PD23-05 PATIENT REFERRAL TRENDS AND OUTCOMES OF PENILE PLICATION IN THE CONTEMPORARY ERA: IS XIAFLEX® DRIVING PATIENTS TO SURGERY?

Abstract

You have accessJournal of UrologyCME1 May 2022PD23-05 PATIENT REFERRAL TRENDS AND OUTCOMES OF PENILE PLICATION IN THE CONTEMPORARY ERA: IS XIAFLEX® DRIVING PATIENTS TO SURGERY? Sam Kusin, Shervin Badkhshan, Samantha Nealon, Gregory Joice, Sarah Sanders, Steven Hudak, and Allen Morey Sam KusinSam Kusin More articles by this author , Shervin BadkhshanShervin Badkhshan More articles by this author , Samantha NealonSamantha Nealon More articles by this author , Gregory JoiceGregory Joice More articles by this author , Sarah SandersSarah Sanders More articles by this author , Steven HudakSteven Hudak More articles by this author , and Allen MoreyAllen Morey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002565.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Injection of Clostridium Histolyticum (Xiaflex®, CCH) has become increasingly more common since its FDA approval for non-surgical treatment for Peyronie’s Disease (PD) in December 2013. We evaluated practice patterns for PD in the Xiaflex® era and the outcomes for penile plication (PP) after CCH failure at our tertiary referral center. METHODS: We performed a retrospective study of our single-surgeon PP database from 2013-2021. Patients who underwent PP were stratified by history of CCH treatment for PD. Variables compared included number of CCH cycles, time from CCH to PP, change in degree of curvature, and need for revision plication. The EPIC SlicerDicer program was used to identify all clinic visits with a primary PD diagnosis using ICD-10 code N48.6. Two-tailed t-tests for continuous variables were performed using PRISM 9.2. RESULTS: The annual number of clinic visits for PD during the study period nearly doubled (242 in 2013-14 vs. 436 in 2019-20, p <0.01). The annual number of PPs performed and the proportion with prior CCH failure escalated at a similar rate (Figure 1). Among 43 men who underwent PP after prior CCH treatment, a mean of 3.6 treatment cycles (range 1 – 6) were completed with an average time from final CCH treatment to PP of 13.0 months (range 4 – 25). Patients frequently reported no change (19/43 41.3%) or mild improvement (12/43, 26.0%) following CCH treatment. Worsening curvature (8/43, 17.4%) and corporal rupture (2/46, 4.3%) were also reported after CCH. Mean pre-CCH curvature was 61.6° ± 20.7° with an average improvement of 13° ± 17° with CCH. PP further improved curvature by 49° ± 20° with residual curvature of 3° ± 7°. There was no significant difference in the need for revision PP between the CCH and non-CCH groups (2/43, 4.7% vs. 14/372, 3.8%, p <0.01). CONCLUSIONS: The introduction of CCH for the treatment of PD has led to a significant increase in clinic visits for surgical consultation and PP in patients with previous CCH failure. Post-CCH PP appears to be feasible and safe with overall excellent improvement in curvature. Source of Funding: NA © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e410 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sam Kusin More articles by this author Shervin Badkhshan More articles by this author Samantha Nealon More articles by this author Gregory Joice More articles by this author Sarah Sanders More articles by this author Steven Hudak More articles by this author Allen Morey More articles by this author Expand All Advertisement PDF DownloadLoading ...