(040) MULTI-CENTER RETROSPECTIVE STUDY ON THE IMPACT OF TESTOSTERONE ON PENILE CURVATURE IN PATIENTS WITH PEYRONIE’S DISEASE UNDERGOING COLLAGENASE CLOSTRIDIUM HISTOLYTICUM TREATMENT
Authors: Orozco Rendon D , Saffati G , Hinojosa-Gonzalez D , Kronstedt S , Miller J , Moukhtar Hammad MA , Yafi F , Angulo-Llanos L , Garrett G , Sandler M , Tran D , Masterson T , Raheem O , Khera M 
Published: December 2024

Abstract

Introduction
Peyronie's disease (PD) is an acquired connective tissue disorder characterized by the formation of fibrous plaques within the tunica albuginea of the penis. There has been speculation suggesting that hypogonadism and testosterone levels prior to treatment with Collagenase Clostridium Histolyticum (CCH) impacts the degree of initial curvature in patients with PD, as well as the improvement of penile curvature following CCH management. This may be due to the role testosterone plays in collagen metabolism and wound healing. However, smaller, single institution studies have not found a significant correlation between baseline testosterone level and PD.

Objective
This study aimed to determine whether baseline testosterone levels prior to CCH treatment impacted penile curvature on presentation, improvement in curvature, and any side effects experienced by patients with PD.

Methods
This multi-center, retrospective study was approved by our Institutional Review Board and investigated patients who received CCH injections for the treatment of PD. Inclusion criteria consisted of patients who received CCH treatment without worsening curvature and for whom we recorded pretreatment baseline testosterone levels. Demographic data were extracted from patients' medical records as well as pre-treatment and post-treatment penile curvature, overall change in curvature, and hypogonadal status. Hypogonadism was defined as a baseline testosterone level &lt; 300 ng/dl.

Results
In total, 176 patients met inclusion criteria. The average age of the cohort was 57 years (SD 9.14) and the mean total baseline testosterone was 499.8 ng/dl (SD 305.6). The average pre-treatment penile curvature was 48.3° (SD 15.5), while average post-treatment penile curvature was 32.7° (SD 16.5). Overall, the mean improvement in curvature was found to be 15.6°. In those with hypogonadism, average pre-treatment penile curvature was 48.5° (SD 13.8), compared to 48.3° (SD 15.9) in those without hypogonadism. This was not statistically different (p = 0.4737). Average improvement of penile curvature in those with hypogonadism was 16.1° (SD 12.5) and 15.5° (SD 12.7) in those without hypogonadism, which was not found to be statistically different (p = 0.8237). On linear regression analysis, pre-treatment testosterone levels did not significantly predict improvement in the degree of penile curvature patients may experience (β = 0.002; R2 = 0.002; p = 0.5271). Table 1 summarizes average baseline testosterone levels in those experiencing side effects with CCH treatment, or patients who opt for surgical management of their PD; this relationship was not statistically significant.

Conclusions
Baseline testosterone levels prior to CCH treatment are not associated with pre-treatment penile curvature, improvement in penile curvature, or side effects experienced amongst PD patients.

Disclosure
No.