MP36-04 PREDICTORS OF PENILE PLICATION AFTER INTRALESIONAL COLLAGENASE CLOSTRIDIUM HISTOLYTICUM INJECTION IN MEN WITH PEYRONIE’S DISEASE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP36-04 PREDICTORS OF PENILE PLICATION AFTER INTRALESIONAL COLLAGENASE CLOSTRIDIUM HISTOLYTICUM INJECTION IN MEN WITH PEYRONIE’S DISEASE Taher Naeem, Gal Saffati, Neal Mody-Bailey, Whitney Jin, Sagar Patel, Basil Kaaki, Larry I. Lipshultz, and Mohit Khera Taher NaeemTaher Naeem More articles by this author , Gal SaffatiGal Saffati More articles by this author , Neal Mody-BaileyNeal Mody-Bailey More articles by this author , Whitney JinWhitney Jin More articles by this author , Sagar PatelSagar Patel More articles by this author , Basil KaakiBasil Kaaki More articles by this author , Larry I. LipshultzLarry I. Lipshultz More articles by this author , and Mohit KheraMohit Khera More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003270.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s Disease (PD) is a common acquired disorder defined by an accumulation of fibrous tissue along the tunica albuginea resulting in a curvature of the penis. This deformity can lead to erectile dysfunction, psychological distress, and pain. Clinical management involves intralesional injection of collagenase clostridium histolyticum (CCH). While efficacious, many cases are refractory, requiring a plication procedure. We seek to investigate predictive factors for plication after receiving a CCH injection. METHODS: A retrospective medical record review was performed on patients who have been treated for PD at an academic institution. Two cohorts were created, those who achieved resolution with initial CCH injection (CCH cohort) and those who failed initial CCH injection and required a plication (plication cohort). Univariate logistic regression modeling was performed to determine statistical significance. RESULTS: A total of 282 patients were included in the study, 11% (n=30) required CCH and a plication while 89% (n=252) had resolution of PD with CCH injection. The median (IQR) ages in the plication and CCH cohorts were 56.7 (50.6 – 63.2) and 57.9 (52.7 – 62.9) years old, respectively. The plication cohort’s median (IQR) degree of initial curvature, (65° [45 - 90]), was significantly greater than the CCH cohort, (45° [40 - 60]); p<0.001. Additionally, in the plication and CCH cohorts, median (IQR) testosterone levels were 343 (230 - 629) compared to 352 ng/dl (255 – 489); p=0.07, hypogonadism was 50% (n=15) compared to 20% (n=51); p=0.70, and median (IQR) plaque size was 8 (1.0 – 14.3) compared to 5.3 mm (1.4 – 9.9); p=0.61, respectively. Median (IQR) time to CCH treatment were 3.5 (2 – 5) and 4 (2 – 9) months in the plication and CCH cohorts, respectively; p=0.15. In the plication cohort, time to plication had a median (IQR) of 12 (8 – 20) months. CONCLUSIONS: Our analysis shows presenting degree of curvature significantly influences the probability of requiring a plication following CCH injection. Additionally, other factors such as hypogonadism, lower levels of testosterone, and larger plaque sizes may point towards trends that could predict progression to plication. These findings could be used to determine when plication should be used over CCH as initial treatment for PD. The effect would conclude in shorter waiting times for resolution of PD. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e480 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Taher Naeem More articles by this author Gal Saffati More articles by this author Neal Mody-Bailey More articles by this author Whitney Jin More articles by this author Sagar Patel More articles by this author Basil Kaaki More articles by this author Larry I. Lipshultz More articles by this author Mohit Khera More articles by this author Expand All Advertisement PDF downloadLoading ...