Surgical Correction of Persistent Peyronie's Disease Following Collagenase Clostridium Histolyticum Treatment |
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| Institution: | 2. LANAIS (UBA‐CONICET), Buenos Aires, Argentina;3. Cátedra de Urología, Hospital de Clínicas “José de San Martin,” Buenos Aires, Argentina;2. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA;3. Evans Department of Medicine, Whitaker Cardiovascular Institute, Boston University, Boston, MA, USA;4. Division of Cardiology, University of California San Francisco, San Francisco, CA, USA;2. Institute for Humanities and Health, Federal Fluminense University, Rio das Ostras, Brazil;2. Department of Urology, Ajou University School of Medicine, Suwon, Korea;3. School of Life Sciences and National Leading Research Laboratory, Gwangju Institute of Science and Technology, Gwangju, Korea;4. Department of Physiology and Biophysics, Seoul National University College of Medicine, Seoul, Korea;5. Department of Urology, Medical School, Jeonju, Korea;11. Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, Korea;1. Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA;2. Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, MA, USA;3. Division of Haematology and Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA |
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| Abstract: | IntroductionCollagenase clostridium histolyticum (CCH) is an Food and Drug Administration‐approved intralesional injection for treatment of Peyronie's disease (PD) that has been shown to reduce penile curvature deformity and PD symptom bother in phase 2b and phase 3 placebo‐controlled clinical trials. For some patients, nonsurgical treatment with CCH may not sufficiently improve penile curvature, and surgical correction may be pursued following CCH therapy.AimThis study aims to examine intraoperative and postsurgical outcomes of surgical correction of persistent penile curvature in patients with PD who had previously received CCH.MethodsRetrospective chart review was used to identify patients with PD who had received CCH intralesional injection within either the phase 2b or phase 3 CCH clinical trials and then underwent surgical correction due to remaining penile curvature. Surgical techniques used were partial plaque excision and grafting (PEG) and/or tunica albuginea plication (TAP).Main Outcome MeasuresPrimary assessments included pre‐ and postsurgery penile curvature, erectile rigidity, stretched penile length, intraoperative time, and occurrence of adverse events.ResultsSeven men were identified who underwent surgical straightening with TAP or PEG following CCH treatment. Mean number of days from the final CCH injection to surgery was 182 (standard deviation 118; median 127 days). Average penile curvature prior to surgical straightening was 58°. No anatomical difficulties or complications secondary to the effects of prior CCH treatment occurred during surgery. Intraoperative time was representative of standard TAP and PEG surgeries (range 88–146 minutes). All men reported penile curvature <20° postsurgery. One patient experienced a postsurgery subgraft hematoma that required aspiration. There were no postsurgery reports of decreased penile sexual sensation and no occurrence of vascular compromise or decreased penile rigidity.ConclusionThis initial case series supports the hypothesis that prior CCH treatment is not a contraindication to PEG or TAP surgery in the treatment of penile curvature in patients with PD. Levine LA and Larsen SM. Surgical correction of persistent Peyronie's disease following collagenase clostridium histolyticum treatment. J Sex Med 2015;12:259–264. |
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