What are your thoughts on the use of topical verapamil application via iontophoresis?

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Dr. Larry Levine from Chicago has shown very elegantly that the use of iontophoresis allows verapamil applied to the skin to be absorbed into the tunica albuginea. This is in direct contrast to the use of transdermal verapamil without iontophoresis, as it has been clearly shown that in this case no verapamil gets absorbed into the tunica albuginea and so most experts believe that regular transdermal verapamil has no chance of working. There is a small amount of evidence that iontophoretic delivery of verapamil may be of some benefit, however, the structure of the studies to date preclude any definitive answer to the question. There is some debate among experts as to what the purpose of medical (nonsurgical) therapy is: is it to correct the deformity or is it to prevent it worsening? I would contend that the latter is more achievable that the former but there are some men who obtain an improvement in curvature with medical treatment. The bottom line is that the final answer is not known yet. Most importantly, transdermal verapamil is not dangerous. Verapamil is used primarily as a blood pressure agent so the rare man may have a slight drop in blood pressure but it is generally accepted to be a very safe agent. The only concern would be that if it is shown that it is not effective that men may have been wasting time in ignoring other treatments.

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