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Outcomes of Surgery in Peyronie’s Disease Following Intralesional Collagenase Clostridium Histolyticum Injections

  • Men's Health (A Dabaja, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To explore the potential hurdles surgeons may encounter when preforming surgical correction of penile curvature in patients with Peyronie’s Disease following intralesional collagenase clostridium histolyticum injections.

Recent Findings

Although limited data exists, retrospective analysis of surgeon experiences in surgical treatment of refractory penile curvature in patients with Peyronie’s disease appears to not result in more post-operative complications and may only slightly increase intra-operative difficulty.

Summary

As the use of intralesional collagenase clostridium histolyticum continues to increase and patients who demonstrate persistent curvature despite treatment seek further management, the role of investigating the feasibility of surgery demonstrates significant importance. Although limited data exists, it appears that surgery following intralesional collagenase clostridium histolyticum is safe without added post-operative complications. At the present time, however, further data on intra-operative findings and post-operative outcomes remain necessary, and as the use of this intralesional therapy continues to rise, further information should become readily available.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Nehra A, et al. Peyronie’s disease: AUA Guideline. J Urol. 2015;194(3):745–53.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Schwarzer U, et al. The prevalence of Peyronie’s disease: results of a large survey. BJU Int. 2001;88(7):727–30.

    Article  CAS  PubMed  Google Scholar 

  3. Stuntz M, et al. The prevalence of Peyronie’s disease in the United States: a population-based study. PLoS One. 2016;11(2):e0150157.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Sommer F, et al. Epidemiology of Peyronie’s disease. Int J Impot Res. 2002;14(5):379–83.

    Article  CAS  PubMed  Google Scholar 

  5. Shiraishi K, Shimabukuro T, Matsuyama H. The prevalence of Peyronie’s disease in Japan: a study in men undergoing maintenance hemodialysis and routine health checks. J Sex Med. 2012;9(10):2716–23.

    Article  PubMed  Google Scholar 

  6. Terrier JE, Nelson CJ. Psychological aspects of Peyronie’s disease. Transl Androl Urol. 2016;5(3):290–5.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rosen R, et al. Impact of Peyronie’s disease on sexual and psychosocial functioning: qualitative findings in patients and controls. J Sex Med. 2008;5(8):1977–84.

    Article  PubMed  Google Scholar 

  8. Nelson CJ, Mulhall JP. Psychological impact of Peyronie’s disease: a review. J Sex Med. 2013;10(3):653–60.

    Article  PubMed  Google Scholar 

  9. Burri A, Porst H. The relationship between penile deformity, age, psychological bother, and erectile dysfunction in a sample of men with Peyronie’s disease (PD). Int J Impot Res. 2018;30(4):171–8.

    Article  PubMed  Google Scholar 

  10. Mulhall JP, et al. Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. J Urol. 2004;171(6 Pt 1):2350–3.

    Article  PubMed  Google Scholar 

  11. Carrieri MP, et al. A case-control study on risk factors for Peyronie’s disease. J Clin Epidemiol. 1998;51(6):511–5.

    Article  CAS  PubMed  Google Scholar 

  12. El-Sakka Ahmed I, Tayeb Khalid A. Peyronie’s disease in diabetic patients being screened for erectile dysfunction. J Urol. 2005;174(3):1026–30.

    Article  CAS  PubMed  Google Scholar 

  13. El-Sakka AI, et al. The pathophysiology of Peyronie’s disease. Arab J Urol. 2013;11(3):272–7.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Valenzuela R, et al. The use of penile traction therapy in the management of Peyronie’s disease: current evidence and future prospects. Therapeutic advances in urology, vol. 11; 2019. p. 1756287219838139.

    Google Scholar 

  15. La Pera G, et al. Peyronie’s disease: prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50-69 years. Eur Urol. 2001;40(5):525–30.

    Article  PubMed  Google Scholar 

  16. Weidner W, Hauck EW, Schnitker J. Potassium paraaminobenzoate (POTABA) in the treatment of Peyronie’s disease: a prospective, placebo-controlled, randomized study. Eur Urol. 2005;47(4):530–5 discussion 535-6.

