World J Mens Health.  2020 Jan;38(1):78-84. 10.5534/wjmh.190026.

How Atypical Penile Curvature Influence Clinical Outcomes in Patients with Peyronie's Disease Receiving Collagenase Clostridium Histolyticum Therapy?

Affiliations
  • 1Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. cocci.andrea@gmail.com
  • 2Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy.
  • 3Department of Urology, University of Turin, Turin, Italy.
  • 4Department of Urology, University of Verona, Verona, Italy.
  • 5Urology Section, Villa Donatello Clinic, Sesto Fiorentino, Italy.

Abstract

PURPOSE
The aim of this study was to evaluate the efficacy of collagenase Clostridium histolyticum (CCH) in patients with Peyronie's disease (PD) suffering from atypical deformities.
MATERIALS AND METHODS
We retrospectively collected data of patients with atypical penile curvature (PC) secondary to PD. All patients underwent a modified treatment protocol, consisting of 3 intralesional injections of 0.9 mg of CCH performed at 4-week intervals at the point of maximum PC. Patients were instructed to follow a strict routine, involving daily modeling of erect penis and stretching at the urinary toilette time, two minutes each. Success was defined as a decrease in PC of ≥20° from baseline.
RESULTS
Sixty-five patients were included in the analysis. Median age was 59.0 years (interquartile range [IQR], 53.0 to 63.0 years), median curvature 40.0° (IQR, 30.0° to 45.0°) median duration of the disease 12.0 years (IQR, 6.5 to 24.0 years). Fifty-three patients (81.54%) had ventral PC, 7 (10.77%) hourglass PC, and 5 (7.69%) shortening PC. Median changes of PC were −20.0 (IQR, −20.0 to −10.0; p<0.01) in ventral PC, −20.0 (IQR, −20.0 to 0; p<0.01) in hourglass and −15.0 (IQR, −15.0 to −15.0; p<0.01) in shortening PC. At Kruscal-Wallis test, significant differences between groups were not found. The rate of PC success was 56.60% (30/53) in ventral PC, 57.14% (4/7) in hourglass and 20.00% (1/5) in shortening PC (p=0.29). Treatment success was not influenced by characteristics of curvature (odds ratio=0.66; p=0.20).
CONCLUSIONS
CCH intralesional injections could represent an effective therapeutic option for the conservative management of patients with atypical PC.

Keyword

Collagenases; Intralesional injections; Therapeutics; Penile induration; Peyronie's disease

MeSH Terms

Clinical Protocols
Collagenases*
Congenital Abnormalities
Humans
Injections, Intralesional
Male
Microbial Collagenase*
Penile Induration*
Penis
Retrospective Studies
Collagenases
Microbial Collagenase
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