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Treatment of peyronie’s disease with combination of clostridium histolyticum collagenase and penile traction therapy: a prospective, multicenter, single-arm study

International Journal of Impotence Research volume 33, pages 325–331 (2021)Cite this article

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Abstract

The aim of this paper is to analyze our experience with intraplaque administration of collagenase from Clostridium Histolyticum (CCH) together with penile modeling for selected patients with Peyronie’s disease (PD). We conducted a prospective, multicenter, single-arm study. Patients were included from October 2015 to August 2019. We carried out the I + E PROTOCOL (IMPRESS + extender). Each cycle involved administration of two injections of CCH separated 24–72 h, up to a maximum of four cycles. 24–48 h after injection patients underwent penile modeling maneuvers with the use of a PTD at home for at least 4 h a day. After each cycle, penile curvature was evaluated by the Kelami test. Mean pretreatment curvature was 57° (30–100). Eighty-seven patients underwent at least a single cycle and were eligible for analysis. Mean number of cycles administered was 2. Final average curvature after treatment, regardless of the number of cycles was 34°, with a mean reduction in curvature of −23.29° (−41%). Across the first three cycles we found statistically significant differences in the means in terms of the degrees of curvature after each cycle (p < 0.05), however this was not maintained in the fourth cycle. Statistical significance was also found when comparing the initial and final curvature after the complete treatment. We can conclude that treatment with CCH for PD is safe and effective. The concomitant use of CCH and PTT may limit the number of treatment cycles necessary to optimize outcomes when compared with CCH alone.

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Fig. 1: Description of the scheme of treatment with the I + e protocol.
Fig. 2: Diagram representing the distribution of the patients at the time of the analysis by clinical status.
Fig. 3: Evolution of the mean curvatures after the administration of each treatment cycle.
Fig. 4

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Authors and Affiliations

  1. Department of Urology, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain

    Borja García-Gómez, Esther García-Rojo, Manuel Alonso-Isa, José Medina-Polo, Rocío Santos-Pérez de la Blanca, Alfredo Rodríguez-Antolín & Javier Romero-Otero

  2. Department of Urology, Hospital Universitario HM Montepríncipe, Madrid, Spain

    Borja García-Gómez, José Medina-Polo & Javier Romero-Otero

  3. Department of Urology, Hospital Universitario HM Puerta del Sur, Madrid, Spain

    Manuel Alonso-Isa, Juan Justo-Quintas & Javier Romero-Otero

  4. Department of Urology, The Christine NHS Foundation Trust, Manchester, United Kingdom

    Arie Parnham

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  1. Borja García-Gómez
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Correspondence to Javier Romero-Otero.

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García-Gómez, B., García-Rojo, E., Alonso-Isa, M. et al. Treatment of peyronie’s disease with combination of clostridium histolyticum collagenase and penile traction therapy: a prospective, multicenter, single-arm study. Int J Impot Res 33, 325–331 (2021). https://doi.org/10.1038/s41443-020-0292-y

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