    Article  CAS  PubMed  Google Scholar 

  17. Bennett NE, Guhring P, Mulhall JP. Intralesional verapamil prevents the progression of Peyronie’s disease. Urology. 2007;69(6):1181–4.

    Article  PubMed  Google Scholar 

  18. Smith JF, Shindel AW, Huang YC, Clavijo RI, Flechner L, Breyer BN, et al. Pentoxifylline treatment and penile calcifications in men with Peyronie’s disease. Asian J Androl. 2011;13(2):322–5.

  19. Barrett-Harlow B, Wang R. Oral therapy for Peyronie’s disease, does it work? Transl Androl Urol. 2016;5(3):296–302.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Russo GI, Milenkovic U, Hellstrom W, Levine LA, Ralph D, Albersen M. Clinical efficacy of injection and mechanical therapy for Peyronie’s disease: a systematic review of the literature. Eur Urol. 2018;74(6):767–81.

    Article  PubMed  Google Scholar 

  21. Kayes O, Khadr R. Recent advances in managing Peyronie’s disease. F1000Res. 2016;5:F1000 Faculty Rev-2372.

  22. Brimley SC, Yafi FA, Greenberg J, Hellstrom WJG, Tue Nguyen HM, Hatzichristodoulou G. Review of management options for active-phase Peyronie’s disease. Sex Med Rev. 2019;7(2):329–37.

    Article  PubMed  Google Scholar 

  23. Levine LA, Larsen SM. Surgical correction of persistent Peyronie’s disease following collagenase clostridium histolyticum treatment. J Sex Med. 2015;12(1):259–64.

    Article  PubMed  Google Scholar 

  24. • DeLay K, et al. Successful treatment of residual curvature in Peyronie disease in men previously treated with intralesional collagenase clostridium histolyticum. Urology. 2017;110:110–3 This retrospective review by DeLay et al. outlines the foundation for the fundamental question in our review; it assesses the safety and outcomes of surgical correction of penile curvature following CCH injections.

    Article  PubMed  Google Scholar 

  25. Yang KK, Bennett N. The history of collagenase clostridium histolyticum. Sex Med Rev. 2015;3(4):289–97.

    Article  PubMed  Google Scholar 

  26. Starkweather KD, Lattuga S, Hurst LC, Badalamente MA, Guilak F, Sampson SP, et al. Collagenase in the treatment of Dupuytren’s disease: an in vitro study. J Hand Surg Am. 1996;21(3):490–5.

  27. Badalamente MA, Hurst LC. Enzyme injection as nonsurgical treatment of Dupuytren’s disease. J Hand Surg Am. 2000;25(4):629–36.

    Article  CAS  PubMed  Google Scholar 

  28. Shaw RB Jr, Chong AKS, Zhang A, Hentz VR, Chang J. Dupuytren’s disease: history, diagnosis, and treatment. Plast Reconstr Surg. 2007;120(3):44e–54e.

    Article  PubMed  CAS  Google Scholar 

  29. Costas B, et al. Efficacy and safety of collagenase clostridium histolyticum for Dupuytren disease nodules: a randomized controlled trial. BMC Musculoskelet Disord. 2017;18(1):374.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Carson Iii CC, et al. Analysis of the clinical safety of intralesional injection of collagenase clostridium histolyticum (CCH) for adults with Peyronie’s disease (PD). BJU Int. 2015;116(5):815–22.

    Article  CAS  Google Scholar 

  31. Traore EJ, Wang W, Yafi FA, Hellstrom WJG. Collagenase clostridium histolyticum in the management of Peyronie’s disease: a review of the evidence. Ther Adv Urol. 2016;8(3):192–202.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Cwikla DJ, Yafi FA. Intralesional collagenase Clostridium histolyticum in the management of Peyronie’s disease: current best practice. Ther Adv Urol. 2018;10(4):139–53.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Gelbard M, Goldstein I, Hellstrom WJG, McMahon CG, Smith T, Tursi J, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of Peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190(1):199–207.

  34. Capece M, Cocci A, Russo G, Cito G, Giubilei G, Cacciamani G, et al. Collagenase clostridium histolyticum for the treatment of Peyronie’s disease: a prospective Italian multicentric study. Andrology. 2018;6(4):564–7.

