Abstract
Objective
To compare outcomes of men with or without calcified plaques undergoing collagenase
Clostridium histolyticum (CCH) injections for Peyronie's disease (PD) and identify predictors of CCH success.
Materials and Methods
From March 2014 through January 2017, data were prospectively collected on 192 patients
who underwent 1-4 cycles of CCH for the treatment of PD. Of these, 115 completed ≥2
CCH cycles and had data on curvature assessment. The primary outcome was the percentage
of men with >20% improvement in composite curvature. Univariate analysis was performed
to compare rate of success based on patient and disease characteristics, and multivariate
logistic regression was used to identify predictors of successful treatment.
Results
Calcified plaques were identified in 34 of 115 (30%) patients. Patients with calcified
plaque were younger, had longer duration of disease, and higher rates of significant
erectile dysfunction. On multivariate logistic regression controlling for calcification
and degrees composite curvature, noncalcified plaque (odds ratio 2.50; 95% confidence
interval 1.06-6.00; P = .03) and curvature ≥60° (odds ratio 5.01; 95% confidence interval 1.34-21.62; P = .02) were found to be significant predictors of ≥20% improvement in composite curvature.
When differentiated by calcification severity, those with no calcification achieved
significant improvements in curvature (28.1° vs 10.3°, P = .04), compared to moderate (shadowing) or severe (>1 cm).
Conclusion
Plaque calcification is associated with a significantly lower rate of success of CCH
therapy for PD, while greater baseline curvature is associated with increased odds
of successful curvature improvement.
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Article info
Publication history
Published online: June 14, 2018
Accepted:
June 1,
2018
Received in revised form:
May 31,
2018
Received:
March 21,
2018
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
