Improved Peyronie's Disease Curvature Outcomes Using a Novel Collagenase Administration Protocol.

Abstract

OBJECTIVE:

To report outcomes of a novel collagenase clostridium histolyticum (CCH) injection protocol.

METHODS:

A prospective, sequential database was maintained of all Peyronie's men undergoing CCH injections since 2015. Our protocol has evolved to include changes with injection technique, timing, aggressive modeling/traction, and wrapping. Results of the "traditional" and "novel" techniques were compared using two definitions: "most recent" assessment and final assessments among men who "completed eight (injections) or were satisfied."

RESULTS:

A total of 509 men underwent greater than or equal to 1 CCH series (traditional, n = 280; novel n = 229). Baseline demographic/clinicopathologic characteristics were similar between groups. Results demonstrated significantly greater curve improvements with the novel technique ("most recent" median 30° vs 20° or 46% vs 28%; "completed eight or satisfied" 34° vs 20° or 58% vs 30%). Using the "completed eight or satisfied" definition, 94% vs 66% of men achieved greater than or equal to 20% improvement (odds ratio 7.6), and 60% vs 24% achieved greater than or equal to 50% improvements (odds ratio 5.0) in the novel cohort (all P < .0001). Importantly, the International Index of Erectile Function Erectile Function Domain score was unchanged, and subjective erectile function (50% vs 5%, P < .0001) and sensation improved (17% vs 8% improved, P = .01) with the new protocol. The novel cohort also reported higher rates of surgery prevention (53% vs 18%), restored/facilitated penetration (57% vs 21%), and hematomas (56% vs 26%), necessitating changes to wrapping procedures (all P < .0001).

CONCLUSIONS:

Use of the novel CCH protocol results in significant improvements with curvature without negatively impacting erectile function or sensation. Given its specialized nature, it is not recommended for low-volume CCH injectors.

• Authors: Ashley Flores, Alissa Tyler, Benjamin Green, Trevor Price, Joshua Savage, Klinton Brearton, Sevann Helo, Matthew Ziegelmann, Tobias Kohler, Landon Trost
• Journal: Urology (Urology) Vol. 170 Pg. 117-123 (12 2022) ISSN: 1527-9995 [Electronic] United States
• PMID: 36241063 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Microbial Collagenase

Topics

• Humans
• Male
• Erectile Dysfunction
• Injections, Intralesional
• Microbial Collagenase (therapeutic use)
• Penile Induration (drug therapy)
• Penis (drug effects, physiopathology)
• Prospective Studies
• Treatment Outcome