Urology · 2016
Impact of Number of Cycles of Collagenase Clostridium Histolyticum on Outcomes in Patients With Peyronie's Disease.
СтатьяНазвание и аннотация: Перевод в очереди
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Anaissie James, Yafi Faysal A, DeLay Kenneth J, Traore Elizabeth J, Sikka Suresh C, Hellstrom Wayne J G
Аннотация
OBJECTIVE: To analyze the impact of the number of cycles of collagenase Clostridium histolyticum (CCH) intralesional injection therapy on outcomes to further characterize CCH therapy.
METHODS: We conducted a retrospective review of the records of all patients treated with CCH for Peyronie disease between April 2014 and March 2016. Collected variables included demographics, pre- and posttreatment sexual function, penile curvature, penile vascular findings, and treatment outcomes.
RESULTS: A total of 77 patients were included in the study, of which 41 (53%) completed 4 cycles of treatment, consisting of 8 total injections. For all-comers regardless of numbers of cycles, curvature improved from 58.2° (standard deviation = 17.9°, range = 30°-105°) pre-treatment to 41.0° (standard deviation = 17.0°, range = 0°-85°) posttreatment (P < .001). In a repeated measures model, penile curvature improved significantly following the first 3 cycles, but not the fourth. Patients who had a ≥20% final reduction in curvature had a significantly greater change in curvature following the first injection (-16.2° vs -5.8°, P < .001).
CONCLUSION: Intralesional CCH therapy is an effective minimally invasive treatment for Peyronie disease, although the therapeutic benefit may decline after the third cycle of treatment. Patients with ≥20% reduction in curvature at the conclusion of treatment documented a greater curvature improvement after the first cycle and received more cycles of CCH.
METHODS: We conducted a retrospective review of the records of all patients treated with CCH for Peyronie disease between April 2014 and March 2016. Collected variables included demographics, pre- and posttreatment sexual function, penile curvature, penile vascular findings, and treatment outcomes.
RESULTS: A total of 77 patients were included in the study, of which 41 (53%) completed 4 cycles of treatment, consisting of 8 total injections. For all-comers regardless of numbers of cycles, curvature improved from 58.2° (standard deviation = 17.9°, range = 30°-105°) pre-treatment to 41.0° (standard deviation = 17.0°, range = 0°-85°) posttreatment (P < .001). In a repeated measures model, penile curvature improved significantly following the first 3 cycles, but not the fourth. Patients who had a ≥20% final reduction in curvature had a significantly greater change in curvature following the first injection (-16.2° vs -5.8°, P < .001).
CONCLUSION: Intralesional CCH therapy is an effective minimally invasive treatment for Peyronie disease, although the therapeutic benefit may decline after the third cycle of treatment. Patients with ≥20% reduction in curvature at the conclusion of treatment documented a greater curvature improvement after the first cycle and received more cycles of CCH.