How Atypical Penile Curvature Influence Clinical Outcomes in Patients with Peyronie's Disease Receiving Collagenase Clostridium Histolyticum Therapy?

The aim of this study was to evaluate the efficacy of collagenase Clostridium histolyticum (CCH) in patients with Peyronie's disease (PD) suffering from atypical deformities.

We retrospectively collected data of patients with atypical penile curvature (PC) secondary to PD. All patients underwent a modified treatment protocol, consisting of 3 intralesional injections of 0.9 mg of CCH performed at 4-week intervals at the point of maximum PC. Patients were instructed to follow a strict routine, involving daily modeling of erect penis and stretching at the urinary toilette time, two minutes each. Success was defined as a decrease in PC of ≥20° from baseline.

Sixty-five patients were included in the analysis. Median age was 59.0 years (interquartile range [IQR], 53.0 to 63.0 years), median curvature 40.0° (IQR, 30.0° to 45.0°) median duration of the disease 12.0 years (IQR, 6.5 to 24.0 years). Fifty-three patients (81.54%) had ventral PC, 7 (10.77%) hourglass PC, and 5 (7.69%) shortening PC. Median changes of PC were -20.0 (IQR, -20.0 to -10.0; p<0.01) in ventral PC, -20.0 (IQR, -20.0 to 0; p<0.01) in hourglass and -15.0 (IQR, -15.0 to -15.0; p<0.01) in shortening PC. At Kruscal-Wallis test, significant differences between groups were not found. The rate of PC success was 56.60% (30/53) in ventral PC, 57.14% (4/7) in hourglass and 20.00% (1/5) in shortening PC (p=0.29). Treatment success was not influenced by characteristics of curvature (odds ratio=0.66; p=0.20).

CCH intralesional injections could represent an effective therapeutic option for the conservative management of patients with atypical PC.

The world journal of men's health. 2019 May 29 [Epub ahead of print]

Andrea Cocci, Fabrizio Di Maida, Giorgio Ivan Russo, Marina di Mauro, Gianmartin Cito, Marco Falcone, Andrea Minervini, Giovanni Cacciamani, Riccardo Campi, Andrea Mari, Francesco Sessa, Nicola Mondaini

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. ., Department of Urology, Careggi Hospital, University of Florence, Florence, Italy., Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy., Department of Urology, University of Turin, Turin, Italy., Department of Urology, University of Verona, Verona, Italy., Urology Section, Villa Donatello Clinic, Sesto Fiorentino, Italy.