Androstanolone treatment for congenital penile curvature

Objectives: To test the etiological hypotheses of congenital penile curvatu re (CPC) and to infer the possible therapeutic approaches. Materials and Me thods: Seventy patients affected by CPC were enlisted for the present study : 37 with left curvature, 21 with ventral curvature, 11 with left ventral-l ateral curvature, and 1 with right curvature. All patients under the age of 21 years were encouraged to take local medical therapy with alcohol andros tanolone gel in a dosage of 0.15 mg/cm(2) of surface area. Group A (17-43 y ears of age) consisted of patients who refused medical therapy and decided to solve their problem with surgery. They underwent Nesbit's operation and were given a contralateral biopsy of the tunica albuginea at the same time. Cytoplasmic androgen receptors (CARs) were quantified in the tunica albugi nea of both cavernous bodies (CBs). Group B consisted of 26 patients aged b etween 4 and 21 years who were given local medical therapy with androstanol one in alcohol gel. They underwent a maximum of 3 therapy cycles each lasti ng 2 months with a 1-month suspension between each. Group C consisted of 9 patients (27-53 years of age) who were fathers of 9 group B patients. These adults were also affected by penile curvature and taken into consideration as a control group because we have observed three spontaneous corrections of penile curvature in puberty. Results: CARs research in group A and in 6 group B patients under the age of 20 revealed a 2-5 times reduction on the concave part of the cavernous body compared to the contralateral one. This difference progressively decreased in older patients. In group B, 14 patien ts aged between 4 and 15 years and 1 aged 17 (53.8%) were treated with a lo cal androstanolone therapy and the result was a regression in the curvature between 30 and 100%. Another 9 patients aged between 17 and 21 years did n ot show any improvement despite androstanolone treatment. Conclusions: The results show a 2-5 times reduction in CARs on the hypoplasic cavernous body of young male patients. These differences progressively decreased in older patients. The positive results of the androstanolone therapy in patients u nder the age of 15 and the negative ones in older patients are certainly re lated to the quantity of CARs present on the tunica albuginea. Copyright (C ) 2001 S. Karger AG, Basel.