Successful Treatment of Residual Curvature in Peyronie Disease in Men Previously Treated With Intralesional Collagenase Clostridium Histolyticum

• Published in: Urology (Ridgewood, N.J.) N.J.), 2017-12, Vol.110, p.110-113
• Main Authors: DeLay, Kenneth, Diao, Linley, Nguyen, Hoang Minh Tue, Zurawin, Jonathan, Libby, Russell, Yafi, Faysal, Hellstrom, Wayne J.G.
• Format: Article
• Language: English
• Subjects: Aged; Combined Modality Therapy; Feasibility Studies; Humans; Injections, Intralesional; Male; Microbial Collagenase - administration & dosage; Middle Aged; Penile Induration - drug therapy; Penile Induration - surgery; Remission Induction; Retrospective Studies
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2017.08.037

To determine the success and feasibility of surgically correcting residual curvature after intralesional collagenase clostridium histolyticum (CCH) for the treatment of Peyronie disease (PD). 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; 1 patient underwent PIG; and 3 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 of 10 patients had no residual curvature after surgical treatment. The mean postprocedure 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 3 (all