in comparison with the control group . Furthermore , larger scale studies are warranted to assess the effect of this drug on the treatment of Peyronie ’s disease OBJECTIVES Multiple conservative therapies for the treatment of Peyronie 's disease have been offered with variable and poor response rates . Calcium channel blockers have been shown in vitro and in vivo to inhibit secretion and synthesis of extracellular matrix , including collagen , glycosaminoglycans , and fibronectin , as well as causing increased collagenase and anti transforming growth factor-beta activity . Calcium antagonists , including verapamil , are effective in stimulating the remodeling and degradation of extracellular matrix in tissue by altering the metabolic pathways of fibroblasts . Recently , a pilot study ( 1994 ) showed preliminary promising results in treating plaque caused by Peyronie 's disease . This r and omized single-blind placebo-based study ( 1994 to 1996 ) was undertaken to confirm the hypothesis . METHODS In this r and omized single-blind study , 14 patients completed the study and were divided into two groups : the verapamil treatment group ( n = 7 ) or the control saline group ( n = 7 ) . Verapamil or saline was injected directly into the Peyronie 's plaque once a week for 6 months . Patients were evaluated before and after treatment with duplex ultrasound to confirm the extent of the lesion and to measure volume of the plaque , and by interview and mailed question naire 3 months after treatment . Patients being treated with oral calcium antagonists were excluded from the study . RESULTS A decreased plaque volume was measured in 57 % of the verapamil-treated men versus 28 % in the control group ( P < 0.04 ) . Penile curvature demonstrated an improvement trend of 37.71 + /- 9.3 degrees to 29.57 + /- 7.3 degrees in the verapamil-treated patients , but the difference was not significant ( P < 0.07 ) . Plaque softening was noted in all patients treated with verapamil . There was significant objective improvement in plaque-associated penile narrowing in all patients in the verapamil group . Subjective plaque-associated erectile dysfunction ( quality of erection ) showed improvement in 42.87 % of the verapamil group versus none in the control group ( P < 0.02 ) . There was no local or systemic toxicity except for an occasional ecchymosis/bruise at the injection site . After a positive clinical response , plaque size , penile angulation , and symptoms continued to improve . Decrease in plaque size was noted in each of the responders in the first 3 months . CONCLUSIONS This r and omized single-blind study suggests that intralesional injection of calcium channel blocker may be a reasonable approach in some selected patients for the treatment of Peyronie 's disease with noncalcified plaque and penile angulation of less than 30 degrees . Patients whose plaque failed to respond to intralesional verapamil therapy within 3 months or whose angulation was greater than 30 degrees at presentation were more likely to benefit from surgery OBJECTIVE To assess the outcomes of a new protocol of intralesional injections of verapamil ( ILIV ) to treat Peyronie disease ( PD ) and to look for predictors of response . METHODS Patients followed up for PD in our center were prospect ively enrolled between 2007 and 2013 . The following data were collected : age , degree of curvature of the penis , Lue score  ( severity score of PD [ 0 - 15 ] ) , and pain  ( analogic Likert scale : 0 - 5 ) . The protocol consisted of 1 verapamil injection per session ( 15 mg in 6 mL ) in the main plaque using a single-puncture approach . Injections were repeated once every 3 weeks , at least 6 times . RESULTS Sixty men were included .  Mean number of injections per patient was 12.6 ( ±8.9 ) . Average Lue scores before and after ILIV were 9.4 ( ±2 ) and 4.5 ( ±2 ; P = .05 ) , respectively . Average penile curvatures during erection before and after ILIV were 37.3 ° ( ±13.3 ) and 21 ° ( ±13 ) , respectively ( P = .02 ) . There were no serious side effects . At the end of follow-up , 47 patients ( 78 % ) considered themselves globally improved . Younger age was the only predictor of response to ILIV in univariate ( odds ratio = 0.91 ; P = .04 ) and multivariate analyses ( odds ratio = 0.87 ; P = .03 ) . CONCLUSION ILIV had a favorable impact reducing PD in 78 % of patients with minimal side effects . Most patients required at least 12 injections to obtain optimal improvement . A protocol consisting of repeated courses of 6 injections using a single-puncture approach appears a valid option . Younger age was the only predictor of success Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more To compare the efficacy of transdermal electromotive administration and intra‐lesional injection of verapamil plus dexamethasone for the treatment of Peyronie 's disease . Patients with Peyronie 's disease of less