Survey of patient and partner satisfaction following collagenase Clostridium histolyticum treatment for Peyronie's disease

Abstract

Intralesional injection of collagenase Clostridium histolyticum (CCH) is a minimally invasive, Food and Drug Administration-approved, effective treatment for Peyronie's disease (PD). To assess the satisfaction of patients and their female sexual partners (FSP) following CCH therapy for PD, we conducted a retrospective review of the records of all patients treated with CCH for PD between 04/2014 and 03/2016. Collected variables included demographics, pre- and post-treatment sexual function, penile curvature, penile vascular findings, and treatment outcomes. Patients and their FSPs were subsequently contacted by telephone and queried regarding their ability to have intercourse and their satisfaction with treatment. A total of 24 couples responded to our questionnaire and constitute the subjects of this analysis. Patient and FSP satisfaction with treatment were 67% and 71%, respectively. Significant predictors of FSP satisfaction with treatment included recall of penile trauma during prior sexual intercourse, improved ability to have sexual intercourse following treatment, and absence of post-procedural glans hypoesthesia. In conclusion, CCH imparts a significant benefit on a couple's sexual health. Partner satisfaction with treatment is correlated with improved ability to have sexual intercourse and absence of patient glans hypoesthesia.

At what cost is collagenase clostridium histolyticum viable for treating Peyronie's disease in a public healthcare system?

“…Though adverse events are experienced by 92.5% of patients, the majority are mild to moderate in severity (including penile swelling/haematoma, and penile/injection site pain) and less than 1% are severe adverse events (including penile fracture) 35 . In relation to PD treatment, patient satisfaction is not directly correlated with objective response in terms of curvature reduction, but rather to return of penetrative intercourse, with Ziegelmann et al finding 40% of patients subjectively felt CCH made a meaningful difference to their disease despite a lack of objective response, with a similar perception of meaning in 50% of patients with a <10° absolute reduction 27,28 …”

“…Secondly, there is significant heterogeneity in the literature regarding markers of success: an absolute reduction in curvature does not account for the patient's starting state, and a relative reduction in curvature, though better, does not consider the underlying intention of treatment—a return to gratifying sexual intercourse (assumed for the majority to be penetrative). Thirdly, there is evidence to suggest that in the management of PD, objective outcome and subjective patient satisfaction are only indirectly linked 27,28 . For these reasons, the outcomes of the three treatment arms are assumed to be equivalent for the purposes of this analysis.…”

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

“…Other studies recently suggested the need for evaluating the subjective sexual experience in both the patient and his sexual partner; one group retrospectively contacted 77 PD patients after completion of CCH treatment and queried them and their partners for sexual satisfaction and satisfaction with treatment in the hopes of identifying factors that may improve both. Although their questionnaire was novel and un-validated and less than one third of patients participated, they noted that, in addition to the resumption of intercourse as well as preserved glans sensation, a history of penile trauma—possibly representing a sexual partner’s feelings of guilt—predicted greater effect of treatment ( 46 ). This highlights, again, the psychological and multifactorial treatment of PD, and the need to be aware of it, if not to outright attempt to measure it.…”

Intralesional collagenase Clostridium histolyticum in the management of Peyronie’s disease: current best practice

“…In an additional study by Anaissie and colleagues at a single institution, 77 men underwent ILI with CCH between April 2014 and March 2016. 33 Retrospective data were collected regarding their pretreatment characteristics such as degree of curvature and sexual function as well as treatment-associated characteristics, such as number of cycles, complications, and further procedures. These patients were subsequently contacted and asked to participate in a survey regarding their experience with CCH.…”