  35. Bella AJ, et al. Canadian Urological Association guideline for Peyronie’s disease and congenital penile curvature. Can Urol Assoc J. 2018;12(5):E197–209.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Cayan S et al. Comparison of patient’s satisfaction and long-term results of two penile plication techniques: lessons learned from 387 patients with penile curvature. Urology. 2019.

  37. • Wayne GF, Cordon BH. Contemporary surgical and non-surgical management of Peyronie’s disease. Transl Androl Urol. 2018;7(4):603–17 This review article by Wayne et al. outlines many of the commonly performed medical and surgical interventions available to patients afflicted by Peyronie’s disease.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Nesbit RM. Congenital curvature of the phallus: report of three cases with description of corrective operation. J Urol. 1965;93:230–2.

    Article  CAS  PubMed  Google Scholar 

  39. Pryor JP, Fitzpatrick JM. A new approach to the correction of the penile deformity in Peyronie’s disease. J Urol. 1979;122(5):622–3.

    Article  CAS  PubMed  Google Scholar 

  40. Kadioglu A, Kucukdurmaz F, Sanli O. Current status of the surgical management of Peyronie’s disease. Nat Rev Urol. 2011;8(2):95–106.

    Article  PubMed  Google Scholar 

  41. Devine CJ Jr, Horton CE. Surgical treatment of Peyronie’s disease with a dermal graft. J Urol. 1974;111(1):44–9.

    Article  PubMed  Google Scholar 

  42. Levine LA, Larsen SM. Surgery for Peyronie’s disease. Asian J Androl. 2013;15(1):27–34.

    Article  PubMed  Google Scholar 

  43. Hatzichristodoulou G. Grafting techniques for Peyronie’s disease. Transl Androl Urol. 2016;5(3):334–41.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Anaissie J, Yafi FA. A review of surgical strategies for penile prosthesis implantation in patients with Peyronie’s disease. Transl Androl Urol. 2016;5(3):342–50.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Rice PG, Somani BK, Rees RW. Twenty years of plaque incision and grafting for Peyronie’s disease: a review of literature. Sex Med. 2019;7:115–28.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Levine LA, Burnett AL. Standard operating procedures for Peyronie’s disease. J Sex Med. 2013;10(1):230–44.

    Article  PubMed  Google Scholar 

  47. Kadioglu A, Akman T, Sanli O, Gurkan L, Cakan M, Celtik M. Surgical treatment of Peyronie’s disease: a critical analysis. Eur Urol. 2006;50(2):235–48.

    Article  PubMed  Google Scholar 

  48. Khera M, Bella A, Karpman E, Brant W, Christine B, Kansas B, et al. Penile prosthesis implantation in patients with Peyronie’s disease: results of the PROPPER study demonstrates a decrease in patient-reported depression. J Sex Med. 2018;15(5):786–8.

  49. Hay DC, Louie DL, Earp BE, Kaplan FTD, Akelman E, Blazar PE. Surgical findings in the treatment of Dupuytren’s disease after initial treatment with clostridial collagenase (Xiaflex). J Hand Surg Eur Vol. 2014;39(5):463–5.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors and editors would like to thank Dr. Bahaa Malaeb, University of Michigan, for providing the review of their manuscript.

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Authors and Affiliations

  1. Henry Ford Health System, Vattikuti Urology Institute, 2799 West Grand Boulevard, Detroit, MI, 48202, USA

    Mahdi Bazzi, Marcus L. Jamil & Ali A. Dabaja

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  1. Mahdi Bazzi
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Correspondence to Ali A. Dabaja.

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Mahdi Bazzi and Marcus L. Jamil each declare no potential conflicts of interest.

Ali A. Dabaja is a section editor for Current Urology Reports.

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Bazzi, M., Jamil, M.L. & Dabaja, A.A. Outcomes of Surgery in Peyronie’s Disease Following Intralesional Collagenase Clostridium Histolyticum Injections. Curr Urol Rep 20, 42 (2019). https://doi.org/10.1007/s11934-019-0910-8

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