THE JOURNAL OF UROLOGYâ
Vol. 195, No. 4S, Supplement, Monday, May 9, 2016
Sexual Function/Dysfunction: Peyronie’s Disease Podium Monday, May 9, 2016
3:30 PM-5:30 PM
PD45-01 RESTORATION OF PENILE FUNCTION AND PATIENT SATISFACTION WITH INTRALESIONAL COLLAGENASE CLOSTRIDIUM HISTOLYTICUM INJECTION FOR PEYRONIE’S DISEASE Matthew Ziegelmann*, Boyd R Viers, Kelly L McAlvany, George C Bailey, Joshua B Savage, Landon W Trost, Rochester, MN INTRODUCTION AND OBJECTIVES: Collagenase clostridium histolyticum (CCH) is approved for the treatment of Peyronie’s disease (PD). To date, no post-release study has evaluated patient perceived outcomes and satisfaction. Therefore, we sought to evaluate patient perceived experience with CCH injection for PD in a clinical practice. METHODS: From March 2014 to July 2015, 66 patients underwent one to four series of CCH injections for PD at our institution. Objective changes in penile curvature as well as patient-reported functional outcomes and patient perceived curvature improvements were evaluated. RESULTS: In total, 27 (41%) patients completed four trials, 35 (53%) three trials, and 50 (76%) two trials. Subjective improvements in curvature increased with each series (Trial 1-14%, Trial 2-27%, Trial 333%, and Trial 4-40%, p<0.05). Among those completing therapy, 65% reported that CCH injections negated a need for surgery, and 66% reported restoration of penetration. Eighty percent of men perceived CCH treatment as meaningful, and 87% reported subjective improvements following four series of injections. Objective measures demonstrated a mean 22 degree curvature improvement (36%, p<0.0001). Six patients (9.1%) experienced penile hematomas and no patients experienced tunical rupture. CONCLUSIONS: CCH injections reduced the need for surgery and restored penetration in the majority of patients completing four series of injections. Subjective improvements in curvature increased with each series of CCH injections, and the majority of patients felt that the therapy was worthwhile. Source of Funding: Internal departmental funding
PD45-02 IMPACT OF NUMBER OF CYCLES OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM ON OUTCOMES IN PATIENTS WITH PEYRONIE’S DISEASE James Anaissie*, Faysal A Yaﬁ, Elizabeth J Traore, Suresh C Sikka, Wayne JG Hellstrom, New Orleans, LA INTRODUCTION AND OBJECTIVES: Intralesional injection of Collagenase Clostridium Histolyticum (CCH) is a minimally invasive, Food and Drug Administration (FDA)-approved, and effective treatment for Peyronie’s disease (PD). We sought to analyze the impact of the number of cycles of CCH therapy on outcomes in order to further optimize therapy. METHODS: We conducted a retrospective review at our institution of the records of all patients treated with CCH for PD between 04/ 2014 and 09/2015. Collected variables included demographics and preand post-treatment sexual function, penile curvature, penile vascular ﬁndings, and treatment outcomes. The primary outcome was signiﬁcant (20%) decrease in penile curvature over baseline at the conclusion of treatment. A repeated measures model was used to determine change in curvature per treatment cycle.
RESULTS: A total of 78 patients were included in the study, of which 36 (46%) completed four cycles of treatment. For all-comers regardless of numbers of cycles, curvature improved from 58.5 degrees pre-treatment to 42.0 degrees post-treatment (p<0.001). In the repeated measures model, penile curvature improved signiﬁcantly following the ﬁrst three cycles, but not the fourth. Overall, patients who had a 20% ﬁnal reduction in curvature had signiﬁcantly more response following the ﬁrst injection (-16.8 degrees vs. -6.2 degrees, p<0.001) and underwent more cycles of CCH (3.6 vs. 2.5, p<0.001). CONCLUSIONS: CCH therapy is an effective treatment for PD, although the therapeutic beneﬁt may decline after the third cycle of treatment. Patients with 20% reduction in curvature over baseline at the conclusion of treatment displayed better curvature improvement after the ﬁrst cycle and received more cycles of CCH.
Source of Funding: none
PD45-03 SURVEY OF PATIENT AND PARTNER SATISFACTION FOLLOWING COLLAGENASE CLOSTRIDIUM HISTOLYTICUM TREATMENT FOR PEYRONIE’S DISEASE Elizabeth J Traore*, Faysal A Yaﬁ, James Anaissie, Suresh C Sikka, Wayne JG Hellstrom, New Orleans, LA INTRODUCTION AND OBJECTIVES: Intralesional injection of collagenase Clostridium histolyticum (CCH) is the only Food and Drug Administration -approved treatment for Peyronie’s disease (PD). We sought to assess patient and partner satisfaction and their predictors following CCH therapy. METHODS: We conducted a retrospective review at our institution of the records of 78 patients treated with CCH for PD between 04/ 2014 and 09/2015. Collected variables included demographics and preand post-treatment sexual function, penile curvature, penile vascular ﬁndings, and treatment outcomes. Patients were contacted by telephone and queried regarding ability to have intercourse and satisfaction with treatment, while their partners were queried regarding pain with intercourse and satisfaction with treatment. RESULTS: A total of 24 couples answered the questions. One patient (4%) had a treatment complication (corporal rupture requiring surgical intervention), and 8 patients (33%) reported some degree of glans hypoesthesia. Sexual intercourse was possible for 16 couples (67%) prior to initiation of therapy and 22 couples (92%) following treatment. Six partners (25%) reported painful intercourse prior to therapy and 4 partners (17%) reported pain following treatment. Overall, 16 patients (67%) and 17 partners (71%) said they were satisﬁed with the treatment and would repeat it. Satisﬁed partners reported increased ability to have intercourse (100% vs. 71%, p¼0.02) and decreased patient glans hypoesthesia (18% vs. 71%, p¼0.01), compared to unsatisﬁed partners.