Can treatment options like injections of verapamil be just as effective if you wait too long for that treatment and the curvature is around 90 degrees?

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Dr. Levine answers: This question will be answered in 2 parts. One pertains to the severity of curvature which at 90 degrees is certainly a severe curve and the other is the duration of disease and whether the scarring process is stable or still active. Published studies have shown that the response to verapamil injections was similar in men regardless of the duration of the PD. With regard to the response to verapamil depending upon severity of curvature, this was also examined. The response rate was evaluated for mild (less than 30 degrees), moderate (30-60 degrees), or severe (greater than 60 degrees) deformity. The study showed that although there was a greater degree of curvature correction in men with moderate to severe curve, overall response rates were similar in all groups. The average degree of curvature correction which has been reported in studies on intralesional verapamil injection is in
the 20 to 30 degree range.

If a man has a 90-degree curve, it is not likely that he will experience more than a 30-degree improvement if he is a responder, which means he still has a fairly severe curve. Some men who have reduced their curve from 90 to 60 degrees, find that they can now function much better and do not require surgery For those who do require surgery, they may not need the more complex grafting procedure and may do well with the less risky plication operation.

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