349 Penile Duplex Ultrasonography Supplements Goniometry in Formal Assessment of Efficacy of Intralesional Collagenase Clostridium Histolyticum for Peyronie's Disease

Abstract

The evaluation of effectiveness of Collagenase Clostridium histolyticum (CCh) in treating men with Peyronie’s disease is largely limited to goniometry, symptoms assessment, and standardized questionnaires. These assessments do not determine objective changes in erectile function or vascular flow. Additionally, goniometry typically does not capture improvement in hourglass deformities or hinge defects. Doppler ultrasound measurement of peak systolic velocities has been investigated as a possible adjunctive assessment tool. While initial studies did not demonstrate improvement in velocities, these studies did not take into consideration velocities both proximal and distal to the penile plaque. This study evaluated the changes in peak systolic velocities of the cavernosal arteries of men with PD before and after 8 injections of CCh. An institutional review board approved database of 152 patients treated with CCh at an academic men’s health practice from January 2016 through April 2019 was reviewed. Doppler ultrasonography was performed after a chemically induced erection by a single examiner both before and after 8 CCh injections. Peak systolic velocities (PSV) were measured both proximal and distal to the palpable plaque bilaterally. Patient demographic information and goniometry data were also extracted. Univariate statistical analysis compared PSV data before and after CCh therapy.