Results of SMSNA Survey Regarding Complications Following Intralesional Injection Therapy With Collagenase Clostridium Histolyticum for Peyronie's Disease
- PMID: 27045265
- DOI: 10.1016/j.jsxm.2016.02.105
Results of SMSNA Survey Regarding Complications Following Intralesional Injection Therapy With Collagenase Clostridium Histolyticum for Peyronie's Disease
Abstract
Introduction: Intralesional injection of collagenase clostridium histolyticum (CCH) for Peyronie's disease (PD) can result in serious adverse events such as hematoma formation and corporal rupture.
Aim: To investigate the prevalence of complications from CCH and management trends among CCH prescribers.
Methods: A survey was sent to all 693 members of the Sexual Medicine Society of North America (SMSNA) with valid email addresses. Responders were asked to participate if they were prescribers of CCH. Data regarding prescriber experience with CCH, procedural preferences, and rates and management strategies of complications were collected.
Main outcome measure: One hundred SMSNA members completed the survey, with 36%, 23%, and 41% of responders having performed ≤10, 10 to 20, and >20 CCH injections, respectively.
Results: Of the responders, 94% reported hematomas in <25% of patients, with 63% preferring to observe and 37% treated with a combination of observation, application of a compressive dressing, and/or drainage of the hematoma. Corporal ruptures were encountered by 34% of physicians at a median of 5 days (0.5 to 30 days) from the last CCH injection. Rupture was located over the treated plaque in 84% of cases, and surgical intervention was the preferred management option by 67% of members. A distal circumcising degloving incision was used in 76% of cases, and 62% of responders reported the quality of tissue to be worse than would be expected with a non-CCH penile fracture. There were no significant differences in erectile function, ability to have intercourse, change in penile curvature, and patient satisfaction among patients who underwent surveillance vs surgery. One observed patient developed a penile abscess.
Conclusion: A wide variation exists among SMSNA members' strategies to prevent and manage complications of CCH. One in 3 prescribers reported encountering a corporal rupture during CCH therapy, and it is currently undetermined if there is a benefit of surgery vs conservative management.
Keywords: Collagenase Clostridium Histolyticum; Corporal Fracture; Hematoma; Intralesional Injection Therapy; Peyronie’s Disease; Xiaflex.
Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Comment in
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Re: Results of SMSNA survey regarding complications following intralesional injection therapy with collagenase clostridium histolyticum for Peyronie's disease.Transl Androl Urol. 2017 Feb;6(1):111-113. doi: 10.21037/tau.2016.12.07. Transl Androl Urol. 2017. PMID: 28217456 Free PMC article. No abstract available.
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Results of SMSNA survey regarding complications following intralesional injection therapy with collagenase clostridium histolyticum for Peyronie's disease.Transl Androl Urol. 2017 Feb;6(1):116-119. doi: 10.21037/tau.2017.01.01. Transl Androl Urol. 2017. PMID: 28217458 Free PMC article. No abstract available.
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Complications and other concerns with intralesional injection therapy with collagenase clostridium histolyticum for Peyronie's disease.Transl Androl Urol. 2017 Feb;6(1):120-122. doi: 10.21037/tau.2017.01.03. Transl Androl Urol. 2017. PMID: 28217459 Free PMC article. No abstract available.
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Collagenase clostridium histolyticum intralesional injections for the treatment of Peyronie's disease: a safety profile.Transl Androl Urol. 2017 Feb;6(1):123-126. doi: 10.21037/tau.2016.12.08. Transl Androl Urol. 2017. PMID: 28217460 Free PMC article. No abstract available.
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Serious complications of collagenase clostridium histiolyticum injection for Peyronie's disease: more than meets the eye!Transl Androl Urol. 2017 Apr;6(2):320-321. doi: 10.21037/tau.2017.03.09. Transl Androl Urol. 2017. PMID: 28540246 Free PMC article. No abstract available.
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