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Conservative treatment of Peyronie’s disease (PD) with intralesional injection therapy using Collagenase Clostridium Histolyticum (CCH) is widely used. This treatment is especially popular in the USA, as CCH is the only FDA-approved conservative treatment for PD.

Surgical therapy still represents the gold standard to correct penile curvature associated with PD.

So far, no comparative studies were available that compared the efficacy of CCH against surgical treatment options. Thus, the aim of our study was to compare the efficacy of CCH against two well established surgical options (plication, partial plaque excision, and grafting). This is the first study with such an approach.

For this purpose, we conducted a multi-center study with centers in the USA, Canada, and Germany. All of the centers are specialized in the diagnosis and treatment of PD.

In total, 57 patients were included in this study.

The results of our study are displayed in detail in the manuscript. All three treatment options resulted in satisfying results for patients with PD. The main advantage of CCH is that it does not require any surgical intervention (just injections into the plaque) and that it can be done in an outpatient setting. On the other side, 34.4% of patients treated with CCH showed a reduction of curvature. Curvature reduction was significantly higher in patients treated with surgical therapy. Patients with plication showed a 94.9% reduction of curvature and patients with partial plaque excision and grafting showed a 92.2% reduction.

In conclusion, we can say that CCH is a safe option for patients who do want to avoid surgery. However, surgical therapy of PD still represents the gold standard to correct disabling penile curvature in patients with PD.

Written by: Georgios Hatzichristodoulou, MD, FEBU, FECSM, Associate Professor of Urology, Senior Physician, Department of Urology and Pediatric Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany
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