AI Article Synopsis
- A study evaluated the outcomes of a new injection protocol using collagenase clostridium histolyticum (CCH) for treating Peyronie's disease, comparing traditional methods to a novel approach.
- The novel technique showed significantly better outcomes in terms of curvature improvement and higher rates of patient satisfaction, with 94% achieving at least a 20% improvement compared to 66% in the traditional group.
- Importantly, the new protocol did not adversely affect erectile function or sensation, although it led to higher rates of surgery prevention and some increased side effects, indicating it may not be suitable for low-volume injectors.
Article Abstract
Objective: To report outcomes of a novel collagenase clostridium histolyticum (CCH) injection protocol.
Methods: A prospective, sequential database was maintained of all Peyronie's men undergoing CCH injections since 2015. Our protocol has evolved to include changes with injection technique, timing, aggressive modeling/traction, and wrapping. Results of the "traditional" and "novel" techniques were compared using two definitions: "most recent" assessment and final assessments among men who "completed eight (injections) or were satisfied."
Results: A total of 509 men underwent greater than or equal to 1 CCH series (traditional, n = 280; novel n = 229). Baseline demographic/clinicopathologic characteristics were similar between groups. Results demonstrated significantly greater curve improvements with the novel technique ("most recent" median 30° vs 20° or 46% vs 28%; "completed eight or satisfied" 34° vs 20° or 58% vs 30%). Using the "completed eight or satisfied" definition, 94% vs 66% of men achieved greater than or equal to 20% improvement (odds ratio 7.6), and 60% vs 24% achieved greater than or equal to 50% improvements (odds ratio 5.0) in the novel cohort (all P < .0001). Importantly, the International Index of Erectile Function Erectile Function Domain score was unchanged, and subjective erectile function (50% vs 5%, P < .0001) and sensation improved (17% vs 8% improved, P = .01) with the new protocol. The novel cohort also reported higher rates of surgery prevention (53% vs 18%), restored/facilitated penetration (57% vs 21%), and hematomas (56% vs 26%), necessitating changes to wrapping procedures (all P < .0001).
Conclusions: Use of the novel CCH protocol results in significant improvements with curvature without negatively impacting erectile function or sensation. Given its specialized nature, it is not recommended for low-volume CCH injectors.
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| http://dx.doi.org/10.1016/j.urology.2022.09.017 | DOI Listing |
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