Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
CONTEXT Conservative therapies for Peyronie 's disease ( PD ) aim to treat early-stage disease by improving clinical outcomes such as penile curvature , penile length erectile dysfunction , and pain .
OBJECTIVE To summarise the available evidence regarding injection and mechanical therapies for PD treatment .
Treatment of Peyronie's Disease With Collagenase Clostridium histolyticum and Vacuum Therapy: A Randomized, Open-Label Pilot Study.
BACKGROUND Collagenase Clostridium histolyticum ( CCH ) is indicated for the treatment of penile curvature in adult men with Peyronie 's disease ( PD ) with palpable plaque and curvature deformity of at least 30 ° at the start of therapy . AIM To evaluate the efficacy and safety of CCH plus vacuum-pump therapy with and without penile modeling for the management of PD . METHODS Adult men with PD and penile curvature of at least 30 ° were r and omly assigned to receive  CCH  0.58 mg plus vacuum therapy alone ( n = 15 ) or with penile plaque modeling ( n = 15 ) . Patients received no more than four treatment cycles ( cycle = ∼6-week duration ) , each consisting of two intralesional injections of CCH administered 24 to 72 hours apart . Vacuum therapy was applied twice daily from 14 days after the second injection of each cycle until the following cycle . Modeling was performed 24 to 72 hours after the second injection of each cycle . OUTCOMES The primary end point was change in penile curvature from baseline to week 36 ; additional end points included changes in Peyronie 's Disease Question naire ( PDQ ) domain scores , composite response ( ≥20 % decrease in penile curvature and decrease in PDQ bother score ≥ 1 point ) , and global response ( small but important , moderate , or much improvement in the Global Assessment of PD ) . RESULTS At week 36 , improvement in penile curvature from baseline was similar in the two groups ( mean change from baseline = -23.7 ° [ SD = 10.9 ] for CCH + vacuum + modeling and -23.3 ° [ SD = 7.2 ] for CCH + vacuum ; between-group difference = -0.3 ° , 95 % CI = -7.3 to 6.6 ) . Improvements in most PDQ domains , including bother , were observed from baseline to week 36 in the two groups . Most patients were composite ( 66.7 % and 84.6 % with CCH + vacuum + modeling and CCH + vacuum , respectively ) and global ( 86.7 % and 92.3 % , respectively ) responders . The most common adverse events were penile contusion , penile swelling , and penile pain . CLINICAL IMPLICATION S Vacuum-pump therapy administered alone or in combination with modeling after CCH treatment could improve PD symptoms . STRENGTHS AND LIMITATIONS This was a pilot study with a small sample and limited follow-up duration . CONCLUSION CCH and vacuum-pump therapy ( alone or combined with modeling ) could be an appropriate consideration for men with PD and warrants further investigation . Ralph DJ , Abdel Raheem A , Liu G. Treatment of Peyronie 's Disease With Collagenase Clostridium histolyticum and Vacuum Therapy : A R and omized , Open-Label Pilot Study . J Sex Med 2017;14:1430 - 1437
Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
CONTEXT Conservative therapies for Peyronie 's disease ( PD ) aim to treat early-stage disease by improving clinical outcomes such as penile curvature , penile length erectile dysfunction , and pain .
OBJECTIVE To summarise the available evidence regarding injection and mechanical therapies for PD treatment .