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KMID : 1037120200380010078
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The World Journal of Men′s Health
2020 Volume.38 No. 1 p.78 ~ p.84
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How Atypical Penile Curvature Influence Clinical Outcomes in Patients with Peyronie's Disease Receiving Collagenase Clostridium Histolyticum Therapy?
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Cocci Andrea
Di Maida Fabrizio
Russo Giorgio Ivan
di Mauro Marina
Cito Gianmartin
Falcone Marco
Minervini Andrea
Cacciamani Giovanni
Campi Riccardo
Mari Andrea
Sessa Francesco
Mondaini Nicola
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Abstract
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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.
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KEYWORD
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Collagenases, Intralesional injections, Therapeutics, Penile induration, Peyronie's disease
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