than 2‐year duration were r and omized into two groups of transdermal electromotive administration and intra‐lesional injection of verapamil plus dexamethasone . During the 6‐week therapy period , a single weekly dose of 10 mg verapamil and 4 mg dexamethasone solution was administered to 30 patients in each group either by transdermal electromotive method or via the conventional injection method by a syringe connected to a 25 G needle . Evaluations of plaque length , width , and volume , penile curvature , erectile dysfunction and penile deviations were carried out before and after 1 and 3 months of the interventions . Erectile pain was reduced in the electromotive group from a mean of 5.1–1.0 in scale of 10 and from 5.4 to 3.6 in the injection group ( p = 0.006 ) . Regarding plaque length , plaque width , penile curvature plaque volume and erectile dysfunction , the electromotive administration group showed better results which , however , were not statistically significant . ( p > 0.05 ) . Transdermal electromotive drug administration yielded comparable results as against current conventional intra‐lesional injection technique and fared better in controlling erectile pain PURPOSE We investigated the efficacy and safety of intralesional interferon alpha-2b for the treatment of Peyronie 's disease . MATERIAL S AND METHODS A total of 117 consecutive patients with a mean age of 55.1 years who had Peyronie 's disease were enrolled in a single-blind , multicenter , placebo controlled , parallel study to determine the efficacy and safety of intralesional interferon alpha-2b therapy ( Schering , Kenilworth , New Jersey ) , including 62 who received placebo and 55 who received interferon alpha-2b . Saline ( 10 ml ) in controls and interferon alpha-2b ( 5 x 10(6 ) U ) were administered biweekly for 12 weeks . Each patient was evaluated for penile curvature , plaque size and density , penile pain , erectile function and penile hemodynamics before and after study completion . Improvement in these parameters was statistically compared between the groups . RESULTS A total of 53 patients in the control arm and 50 in the interferon alpha-2b arm completed the study . Improvement in penile curvature , plaque size and density , and pain resolution was significantly greater in patients treated with interferon alpha-2b vs placebo . The increase in mean International Index of Erectile Function scores was not significantly different between the groups . Penile blood flow improvement was observed in interferon alpha-2b treated patients but not in those who received placebo . The decrease in the number of penile vascular pathologies was significantly higher in interferon alpha-2b cases . Side effects , mostly flu-like symptoms , which were frequently noted in patients on interferon alpha-2b , were mild to moderate in degree and of short duration . CONCLUSIONS This single-blind , multicenter , placebo controlled , parallel study demonstrates that intralesional interferon alpha-2b at a dose of 5 x 10(6 ) units biweekly for 12 weeks is effective and safe as minimally invasive therapy for Peyronie 's disease Aim To determine the effectiveness of transdermal electromotive administration ( TEA ) of verapamil and dexamethasone in the treatment of Peyronie ’s disease ( PD ) . Method Totally , 51 patients with PD were prospect ively included in the study . All patients were evaluated by history , subjective score scales , physical examination , photographs , and penile USG , before and after therapy . All patients were treated with TEA of the combination of verapamil and dexamethasone . The treatment plan included a total of 20 sessions ( at 3-day intervals for a period of 2 months ) , each with a duration of 20 min . At the end of the study , improvements in penile plaques , penile deviation , pain on erection , and erectile dysfunction were determined . Results The findings in 41 of the 51 patients were eligible to present . Median patient age was 52 years . Median duration of disease at presentation was 8 months . Remarkable reduction in palpable plaques and in penile angulation was observed in 10 patients ( 24 % ) and 11 ( 26 % ) patients , respectively . There were significant decreases in median plaque volume from 72 mm2 to 45 mm2 ( P < 0.001 ) , and in median penile angulation from 25º to 15º ( P < 0.001 ) . Impaired sexual activity and pain on erection had completely resolved in 11 ( 55 % ) patients and in 16 ( 80 % ) , respectively . Conclusion The results of our study have shown that TEA of the combination of verapamil and dexamethasone is a more effective therapy for improving subjective symptoms rather than objective symptoms . Therefore , we think that this treatment can be individualized according to the clinical features of PD patients OBJECTIVE To evaluate the effect of intralesional injection of verapamil in Peyronie 's plaque with confirmed lesion . METHODS