Transdermal application of verapamil gel to the penile shaft fails to infiltrate the tunica albuginea

PURPOSE: There currently exists no universally accepted pharmacotherapy for Peyronie's disease. Recently interest has grown in transdermal agents, including verapamil. We evaluated the ability of a commercially available verapamil gel applied to the penile skin to infiltrate the tunica albuginea. MATERIALS AND METHODS: In men scheduled to undergo penile prosthesis surgery for erectile dysfunction verapamil gel was applied to the penile shaft the night before and morning of surgery. Urine was obtained at the commencement of the implant operation and tunical samples were excised from each corporeal body intraoperatively. Verapamil quantification was performed in all specimens using high pressure liquid chromatography. RESULTS: All patients tolerated verapamil gel application without any adverse events. A mean of 1.1 gm. tunical tissue was excised. Mean verapamil concentration in the urine was 46 ng./ml. No verapamil was detected in any tunical specimens. CONCLUSIONS: These data indicate that applying transdermal verapamil gel to the penile shaft results in a small amount of systemic absorption but the gel does not infiltrate the tunica albuginea. Based on these findings the use of transdermal verapamil for Peyronie's disease has no scientific basis.