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Objective

To evaluate the efficacy and safety of Collagenase clostridium histolyticum (CCH) (Xiapex®) in the treatment of Peyronie’s disease (PD) at a single centre using a new modified protocol.

Material and Methods

A prospective study of 40 patients with PD who are having treatment with CCH at a single centre using a new modified protocol. Patients with active disease, complete plaque calcification or ventral curvature were excluded. The angle of curvature, IIEF and Peyronie’s disease questionnaires (PDQ) were performed at baseline and 4 weeks after every treatment. A total of 3 intra-lesional injections of CCH (0.9mg) were given at 4 weekly intervals, 5 patients requested an additional 3 injections. In between injections patients used a combination of home modelling and a vacuum device on a daily basis.

Results

So far 28 patients have completed all 3 treatment cycles, 5 of which had a total of 6 cycles. At baseline, the mean penile curvature was 53.9° (30°-90°). Overall, 26 patients (92.8%) had an improvement in curvature with a mean value of 18.56° (0°-40°) or 33% from baseline (0-60%) after 3 injections. The end mean curvature was 38.4° (12°-75°; p≤ 0.001). There was a statistically significant improvement each of the IIEF questionnaire domains. There were also statistically significant improvements in all 3 PDQ domains and the global assessment of PD questionnaire. The 5 patients who had 6 injections continued to have additional curvature improvement, mean 10.4° (0°-30°). CCH was well tolerated by all patients with only mild and transient penile swelling and bruising occurring in all participants but no systemic adverse events.

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