This r and omized clinical trial was carried out between March 2005 and March 2006 on 16 patients with Peyronie 's disease who were referred to the Urology Clinic of Shohadaye Ashayer Hospital in Khorram Abad , Iran . Performing a comprehensive physical exam , the genitalia of the patients were checked to confirm the diagnosis and reject other sexual disorders . Besides , parameters such as penis curving , lesion size were measured . Then , based on the 10-point visual analogue scale , sexual satisfaction of patients and their wives were recorded in a question naire . Patients got intralesional verapamil every 14 days and were treated for 6 months . After that , the parameters were assessed and data collected was analyzed using paired t-test . P-value < 0.05 was considered statistically significant . RESULTS On average , lesion size and penis curving decreased 30 % . Almost 20 % of patients and their wives were satisfied with the outcome of the treatment . No significant side effect was seen during the treatment . CONCLUSION Injection of calcium channel blockers are effective for treatment of the Peyronie 's disease ; however , more studies with more patients are BACKGROUND Intralesional therapies provide an alternative to surgical treatment of Peyronie 's disease ( PD ) . This study examines the efficacy of intraplaque injections of interferon-alpha-2B ( IFN-alpha-2B ) in the treatment of PD . METHODS Twenty-five patients were enrolled in the study with 21 completing the study . The average age of the study participants was 55.8 years , with 10 of the 21 having diabetes , hypertension , or both . Seven patients received placebo injections using 10 ml saline biweekly for 6 weeks before interferon therapy , and all 21 patients 
    Output:
    
agent
Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose We aim ed to assess the effect of intralesional verapamil on the treatment of Peyronie ’s disease . Material s and methods This r and omized study involved 80 patients . First , they were divided into two groups . The first group ( case : 40 patients ) received intralesional verapamil and the second group ( control : 40 patients ) local saline injection . They were followed about 24 weeks and evaluated for the size of plaques , plaque softening , reduction of pain and amelioration of penile deformity and erectile dysfunction ( estimated by the International Index of Erectile Function ) before and after treatment . Results Reduction of plaque size was seen in 17.5 % of the case group and 12.8 % of the control group ( P : 0.755 ) . Pain was reduced in 30 % of the case group and 28.2 % of the control group ( P : 0.99 ) . Curvature was decreased in 17.5 % of the case group and 23.1 % the control group ( P : 0.586 ) . Plaque softening was seen in 30 % of the case group compared with 25.6 % improvement in the control group ( P : 0.803).Also we found 5 % and 2.6 % improvement in sexual dysfunction in the case and control groups , respectively . ( P : 0.985 ) . Conclusion Although in some studies verapamil has been found to be effective in the treatment of Peyronie ’s disease , we did not find any improvement in comparison with the control group . Furthermore , larger scale studies are warranted to assess the effect of this drug on the treatment of Peyronie ’s disease OBJECTIVES Multiple conservative therapies for the treatment of Peyronie 's disease have been offered with variable and poor response rates . Calcium channel blockers have been shown in vitro and in vivo to inhibit secretion and synthesis of extracellular matrix , including collagen , glycosaminoglycans , and fibronectin , as well as causing increased collagenase and anti transforming growth factor-beta activity . Calcium antagonists , including verapamil , are effective in stimulating the remodeling and degradation of extracellular matrix in tissue by altering the metabolic pathways of fibroblasts . Recently , a pilot study ( 1994 ) showed preliminary promising results in treating plaque caused by Peyronie 's disease . This r and omized single-blind placebo-based study ( 1994 to 1996 ) was undertaken to confirm the hypothesis . METHODS In this r and omized single-blind study , 14 patients completed the study and were divided into two groups : the verapamil treatment group ( n = 7 ) or the control saline group ( n = 7 ) . Verapamil or saline was injected directly into the Peyronie 's plaque once a week for 6 months . Patients were evaluated before and after treatment with duplex ultrasound to confirm the extent of the lesion and to measure volume of the plaque , and by interview and mailed question naire 3 months after treatment . Patients being treated with oral calcium antagonists were excluded from the study . RESULTS A decreased plaque volume was measured in 57 % of the verapamil-treated men versus 28 % in the control group ( P < 0.04 ) . Penile curvature demonstrated an improvement