Stable-Phase Peyronie's Disease: Have Perilesional Injections of Hyaluronic Acid Come of Age?

Background: Peyronie's Disease (PD) is a complex andrological condition that severely compromises patients' quality of life. While a novel formulation of hyaluronic acid (HA) has recently gained traction for treating the acute inflammatory phase, clinical evidence regarding its role in stable-phase (chronic) PD is lacking. We aimed to assess the therapeutic outcomes and safety profile of Perovial®, a specialized HA formulation, in patients with stable disease. Methods: A cohort of 47 patients with stable-phase PD was treated at a single andrological center between June and December 2025. The treatment protocol consisted of eight weekly injections targeted around the tunica albuginea plaque. Clinical efficacy was assessed 3 months post-treatment by comparing baseline data with the following outcome measures: change in penile curvature (Δ°), the international index of erectile function (IIEF-5) score, Peyronie's Disease Questionnaire (PDQ) and Global Assessment of Peyronie's Disease (GAPD). Results: At the 3-month follow-up visit, a statistically significant improvement in penile curvature was registered in 35 out of 47 patients (Δ° - 16) (p < 0.001). All patients had a significant improvement from baseline in terms of IIEF (20 vs. 24; p < 0.001) and in all PDQ domains. No major adverse events or complications were observed during the study period. At the GAPD questionnaire, 43 patients (91.2%) reported subjective improvement of penile curvature. Conclusions: Perilesional injection of Perovial® seems a promising intervention in patients with stable-phase PD in terms of penile curvature reduction and patient-reported quality of life improvement.