Impact of Number of Cycles of Collagenase Clostridium Histolyticum on Outcomes in Patients With Peyronie's Disease

Anaissie, James; Yafi, Faysal A.; DeLay, Kenneth J.; Traore, Elizabeth J.; Sikka, Suresh C.; Hellstrom, Wayne J.G.

doi:10.1016/j.urology.2016.09.050

Cited by 45 publications

(24 citation statements)

References 22 publications

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“…Moreover, contrary to Xiapex ® [18], where it seems that after three cycles of treatment there is no more improvement, addition of sessions of PRP combined with HA after the first cycle of four, improves the results. The reason might lie in the biological process induced by the combination of PRP and HA.…”

Section: Discussionmentioning

confidence: 61%

Evaluation of the benefit of using a combination of autologous platelet rich-plasma and hyaluronic acid for the treatment of Peyronie’s disease

Virag¹,

Sussman²,

Lambion³

et al. 2017

Sex Health Issues

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Section: Discussionmentioning

confidence: 61%

Evaluation of the benefit of using a combination of autologous platelet rich-plasma and hyaluronic acid for the treatment of Peyronie’s disease

Virag¹,

Sussman²,

Lambion³

et al. 2017

Sex Health Issues

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“…Thus, the comparison was made with the final result divided by the number of injections administered to the patient. The efficacy of the last cycle is likely to be much lower and may impoverish this measure, to the detriment of the other protocols . Even so, the single‐cycle improvement in the PNT/CCH group is similar to that observed in other studies with more cycles, suggesting that future cycles in our patients would further improve curvature.…”

Section: Discussionmentioning

confidence: 99%

“…Since the publication of the IMPRESS I and II studies [7], CCH therapy for PD has entered into clinical practice for most groups of urologists specializing in PD. Indeed, several groups have already provided preliminary and medium-term results on the efficacy of this treatment [8,11,12,[23][24][25][26][27], some of them with modifications to the protocol used in the IMPRESS studies (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Optimizing collagenase Clostridium histolyticum therapy for Peyronie’s disease using a novel approach with percutaneous needle tunnelling

et al. 2019

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Objectives To compare the efficacy and safety of a combined treatment of percutaneous needle tunnelling (PNT) and a modified collagenase Clostridium histolyticum (CCH) protocol (PNT/CCH) vs the modified protocol alone (CCH) in the treatment of Peyronie's disease (PD). Patients and Methods A prospective registry of patients treated with a modified CCH protocol was maintained between June 2014 and February 2018. The last 50 patients received PNT as an adjuvant therapy (PNT/CCH), and their data were compared with those of the other 94 patients treated previously (CCH). PNT involves the creation of multiple holes made percutaneously in the plaque before each injection. The modified protocol consisted of two collagenase injections, at 1‐week intervals, followed by penile modelling. Patients used penile traction therapy, tadalafil and pentoxifylline for the next 2 months and were followed up for 6 months. The main outcome was improvement of curvature. Secondary outcomes were improvements in erectile function, PD symptoms, stretched penile length and satisfaction. Results Improvement in curvature was greater in patients in the PNT/CCH group than in the CCH group (mean ± sd 19.2 ± 6.1° vs 12.7 ± 5.0°; P < 0.001 [36.2 ± 12.5% vs 28.1 ± 14.5%; P = 0.001]). Compared with baseline, both interventions were associated with significant improvement in secondary outcomes. The main complications were ecchymosis, bruising and penile pain, with no significant differences between groups. Conclusions Treatment of PD with CCH using our modified protocol in combination with PNT is safe and more effective than the modified protocol alone, with the potential for improved cost‐effectiveness.

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“…Although subsequent studies confirmed its efficacy in ameliorating penile curvature/plaques, treatment‐related adverse events, such as penile haematoma formation and pain, are common. Moreover, intralesional CCH injections do not promote a significant improvement in erectile function (Anaissie, Yafi, DeLay et al., ). Extracorporeal shock wave therapy, which is a type of topical regimen, has been demonstrated to be an effective treatment for decreasing penile plaque size (Gao, Qian, Tang, Li, & Yuan, ), but whether it is effective in restoring erectile function in PD patients is unknown.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Peyronie's-like plaque size using a vacuum erection device in a rat model of Peyronie's disease via the TGF-β/SMAD signalling pathway

Wang

Qin

et al. 2018

Andrologia

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Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea (TA). This study aimed to determine the therapeutic effects of a vacuum erection device (VED) in an animal model of PD and explore the possible mechanisms. Twenty-seven male Sprague-Dawley rats were used. The sham group (group A) (N = 9) received a 50-μl-saline vehicle injection into the TA, while the remaining 18 rats (groups B and C) received a TGF-β1 injection into the TA. The treatment group (group C) underwent VED therapy for 10 days after the TGF-β1 injection. Erectile function was then assessed at day 42. Rats injected with TGF-β1 showed significantly lower intracavernous pressures than those in the sham group (p < 0.0001). After VED therapy, erectile function was significantly better in the treatment group than in the PD group (group B) (p < 0.0147). Masson's trichrome staining confirmed Peyronie's-like plaques at the TGF-β1 injection site in the PD group. Furthermore, the treatment group showed markedly smaller fibrotic plaque sizes than the PD group. A significant increase in TGF-β1, SMAD2, SMAD3 and p-SMAD2/3 protein expression was observed 6 weeks after the TGF-β1 injection. However, the expression of the same proteins decreased after VED therapy. Protein expression trends were confirmed using immunohistochemistry analysis. The findings of this study demonstrate that VED therapy can reduce Peyronie's-like plaque size in a rat model of PD while simultaneously improving erectile function.

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Impact of Number of Cycles of Collagenase Clostridium Histolyticum on Outcomes in Patients With Peyronie's Disease

Cited by 45 publications

References 22 publications

Evaluation of the benefit of using a combination of autologous platelet rich-plasma and hyaluronic acid for the treatment of Peyronie’s disease

Evaluation of the benefit of using a combination of autologous platelet rich-plasma and hyaluronic acid for the treatment of Peyronie’s disease

Optimizing collagenase Clostridium histolyticum therapy for Peyronie’s disease using a novel approach with percutaneous needle tunnelling

Reduction in Peyronie's-like plaque size using a vacuum erection device in a rat model of Peyronie's disease via the TGF-β/SMAD signalling pathway

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