Multi-institutional Prospective Analysis of Intralesional Injection of Collagenase Clostridium Histolyticum, Tunical Plication, and Partial Plaque Excision and Grafting for the Management of Peyronie's Disease
| Autor: | Ling DeYoung, Kenneth J. DeLay, Faysal A. Yafi, Riad Talib, Gerald B. Brock, Linley Diao, Wayne J.G. Hellstrom, Georgios Hatzichristodoulou, Laith Alzweri |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Surgical Sponges Dorsum medicine.medical_specialty Urologic Surgical Procedures Male Urology Penile Induration 030232 urology & nephrology Injections Intralesional 03 medical and health sciences Prospective analysis 0302 clinical medicine Collagenase clostridium histolyticum PEG ratio medicine Deformity Humans In patient Prospective Studies 030219 obstetrics & reproductive medicine business.industry Thrombin Fibrinogen Middle Aged medicine.disease Surgery Drug Combinations Microbial Collagenase Peyronie's disease medicine.symptom Clostridium histolyticum business After treatment Penis medicine.drug |
| Zdroj: | Urology. 120:138-142 |
| ISSN: | 0090-4295 |
| Popis: | To compare in a prospective nonrandomized fashion, the outcomes of collagenase clostridium histolyticum (CCH) and surgical interventions (tunical plication [TP] and partial plaque excision and grafting [PEG]) in patients with Peyronie's disease (PD). Intralesional injection of CCH is the only Food and Drug Administration-approved nonsurgical intervention for PD.Between June 2015 and January 2017, 57 patients with PD and dorsal, dorsolateral, and/or lateral penile curvatures 30°-90° were included in this study. Patients with ventral curvature, hourglass deformity, and previous surgery for PD were excluded. All patients completed questionnaires and underwent penile measurements and penile vascular studies prior to and after completion of treatment, and were followed for at least 6 months.CCH was administered to 18 patients, TP performed in 14, and PEG in 25. The median follow-up for the whole cohort was 12 months (6-28). Mean changes in curvature after treatment were 23.3° (34.4%) for CCH, 72.0° (92.2%) for TP, and 71.8 ° (94.9%) for PEG, P.001. Mean changes in International Index of Erectile Function-5 scores were +5.7 for CCH, +4.9 for TP, and +2.2 for PEG, P = .395. Mean penile length changes were -0.2 cm for CCH, -1.0 cm for TP, and +0.9 cm for PEG, P.001. Three patients in the CCH group had bothersome residual curvature and underwent uneventful TP.Surgical options are associated with superior curvature correction. CCH is an effective and safe option for motivated patients who prefer to avoid surgery. PEG is associated with a small stretched penile length gain. |
| Databáze: | OpenAIRE |
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