Second cycle of intralesional Collagenase Clostridium histolyticum for Peyronie's disease using the modified shortened protocol: Results from a retrospective analysis

Abstract

The purpose of this study was to evaluate the effectiveness and safety of the second cycle of Collagenase Clostridium histolyticum injections using the modified shortened protocol. We performed a retrospective analysis on patients who had already undergone the first cycle of injections using the modified shortened protocol and requested more injections to improve the remaining curvature. The International Index of Erectile Function, the Peyronie's Disease Questionnaire and the Global Assessment of Peyronie's Disease questionnaire were self‐administered to all patients. All the parameters were recorded at baseline, after the first cycle and after the second cycle of injections. All adverse events were recorded. Seventeen patients completed two cycles of injections. All patients had a reduction of the initial curvature after the first cycle, with a mean improvement of 17.4° (27.4%). After the second cycle, the reduction of the curvature was 7.9° (17.1%), and 29.4% of patients had no further improvement. No severe side effect was recorded. The results of the present study confirm the effectiveness and safety of the modified shortened protocol of Collagenase C. histolyticum injections for Peyronie's disease. However, the second cycle of three injections may be less effective, and patients may not be completely satisfied.

Impact of extracorporeal shockwave therapy for erectile dysfunction and Peyronie's disease on reproductive and hormonal testicular function

“…[17][18][19][20] Non-steroidal anti-inflammatory drugs (NSAIDs), penile traction therapy (PTT), collagenases, and shortening or lengthening surgical procedures are some treatment options for PD. [21][22][23][24] In recent years, ESWT has proven to be an effective treatment in selected patients with ED and PD, to improve erectile function and relieve penile pain, respectively. [4][5][6] ESWT is generally described as a safe andrological procedure characterized by mild and transient side effects.…”

“…Oral PDE5Is, intracavernous or topical alprostadil, vacuum devices, and penile prostheses are some therapeutic options for ED 17–20 . Non‐steroidal anti‐inflammatory drugs (NSAIDs), penile traction therapy (PTT), collagenases, and shortening or lengthening surgical procedures are some treatment options for PD 21–24 . In recent years, ESWT has proven to be an effective treatment in selected patients with ED and PD, to improve erectile function and relieve penile pain, respectively 4–6 …”

Improvement in the ability to have sex in patients with Peyronie's disease treated with Collagenase Clostridium histolyticum

“…Capece et al reported that 5/17 patients receiving the second cycle of three injections had a further improvement of the curvature. 16 Following treatment with CCH, only two (3%) patients underwent cavernoplication because of disappointing results.…”

“…10 The modified scheme introduced by Abdel Raheem et al contained three injections 4 weeks apart during 3 months together with the use of a vacuum erection device (VED) twice daily, stretching the penis five times for 2 min. [12][13][14][15][16][17] The treatment of PD with CCH in the acute phase showed good results, even with a single injection. [18][19][20] Treatment with CCH in patients with stable PD has been…”

“…The original IMPRESS trial treatment scheme contained four cycles of two injections within 48–72 h every 6 weeks during 6 months together with modelling the penis 10 . The modified scheme introduced by Abdel Raheem et al contained three injections 4 weeks apart during 3 months together with the use of a vacuum erection device (VED) twice daily, stretching the penis five times for 2 min 12–17 . The treatment of PD with CCH in the acute phase showed good results, even with a single injection 18–20 …”