title: Restoration of Penile Function and Patient Satisfaction with Intralesional Collagenase Clostridium Histolyticum Injection for Peyronie's Disease.
abstract: OBJECTIVE
  Collagenase clostridium histolyticum is approved for the treatment of Peyronie's disease. To date, no post-release study to our knowledge has evaluated patient perceived outcomes and satisfaction. Therefore, we evaluated patient perceived experience with collagenase clostridium histolyticum injection for Peyronie's disease in a clinical practice.
  
  
  METHODS
  From March 2014 to July 2015, 69 patients underwent 1 to 4 series of collagenase clostridium histolyticum injections for Peyronie's disease at our institution. Objective changes in penile curvature as well as patient reported functional outcomes and patient perceived curvature improvements were evaluated.
  
  
  RESULTS
  By the time of analysis 31 patients (45%) had completed 4 trials, 47 (68%) completed 3 trials and 59 (86%) completed 2 trials. Patient reported improvements (percentage) in curvature increased with each series (trial 1-14%, trial 2-28%, trial 3-30% and trial 4-37%, p <0.05). Among those completing therapy 57% reported that collagenase clostridium histolyticum injections negated a need for surgery and 52% reported restoration of penetration. Overall 81% of men perceived collagenase clostridium histolyticum treatment as meaningful and 88% reported subjective improvements after 4 series of injections. Objective measures demonstrated a mean 23-degree curvature improvement (38%, p <0.0001). Seven patients (10%) experienced penile hematomas and no patients experienced tunical rupture.
  
  
  CONCLUSIONS
  Collagenase clostridium histolyticum reduced the need for surgery and restored penetration in the majority of patients completing 4 series of injections. It also significantly reduced the degree of objectively measured penile curvature. Subjective improvements in curvature increased with each series of collagenase clostridium histolyticum injections as well and the majority of patients considered the therapy worthwhile.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ziegelmann
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Boyd R
authors.initials: BR
authors.lastname: Viers
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: McAlvany
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: George C
authors.initials: GC
authors.lastname: Bailey
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Joshua B
authors.initials: JB
authors.lastname: Savage
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota. Electronic address: Trost.Landon@mayo.edu.
authors.forename: Landon W
authors.initials: LW
authors.lastname: Trost
mesh_terms: D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D003012:Microbial Collagenase / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D010411:Penile Induration / Q000188:drug therapy*; D010413:Penis; D011446:Prospective Studies; D020127:Recovery of Function
chemical_list: D003012:Microbial Collagenase
keywords: microbial collagenase; patient satisfaction; penile induration; treatment outcome