Contemporary surgical and non-surgical management of Peyronie’s disease

Wayne, George; Cordon, Billy H.

doi:10.21037/tau.2018.04.06

Cited by 13 publications

(6 citation statements)

References 82 publications

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“…Surgical treatment for PD is most definitive but is reserved for those with stable disease. For patients with acute phase PD, some non-surgical and minimally invasive treatment options include L-citrulline, pentoxifylline, vitamin E, and intralesional interferon-α2b, verapamil, or hyaluronic acid (15,(18)(19)(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Hu¹,

Sigalos²,

Walker³

et al. 2022

Transl Androl Urol

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Background: Peyronie's disease (PD) can be subdivided into acute and chronic phases. Intralesional collagenase Clostridium histolyticum has been shown to improve curvature in the chronic phase. Initial clinical trials excluded patients in the acute phase from treatment. Recent studies show comparable results among men in the acute phase. The definition of acute phase varies among existing studies, but it is generally understood to last 12-18 months and is accompanied by penile pain and progression of deformity. We sought to evaluate the safety and efficacy of intralesional collagenase injection therapy during the acute phase of PD using multiple definitions of the acute phase.Methods: All men receiving intralesional collagenase for PD from October 2015 through December 2020 at a single academic institution were retrospectively assessed for patient demographics and comorbidities, pre-and post-treatment curvature, and adverse events. Two definitions of acute phase were used: (I) acute phase duration ≤6 months, chronic phase duration >6 months; and (II) acute phase duration ≤12 months with penile pain, chronic phase duration >12 or no penile pain.Results: Of 330 patients identified, 229 underwent intralesional collagenase treatment with pre-and post-treatment erect penile goniometry. 65 (28%) met criteria for definition 1 of acute phase, 37 (16%) met criteria for definition 2, and 76 (33%) met criteria for either. Percent change in penile curvature was not significantly different between acute and chronic phases using definition 1 (16.0% vs. 16.6%, P=0.89), definition 2 (19.9% vs. 15.7%, P=0.43), or either (16.5% vs. 16.3%, P=0.96). The rates of development of bruising, swelling, hematoma, or corporal rupture were not significantly different between the acute and chronic phases under either definition (all P>0.05).Conclusions: This single-center, retrospective cohort analysis suggests that intralesional collagenase is both safe and effective for the treatment of men with acute phase PD. Limitations exist inherent to retrospective review, since many men did not return for post-treatment goniometry, possibly skewing our cohort toward incomplete responders. Prospective, randomized studies will be required to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Hu¹,

Sigalos²,

Walker³

et al. 2022

Transl Androl Urol

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Section: Discussionmentioning

confidence: 99%

“…The 60⁰ Guide It was canon that men with curvatures greater than 60⁰ were best served by PIG with or without IPP [26,44,[46][47][48]. This has been challenged by favourable results from plication surgery performed for severe deformities with greater frequency than PIG [44]. The 2016 consensus panel has removed this criterion [49] and the current European Association of Urology (EAU) guideline accepts the evidence for the 60⁰ cut-off point to be insufficient.…”

Section: Discussionmentioning

confidence: 99%

Peyronie’s Disease: A Brief Overview

Feyisetan¹

2023

Cureus

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Peyronie's disease is an acquired connective tissue disease of the tunica albuginea of the penis which usually presents with penile curvature/deformity and a palpable penile plaque. It is more common in Caucasian men over the fifth decade of life, but it is an under-reported disease. Conservative and nonsurgical options are supported by limited evidence except for intralesional injection of collagenase clostridium histolyticum and have limited success. The improved outcome of surgical treatment is accompanied by the risk of erectile dysfunction. This is a brief overview of Peyronie's disease, its impact on the patient, and the available treatment options.

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“…However, several issues with these treatment options remain. While the improvement in PC with CCH is indisputable, its cost efficacy for all PD patients is not (39,40). In the recent years, we have come to appreciate the complex spectrum of patients suffering from PD, there is an increased focus on pathophysiology, stage of disease, diagnostic evaluation and mental health [as previously mentioned, nearly 50% of PD patients experience depressive symptoms (4)].…”

Section: Traversing the Treatment Gap In Pdmentioning

confidence: 99%

Evolving therapies for Peyronie’s disease: how can we work towards new drugs?

Milenković

Duponselle

Bivalacqua³

et al. 2020

Transl Androl Urol

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Peyronie's disease (PD) is an idiopathic chronic fibrotic disease that causes a penile curvature (PC), subsequent erectile dysfunction (ED) and impaired sexual intercourse in patients. As of yet, there are no reliable non-surgical treatment options available. Intralesional injection with collagenase Clostridum Histolyticum has been FDA approved since 2013, but post-approval studies have not been unanimously positive. Moreover, it renders a curvature improvement of only 30% on average, usually still requiring surgical intervention to remedy PC. Therefore, there is a need for drugs which could prevent surgery altogether. Development of new drugs can either be through a target-based or phenotypic assay-based approach. The current in vivo model for PD is dependent on treatment of primary PD-derived fibroblasts with transforming growth factor-β1. Moreover, despite the existence of a genetic in vivo PD model, it does not allow for drug screening or testing. While some advances have been made in the past few years, new in vivo and in vivo systems and well-designed studies are urgently needed for the non-surgical treatment of PD.

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Contemporary surgical and non-surgical management of Peyronie’s disease

Cited by 13 publications

References 82 publications

Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Peyronie’s Disease: A Brief Overview

Evolving therapies for Peyronie’s disease: how can we work towards new drugs?

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