Abstract
Objective
To compare in a prospective nonrandomized fashion, the outcomes of collagenase clostridium
histolyticum (CCH) and surgical interventions (tunical plication [TP] and partial
plaque excision and grafting [PEG]) in patients with Peyronie's disease (PD). Intralesional
injection of CCH is the only Food and Drug Administration-approved nonsurgical intervention
for PD.
Materials and Methods
Between June 2015 and January 2017, 57 patients with PD and dorsal, dorsolateral,
and/or lateral penile curvatures 30°-90° were included in this study. Patients with
ventral curvature, hourglass deformity, and previous surgery for PD were excluded.
All patients completed questionnaires and underwent penile measurements and penile
vascular studies prior to and after completion of treatment, and were followed for
at least 6 months.
Results
CCH was administered to 18 patients, TP performed in 14, and PEG in 25. The median
follow-up for the whole cohort was 12 months (6-28). Mean changes in curvature after
treatment were 23.3° (34.4%) for CCH, 72.0° (92.2%) for TP, and 71.8 ° (94.9%) for
PEG, P<.001. Mean changes in International Index of Erectile Function-5 scores were +5.7
for CCH, +4.9 for TP, and +2.2 for PEG, P = .395. Mean penile length changes were −0.2 cm for CCH, −1.0 cm for TP, and +0.9
cm for PEG, P<.001. Three patients in the CCH group had bothersome residual curvature and underwent
uneventful TP.
Conclusion
Surgical options are associated with superior curvature correction. CCH is an effective
and safe option for motivated patients who prefer to avoid surgery. PEG is associated
with a small stretched penile length gain.
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Article info
Publication history
Published online: July 27, 2018
Accepted:
June 12,
2018
Received in revised form:
June 6,
2018
Received:
May 7,
2018
Footnotes
Financial Disclosures: Dr. Wayne Hellstom is on a speakers bureau for Endo Pharmaceuticals. No financial support exists regarding the preparation or completion of this article.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
