Impact of Number of Cycles of Collagenase Clostridium Histolyticum on Outcomes in Patients With Peyronie's Disease.
OBJECTIVE
To analyze the impact of the number of cycles of collagenase Clostridium histolyticum (CCH) intralesional injection therapy on outcomes to further characterize CCH therapy.


METHODS
We conducted a retrospective review of the records of all patients treated with CCH for Peyronie disease between April 2014 and March 2016. Collected variables included demographics, pre- and posttreatment sexual function, penile curvature, penile vascular findings, and treatment outcomes.


RESULTS
A total of 77 patients were included in the study, of which 41 (53%) completed 4 cycles of treatment, consisting of 8 total injections. For all-comers regardless of numbers of cycles, curvature improved from 58.2° (standard deviation = 17.9°, range = 30°-105°) pre-treatment to 41.0° (standard deviation = 17.0°, range = 0°-85°) posttreatment (P < .001). In a repeated measures model, penile curvature improved significantly following the first 3 cycles, but not the fourth. Patients who had a ≥20% final reduction in curvature had a significantly greater change in curvature following the first injection (-16.2° vs -5.8°, P < .001).


CONCLUSIONS
Intralesional CCH therapy is an effective minimally invasive treatment for Peyronie disease, although the therapeutic benefit may decline after the third cycle of treatment. Patients with ≥20% reduction in curvature at the conclusion of treatment documented a greater curvature improvement after the first cycle and received more cycles of CCH.
Department of Urology, Tulane University School of Medicine, New Orleans, LA.
James
J
Anaissie
Department of Urology, Tulane University School of Medicine, New Orleans, LA.
Faysal A
FA
Yafi
Department of Urology, Tulane University School of Medicine, New Orleans, LA.
Kenneth J
KJ
DeLay
Department of Urology, Tulane University School of Medicine, New Orleans, LA.
Elizabeth J
EJ
Traore
Department of Urology, Tulane University School of Medicine, New Orleans, LA.
Suresh C
SC
Sikka
Department of Urology, Tulane University School of Medicine, New Orleans, LA. Electronic address: whellst@tulane.edu.
Wayne J G
WJG
Hellstrom
D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D003012:Microbial Collagenase / Q000627:therapeutic use*; D008875:Middle Aged; D017060:Patient Satisfaction; D010410:Penile Erection; D010411:Penile Induration / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D003012:Microbial Collagenase