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

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

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.'

509 men underwent ≥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 ≥20% improvement (odds ratio 7.6), and 60% vs 24% achieved ≥50% improvements (odds ratio 5.0) in the novel cohort (all p<0.0001). Importantly, the International Index of Erectile Function Erectile Function Domain score was unchanged, and subjective erectile function (50% vs 5%, p<0.0001) and sensation improved (17% vs 8% improved, p=0.01) 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<0.0001).

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.

Urology. 2022 Oct 11 [Epub ahead of print]

Ashley Flores, Alissa Tyler, Benjamin Green, Trevor Price, Joshua Savage, Klinton Brearton, Sevann Helo, Matthew Ziegelmann, Tobias Kohler, Landon Trost

CURE PD., Male Fertility and Peyronie's Clinic., CURE PD; Brigham Young University., Brigham Young University., Mayo Clinic., CURE PD; Male Fertility and Peyronie's Clinic; Brigham Young University; Mayo Clinic. Electronic address: .