(402) Peyronie's Disease Treatment- Active Vs. Stable Phase- Retrospective Review of Cases

Abstract

Abstract Introduction Peyronie's disease (PD) may be treated with collagenase clostridium histolyticum (CCH) during the stable phase. However, the effectiveness and safety of this treatment during the active phase remain unclear. To address this, we investigated and compared the outcomes of patients receiving treatment in the active phase versus the stable phase of PD. Objective To assess the effectiveness and safety of CCH treatment in patients diagnosed with PD during the active phase. Methods A retrospective review was conducted on men who underwent at least one cycle of CCH injections for PD with a single fellowship-trained urologist between 2017 and 2023. Active PD was defined as occurring within one year from the onset of symptoms. The severity of penile curvature was measured at the point of maximal curvature and assessed at baseline and after each CCH cycle. In addition to the CCH treatment, patients were prescribed daily phosphodiesterase inhibitors (PDEi) and coenzyme-Q10 (CoQ-10). The treatment response was defined as any improvement in curvature from baseline to the final assessment. The characteristics and outcomes of patients were compared between those with active and stable PD. Results Of 107 patients who underwent CCH treatment, 75 were diagnosed with stable PD and 32 with active PD. There were no significant differences observed between the two groups in terms of age (58.1 vs. 57.9 years, p = 0.89), baseline curvature (58.4 vs. 60.5 degrees, p = 0.60), or the number of CCH cycles received (6.6 vs. 6.3 cycles, p = 0.57). Among the active PD patients, 26 (81.2%) experienced an improvement in curvature, which was comparable to the stable PD group (58 (77.3%), p = 0.85). There were no significant differences in the degree of curvature improvement (14.4 vs. 14.0 degrees, p = 0.91) or the percentage of improvement from baseline (22.67% vs. 24.05%, p = 0.86) between the active and stable PD patients. In the subset of patients who showed an improvement in curvature angle, there was no notable distinction in the percentage of improvement from baseline between the stable and active phases (37.4% vs 34.8%, p=0.63). Among the treated patients, we observed two cases of potential penile fractures in the stable phase. All adverse events were conservatively managed. Conclusions Patients treated with CCH during the active phase achieved comparable outcomes to those in the stable phase. There were no additional adverse events in the active phase treatment group. These data suggest that early active phase treatment yields similar effectiveness as treatment administered during the stable phase. Treatment during the active phase could be a disease modifier and may change the course of progression. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Endo, Roman Health.