MP56-04 SAFETY AND EFFECTIVENESS OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM IN THE TREATMENT OF PEYRONIE'S DISEASE USING A NEW SHORTENED PROTOCOL

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie’s Disease II1 Apr 2017MP56-04 SAFETY AND EFFECTIVENESS OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM IN THE TREATMENT OF PEYRONIE'S DISEASE USING A NEW SHORTENED PROTOCOL Amr Abdel Raheem, Marco Capece, Ayo Kaljaiye, Amr Mobasher, Giulio Garaffa, Nim Christopher, and David Ralph Amr Abdel RaheemAmr Abdel Raheem More articles by this author , Marco CapeceMarco Capece More articles by this author , Ayo KaljaiyeAyo Kaljaiye More articles by this author , Amr MobasherAmr Mobasher More articles by this author , Giulio GaraffaGiulio Garaffa More articles by this author , Nim ChristopherNim Christopher More articles by this author , and David RalphDavid Ralph More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1757AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Collagenase clostridium histolyticum (CCH)is the only licensed product for the treatment of Peyronie's disease (PD). The clinical safety and efficacy of CCH in PD was shown in two large clinical trials; IMPRESS I & II. The aim of this study is to evaluate the efficacy and safety of CCH in the treatment of PD using a new modified treatment protocol which aims at reducing the number of injections needed and reducing patient visits, thus reducing the cost and duration of treatment. METHODS A prospective study of 50 patients with PD who are having treatment with CCH at a single centre using a new modified protocol. Patients with active disease, complete plaque calcification or ventral curvature were excluded. The angle of curvature assessment after an intra-cavernosal injection of PGE1, IIEF and Peyronie's disease questionnaire (PDQ) were performed at baseline and at week 12. The global assessment of PD questionnaire was performed at week 12. Under a penile block of 10ml of lignocaine 1%, a total of 3 intra-lesional injections of CCH (0.9mg) were given at 4 weekly intervals using a new modified injection technique. CCH was injected in the plaque along 3 lines separated by 2mm at the apex of the curvature with the penis in the flaccid state. Six patients requested an additional 3 injections to have a total of 6 injections. In between injections patients used a combination of home modelling, stretching and a vacuum device on a daily basis in order to mechanically stretch the plaque. Investigator modelling was not performed. RESULTS So far 46 patients have completed treatment; all had 3 injections. At baseline, the mean penile curvature was 53.8°(30°-90°). Overall, 44 patients (95.6%) had an improvement in curvature with a mean value of 17.08° (0°-40°) or 30.8% from baseline (0-57%) after 3 injections. The end mean curvature for all patients after 3 injections was 37° (12°- 75°; p≤ 0.001). There was a statistically significant improvement in each of the IIEF questionnaire domains, all 3 PDQ domains and the global assessment of PD questionnaire. The 6 patients who had 3 more injections continued to have additional curvature improvement, mean 19.8° (0°-40°). CCH was well tolerated by all patients with only mild and transient local side effects. The results of this study with only 3 CCH injections are comparable to those of the clinical trials using 8 CCH injections. With the new protocol, only 4 patient visits are needed including assessments versus 14 visits as per trial protocol. CONCLUSIONS The new shortened protocol for CCH in PD is safe, effective and cost efficient. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e756 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Amr Abdel Raheem More articles by this author Marco Capece More articles by this author Ayo Kaljaiye More articles by this author Amr Mobasher More articles by this author Giulio Garaffa More articles by this author Nim Christopher More articles by this author David Ralph More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...