World J Mens Health.  2019 May;37(2):234-239. 10.5534/wjmh.180073.

The Impact of Clostridium Histolyticum Collagenase on the Prevalence and Management of Peyronie's Disease in the United States

Affiliations
  • 1Department of Urology, Stanford University, Stanford, CA, USA. eisenberg@stanford.edu
  • 2Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.

Abstract

PURPOSE
We evaluated the impact of collagenase clostridium histolyticum (CCH) on rates of diagnosis, treatment, and corporal rupture in Peyronie's disease (PD). We examined the impact of CCH on cost of PD treatment.
MATERIALS AND METHODS
We extracted data on PD diagnosis (ICD-9 607.95 and ICD-10 N48.6), corporal rupture (ICD-9 959.13 and ICD-10 S39.840A), CCH use (J0775), penile injections (CPT 54200), and corporal rupture repair from 2008 to 2016 in men over 40 years old using the Clinformatics® Data Mart Database (3.7 to 4.9 million males). We analyzed for prevalence of PD, rates of PD treatments, cost associated with treatment, and rates of corporal rupture and repair by year.
RESULTS
The prevalence of PD was 0.29% in 2013 and did not increase after CCH entered the market in 2014. An average of 2.52% of men with PD received treatment before CCH, compared with 3.75% after (p<0.0001). Penile injection rates increased (1.34% vs. 2.61%, p<0.0001), while rates of surgical treatments decreased between these periods. There was no change in rate of corporal rupture in men with PD before (0.024%) and after (0.024%) CCH. Overall, only 20.0% of corporal ruptures were repaired. After CCH entered practice, a significant increase in cost occurred (p=0.013).
CONCLUSIONS
The prevalence of men with PD did not change after CCH. However, more men with PD received treatment due to an increase in penile injections. The cost of treating PD increased after CCH became available. The overall prevalence of corporal rupture did not change after CCH entered the market.

Keyword

Clostridium histolyticum; Epidemiology; Penile induration; Peyronie's disease; Urologists

MeSH Terms

Clostridium histolyticum*
Clostridium*
Diagnosis
Epidemiology
Humans
International Classification of Diseases
Male
Microbial Collagenase*
Penile Induration*
Prevalence*
Rupture
United States*
Microbial Collagenase
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