MP36-02 SAFETY AND EFFECTIVENESS OF INTRALESIONAL CLOSTRIDIUM HISTOLYTICUM INJECTIONS FOR ATYPICAL PRESENTATIONS OF PEYRONIE'S DISEASE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP36-02 SAFETY AND EFFECTIVENESS OF INTRALESIONAL CLOSTRIDIUM HISTOLYTICUM INJECTIONS FOR ATYPICAL PRESENTATIONS OF PEYRONIE'S DISEASE Zhan Wu, Mystie Chen, Jasmine Kashkoush, and Ryan Mori Zhan WuZhan Wu More articles by this author , Mystie ChenMystie Chen More articles by this author , Jasmine KashkoushJasmine Kashkoush More articles by this author , and Ryan MoriRyan Mori More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003270.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s disease (PD) is a common condition that causes sexual dysfunction and significant psychosocial distress. Intralesional injection of Clostridium Histolyticum (CCH) is a safe and effective treatment for well selected patients with PD. Limited data currently address the use of CCH for atypical presentations of PD which include hourglass deformity, ventral curvature, multi-planar curvature, and calcified plaque. We aim to assess the safety and effectiveness of CCH for patients with atypical PD. METHODS: A retrospective review was conducted on patients who received CCH at an integrated health system from October 2016 to September 2022. Patients were split into two groups: typical PD and atypical PD. Atypical PD patients included those with hourglass deformity, ventral curvature, multi-planar curvature, and calcified plaque. Demographics, treatment details, objective outcomes (curvature assessments), patient-reported outcome measures (Peyronie’s Disease Questionnaire), and complications were assessed. RESULTS: 83 men with stable phase PD underwent intralesional CCH injections. The mean age was 55.27 (SD=8.09). This included 44 men (53%) with atypical PD: 25 with hourglass deformity, 16 with multi-planar curvature, 13 with calcified plaque, and 4 with ventral curvature. The mean absolute change in penile curvature for patients with atypical PD was similar to patients with typical PD (18.3 degrees vs. 20.8 degrees, p=0.294). This represented an overall improvement in curvature by 38.9% and 40.8% for atypical and typical PD respectively (p=0.656). CCH was equally well tolerated with both groups with only minor complications. The most common post-procedural complaints were ecchymosis and mild penile pain. Corporal rupture was exceedingly rare with 1 case in each group. The composite psychosocial/physical symptoms score on PDQ assessment decreased by 4.88 and 4.48 for typical and atypical PD respectively (p=0.859). Likewise, the composite symptom bother score of PDQ decreased by 4.13 and 2.76 for typical and atypical PD respectively (p=0.270). CONCLUSIONS: Intralesional CCH has been shown to be safe and effective for treatment of PD presenting as isolated unidirectional dorsal or lateral deformity. These data suggest CCH is safe and effective for atypical presentations of PD including hourglass deformity, ventral curvature, multi-planar curvatures, and calcified plaque. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e479 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zhan Wu More articles by this author Mystie Chen More articles by this author Jasmine Kashkoush More articles by this author Ryan Mori More articles by this author Expand All Advertisement PDF downloadLoading ...