Impact of Number of Cycles of Collagenase Clostridium Histolyticum on Outcomes in Patients with Peyronie's Disease

To analyze the impact of the number of cycles of collagenase Clostridium histolyticum (CCH) intralesional injection therapy on outcomes in order to further characterize CCH therapy.

We conducted a retrospective review of the records of all patients treated with CCH for PD between 04/2014 and 03/2016. Collected variables included demographics, pre- and post-treatment sexual function, penile curvature, penile vascular findings, and treatment outcomes.

A total of 77 patients were included in the study, of which 41 (53%) completed four cycles of treatment, consisting of eight total injections. For all-comers regardless of numbers of cycles, curvature improved from 58.2° (SD=17.9°, range=30-105°) pre-treatment to 41.0 degrees (SD=17.0°, range=0-85°) post-treatment (p<0.001). In a repeated measures model, penile curvature improved significantly following the first three cycles, but not the fourth. Patients who had a ≥20% final reduction in curvature had a significantly greater change in curvature following the first injection (-16.2 degrees vs. -5.8 degrees, p<0.001).

Intralesional CCH therapy is an effective minimally invasive treatment for PD, although the therapeutic benefit may decline after the third cycle of treatment. Patients with ≥20% reduction in curvature at the conclusion of treatment documented a greater curvature improvement after the first cycle and received more cycles of CCH.

Urology. 2016 Nov 02 [Epub ahead of print]

James Anaissie, Faysal A Yafi, Kenneth J DeLay, Elizabeth J Traore, Suresh C Sikka, Wayne J G Hellstrom

Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA., Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: .

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