355 Safety and Efficacy of Intralesional Collagenase Clostridium Histolyticum Injection Therapy in the Acute Phase of Peyronie's Disease: A single-center, Retrospective Cohort Study

Abstract

Peyronie’s disease (PD) is classically divided into two categories: the acute phase, followed by the chronic (stable) phase. The initial clinical trials for intralesional collagenase Clostridium histolyticum (CCH) excluded men in the acute phase. Though the acute phase has varying definitions in the literature, it is generally understood that it can last 12-18 months and is accompanied by pain or progression of deformity. For men in the chronic phase, intralesional CCH has been shown to be effective in improving penile curvature, with an acceptable risk for adverse events, including swelling, bruising, hematoma, and corporal rupture. Few studies have evaluated the role of intralesional CCH in the acute phase of Peyronie’s disease. To evaluate the safety and efficacy of intralesional CCH during the acute phase of PD compared to the chronic phase. All men receiving CCH injections from January 2016 through June 2019 at a single academic institution were included in an institutional review board (IRB) approved database. Curvature outcomes and adverse events were retrospectively assessed. To account for varying definitions in literature, patients were stratified into the acute and chronic phase using two definitions: 1) acute phase – symptoms of PD ≤ 12 months (Group 1), chronic phase – symptoms of PD > 12 months (Group 2); and 2) acute phase – symptoms of PD ≤ 12 months and reported pain at time of first CCH injection (Group 3), chronic phase – symptoms of PD > 12 months without pain (Group 4). Adverse events were defined as swelling, bruising, hematoma, or corporal rupture. A Wilcoxon rank sum test was used to analyze percent change in penile deformity between groups, and a one-way ANOVA was used to analyze adverse event development between groups.