Successful Treatment of Residual Curvature in Peyronie's Disease in Men Previously Treated with Intralesional Collagenase Clostridium Histolyticum

To determine the success and feasibility of surgically correcting residual curvature after intralesional collagenase Clostridium histolyticum (CCH) for the treatment of Peyronie's disease.

We performed a retrospective analysis of patients who had intralesional CCH treatment for (PD) and who subsequently underwent penile plication (PP), plaque incision and grafting (PIG), or inflatable penile prosthesis (IPP) placement.

Ten men who underwent PP, PIG, or IPP for the treatment of residual curvature after intralesional CCH were identified. Six patients underwent PP, one patient underwent PIG and three patients underwent IPP with ancillary straightening maneuvers. The mean time from the last CCH injection to surgical correction was 150.9 days, or 5 months. The mean pre-CCH curvature was 67 degrees and the mean post-CCH curvature was 51 degrees. Eight out of 10 patients had no residual curvature after surgical treatment. The mean post-procedure curvature was 4.5 degrees. The mean operative time was 72.1 minutes. The mean estimated blood loss was 20 mL. Increased fibrosis with increased surgical difficulty was noted in three (all < 6 months post CCH treatment) out of 10 patients. No postoperative complications were noted.

The surgical treatment of PD after intralesional CCH is safe and effective. If surgery is considered, this should be performed at least six months after the last CCH injection, given the potential for an increased inflammatory reaction in this area.

Urology. 2017 Sep 05 [Epub ahead of print]

Kenneth DeLay, Linley Diao, Hoang M T Nguyen, Jonathan Zurawin, Russell Libby, Faysal Yafi, Wayne J G Hellstrom

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