MP28-18 COMPARISON OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM TO SURGERY FOR THE MANAGEMENT OF PEYRONIE’S DISEASE: A RANDOMIZED TRIAL—1 YEAR OUTCOMES

Field: Medicine (Health Sciences)

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie's Disease (MP28)1 May 2024MP28-18 COMPARISON OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM TO SURGERY FOR THE MANAGEMENT OF PEYRONIE'S DISEASE: A RANDOMIZED TRIAL—1 YEAR OUTCOMES Bryce Palmer, Joshua Savage, Klint Brearton, Riley Warner, Matthew Ziegelmann, Sevann Helo, Tobias Kohler, and Landon Trost Bryce PalmerBryce Palmer , Joshua SavageJoshua Savage , Klint BreartonKlint Brearton , Riley WarnerRiley Warner , Matthew ZiegelmannMatthew Ziegelmann , Sevann HeloSevann Helo , Tobias KohlerTobias Kohler , and Landon TrostLandon Trost View All Author Informationhttps://doi.org/10.1097/01.JU.0001008872.42208.7a.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Since FDA approval of Collagenase Clostridium Histolyticum (CCH) for the treatment of Peyronie's Disease (PD), there has been significant debate as to its role and comparable efficacy in relation to surgical therapies. We therefore sought to compare key outcomes between the two therapies. METHODS: A randomized, controlled trial is ongoing. Participants were randomized 1:1 to receive either CCH+traction (RestoreX) + sildenafil (CCH) or penile surgery (plication and/or incision and grafting) + traction+sildenafil for PD (Surgery). Objective, standardized, and non-standardized assessments were obtained at baseline and 3, 6, 12, 24, 36, 48, and 60 months post-treatment. Key outcomes included differences in standardized questionnaires, penile curvature, penile length, subsequent interventions, and non-standardized questionnaire responses. RESULTS: A total of 40 men were randomized with 12-month data available in 28 (CCH=12, surgery=16). Mean age was 54.7 years, PD duration 37.4 months (mo), composite curvature 73.1 degrees (deg), and penile length 12.7 cm. All baseline variables were similar between cohorts. Regarding primary outcomes, at 12-months post-treatment, CCH men reported being very satisfied 38%, satisfied 31%, and neutral 31% with none dissatisfied. Men in the Surgery cohort reported 13% very satisfied, 60% satisfied, 0% neutral, and 27% dissatisfied (p<0.01). For secondary outcomes, no differences were noted with standardized questionnaire outcomes, length change (CCH+1.0 vs -0.1 cm, p<0.05), curvature absolute change (-45 vs -54 degrees, p=0.16), and curvature % improvement (62% vs 82%, p=0.33). Compared to 3-month data, Surgery men experienced greater curve recurrence (objective: Surgery+5 degrees vs -5 degrees CCH, p=0.03), decreased subjective penile length 64% vs 23% (p=0.02) and decreased sensitivity (57% vs 31% CCH, p=0.02). Both groups reported similar changes in erectile function (CCH 46% improved, 8% worsened; Surgery 57% improved, 14% worsened, p=0.65). CONCLUSIONS: Preliminary data suggests that when compared to surgery at 12-months, CCH men experienced higher satisfaction, greater sustained length improvements, lower curvature recurrence rates and lesser negative impacts on penile sensation. Source of Funding: Endo Pharmaceuticals © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e479 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Bryce Palmer More articles by this author Joshua Savage More articles by this author Klint Brearton More articles by this author Riley Warner More articles by this author Matthew Ziegelmann More articles by this author Sevann Helo More articles by this author Tobias Kohler More articles by this author Landon Trost More articles by this author Expand All Advertisement PDF downloadLoading ...