trend of 37.71 + /- 9.3 degrees to 29.57 + /- 7.3 degrees in the verapamil-treated patients , but the difference was not significant ( P < 0.07 ) . Plaque softening was noted in all patients treated with verapamil . There was significant objective improvement in plaque-associated penile narrowing in all patients in the verapamil group . Subjective plaque-associated erectile dysfunction ( quality of erection ) showed improvement in 42.87 % of the verapamil group versus none in the control group ( P < 0.02 ) . There was no local or systemic toxicity except for an occasional ecchymosis/bruise at the injection site . After a positive clinical response , plaque size , penile angulation , and symptoms continued to improve . Decrease in plaque size was noted in each of the responders in the first 3 months . CONCLUSIONS This r and omized single-blind study suggests that intralesional injection of calcium channel blocker may be a reasonable approach in some selected patients for the treatment of Peyronie 's disease with noncalcified plaque and penile angulation of less than 30 degrees . Patients whose plaque failed to respond to intralesional verapamil therapy within 3 months or whose angulation was greater than 30 degrees at presentation were more likely to benefit from surgery OBJECTIVE To assess the outcomes of a new protocol of intralesional injections of verapamil ( ILIV ) to treat Peyronie disease ( PD ) and to look for predictors of response . METHODS Patients followed up for PD in our center were prospect ively enrolled between 2007 and 2013 . The following data were collected : age , degree of curvature of the penis , Lue score  ( severity score of PD [ 0 - 15 ] ) , and pain  ( analogic Likert scale : 0 - 5 ) . The protocol consisted of 1 verapamil injection per session ( 15 mg in 6 mL ) in the main plaque using a single-puncture approach . Injections were repeated once every 3 weeks , at least 6 times . RESULTS Sixty men were included .  Mean number of injections per patient was 12.6 ( ±8.9 ) . Average Lue scores before and after ILIV were 9.4 ( ±2 ) and 4.5 ( ±2 ; P = .05 ) , respectively . Average penile curvatures during erection before and after ILIV were 37.3 ° ( ±13.3 ) and 21 ° ( ±13 ) , respectively ( P = .02 ) . There were no serious side effects . At the end of follow-up , 47 patients ( 78 % ) considered themselves globally improved . Younger age was the only predictor of response to ILIV in univariate ( odds ratio = 0.91 ; P = .04 ) and multivariate analyses ( odds ratio = 0.87 ; P = .03 ) . CONCLUSION ILIV had a favorable impact reducing PD in 78 % of patients with minimal side effects . Most patients required at least 12 injections to obtain optimal improvement . A protocol consisting of repeated courses of 6 injections using a single-puncture approach appears a valid option . Younger age was the only predictor of success Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more To compare the efficacy of transdermal electromotive administration and intra‐lesional injection of verapamil plus dexamethasone for the treatment of Peyronie 's disease . Patients with Peyronie 's disease of less than 2‐year duration were r and omized into two groups of transdermal electromotive administration and intra‐lesional injection of verapamil plus dexamethasone . During the 6‐week therapy period , a single weekly dose of 10 mg verapamil and 4 mg dexamethasone solution was administered to 30 patients in each group either by transdermal electromotive method or via the conventional injection method by a syringe connected to a 25 G needle . Evaluations of plaque length , width , and volume , penile curvature , erectile dysfunction and penile deviations were carried out before and after 1 and 3 months of the interventions . Erectile pain was reduced in the electromotive group from a mean of 5.1–1.0 in scale of 10 and from 5.4 to 3.6 in the injection group ( p = 0.006 ) . Regarding plaque length , plaque width , penile curvature plaque volume and erectile dysfunction , the electromotive administration group showed better results which , however , were not statistically significant . ( p > 0.05 ) . Transdermal electromotive drug administration yielded comparable results as against current conventional intra‐lesional injection technique and fared better in controlling erectile pain PURPOSE We investigated the efficacy and safety of intralesional interferon alpha-2b for the treatment of Peyronie 's disease . MATERIAL S AND METHODS A total of 117 consecutive patients with a mean age of 55.1 years who had Peyronie 's disease were enrolled in a single-blind , multicenter , placebo controlled , parallel study to determine the efficacy and safety of intralesional interferon alpha-2b therapy ( Schering , Kenilworth , New Jersey ) , including 62 who received placebo and 55 who received interferon alpha-2b . Saline ( 10 ml ) in controls and interferon alpha-2b ( 5 x 10(6 ) U ) were administered biweekly for 12 weeks . Each patient was evaluated for penile curvature , plaque size and density , penile pain , erectile function and penile hemodynamics before and after study completion . Improvement in these parameters was statistically compared between the groups . RESULTS A total of 53 patients in the control arm and 50 in the interferon alpha-2b arm completed the study . Improvement in penile curvature , plaque size and density , and pain resolution was significantly greater in patients treated with interferon alpha-2b vs placebo . The increase in mean International Index of Erectile Function scores was not significantly different between the groups . Penile blood flow improvement was observed in interferon alpha-2b treated patients but not in those who received placebo . The decrease in the number of penile vascular pathologies was significantly higher in interferon alpha-2b cases . Side effects , mostly flu-like symptoms , which were frequently noted in patients on interferon alpha-2b , were mild to moderate in degree and of short duration . CONCLUSIONS This single-blind , multicenter , placebo controlled , parallel study demonstrates that intralesional interferon alpha-2b at a dose of 5 x 10(6 ) units biweekly for 12 weeks is effective and safe as minimally invasive therapy for Peyronie 's disease Aim To determine the effectiveness of transdermal electromotive administration ( TEA ) of verapamil and dexamethasone in the treatment of Peyronie ’s disease ( PD ) . Method Totally , 51 patients with PD were prospect ively included in the study . All patients were evaluated by history , subjective score scales , physical examination , photographs , and penile USG , before and after therapy . All patients were treated with TEA of the combination of verapamil and dexamethasone . The treatment plan included a total of 20 sessions ( at 3-day intervals for a period of 2 months ) , each with a duration of 20 min . At the end of the study , improvements in penile plaques , penile deviation , pain on erection , and erectile dysfunction were determined . Results The findings in 41 of the 51 patients were eligible to present . Median patient age was 52 years . Median duration of disease at presentation was 8 months . Remarkable reduction in palpable plaques and in penile angulation was observed in 10 patients ( 24 % ) and 11 ( 26 % ) patients , respectively . There were significant decreases in median plaque volume from 72 mm2 to 45 mm2 ( P < 0.001 ) , and in median penile angulation from 25º to 15º ( P < 0.001 ) . Impaired sexual activity and pain on erection had completely resolved in 11 ( 55 % ) patients and in 16 ( 80 % ) , respectively . Conclusion The results of our study have shown that TEA of the combination of verapamil and dexamethasone is a more effective therapy for improving subjective symptoms rather than objective symptoms . Therefore , we think that this treatment can be individualized according to the clinical features of PD patients OBJECTIVE To evaluate the effect of intralesional injection of verapamil in Peyronie 's plaque with confirmed lesion . METHODS This r and omized clinical trial was carried out between March 2005 and March 2006 on 16 patients with Peyronie 's disease who were referred to the Urology Clinic of Shohadaye Ashayer Hospital in Khorram Abad , Iran . Performing a comprehensive physical exam , the genitalia of the patients were checked to confirm the diagnosis and reject other sexual disorders . Besides , parameters such as penis curving , lesion size were measured . Then , based on the 10-point visual analogue scale , sexual satisfaction of patients and their wives were recorded in a question naire . Patients got intralesional verapamil every 14 days and were treated for 6 months . After that , the parameters were assessed and data collected was analyzed using paired t-test . P-value < 0.05 was considered statistically significant . RESULTS On average , lesion size and penis curving decreased 30 % . Almost 20 % of patients and their wives were satisfied with the outcome of the treatment . No significant side effect was seen during the treatment . CONCLUSION Injection of calcium channel blockers are effective for treatment of the Peyronie 's disease ; however , more studies with more patients are BACKGROUND Intralesional therapies provide an alternative to surgical treatment of Peyronie 's disease ( PD ) . This study examines the efficacy of intraplaque injections of interferon-alpha-2B ( IFN-alpha-2B ) in the treatment of PD . METHODS Twenty-five patients were enrolled in the study with 21 completing the study . The average age of the study participants was 55.8 years , with 10 of the 21 having diabetes , hypertension , or both . Seven patients received placebo injections using 10 ml saline biweekly for 6 weeks before interferon therapy , and all 21 patients 
    Output:
    