Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Jan 8;11(1):166.
doi: 10.1038/s41598-020-80551-3.

Surgical outcomes after collagenase Clostridium histolyticum failure in patients with Peyronie's disease in a multicenter clinical study

Andrea Cocci  1 , David Ralph  2 , Rados Djinovic  3 , Georgios Hatzichristodoulou  4 , Girolamo Morelli  5 , Andrea Salonia  6 , Paolo Capogrosso  6 , Andrea Romano  1 , Gianmartin Cito  1 , Fabrizio Di Maida  1 , Esaú Fernández-Pascual  7 , Javier Romero-Otero  8 , Paulo Egydio  9 , Marco Falcone  10 , Mirko Preto  10 , Giovanni Chiriacò  2 , Jack Beck  11 , Maarten Albersen  12 , Suks Minhas  13 , Giovanni Cacciamani  14 , Juan Ignacio Martinez Salamanca  15 , Nicola Mondani  16 , Andrea Minervini  1 , Giorgio Ivan Russo  17
Affiliations
Multicenter Study

Surgical outcomes after collagenase Clostridium histolyticum failure in patients with Peyronie's disease in a multicenter clinical study

Andrea Cocci et al. Sci Rep. .

Abstract

In the present study we aimed to investigate the surgical outcomes of patients with persistent penile curvature (PC) after Collagenase Clostridium histolyticum (CCH) intraplaque injections. Data from 90 patients with persistent PC after CCH in a multicentre study from 6 andrological centres were retrospectively reviewed. Three standardized surgical techniques were performed. Group 1: plaque incision grafting (PIG) with penile prosthesis implant (PPI); Group 2: PIG without PPI; Group 3: Nesbit technique. Hospital stay, operative time, postoperative complications and PC persistency/recurrence (> 20°) were evaluated. Overall satisfaction and functional outcomes were assessed through International Index of Erectile Function-Erectile Function (IIEF-EF), Peyronie's Disease Questionnaire (PDQ), Female Sexual Function Index (FSFI) administered pre and 3 months postoperatively. Of all, 25 (27.8%) patients received grafting procedure + PPI (Group 1), 18 (20.0%) patients belonged to Group 2, and 47 (52.2%) to Group 3. Bovine pericardium graft and collagen fleece have been used in in 22 (51.2%) and 21 (48.8%) patients, respectively. Median penile length after surgery was 13.0 cm (IQR 12.0-15.0). After surgery, Group 1 showed higher increase in penile length after surgery and better improvements in terms of PDQ-PS. In contrast, both IIEF-EF and FSFI scores did not differ among groups. Overall, 86 (95.6%) did not report any complication. 4 (4.4%) patients had PC recurrence; of those, 2 (8.0%), 1 (5.6%) and 1 (2.1%) cases were observed in Group 1, Group 2 and Group 3, respectively. In case of persistent PC after CCH, surgical correction by grafting with or without concomitant PPI or Nesbit technique emerged as a technically feasible, effective and safe procedure, with no significant postoperative complications.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Identification of the maximum curvature point on the concave side of the penile shaft, through an artificial erection with saline solution.
Figure 2
Figure 2
A standard double-Y relaxing tunical incision was performed to completely straighten the penile shaft.
Figure 3
Figure 3
Application of penile grafting and fixation to the edges of the tunical defect with a 4-0 PDS running suture.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

References

    1. Carson 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;116:815–822. doi: 10.1111/bju.13120. - DOI - PubMed
    1. Cocci A, et al. Predictive factors of patients’ and their partners’ sexual function improvement after collagenase Clostridium histolyticum injection for Peyronie’s disease: Results from a multi-center single-arm study. J. Sex. Med. 2018;15:716–721. doi: 10.1016/j.jsxm.2018.03.084. - DOI - PubMed
    1. Russo GI, et al. Comparative effectiveness of intralesional therapy for Peyronie’s disease in controlled clinical studies: A systematic review and network meta-analysis. J. Sex. Med. 2019;16:289–299. doi: 10.1016/j.jsxm.2018.12.011. - DOI - PubMed
    1. Cocci A, et al. Predictors of treatment success after collagenase Clostridium histolyticum injection for Peyronie’s disease: Development of a nomogram from a multicentre single-arm, non-placebo controlled clinical study. BJU Int. 2018;122:680–687. doi: 10.1111/bju.14410. - DOI - PubMed
    1. Capece M, et al. Collagenase Clostridium histolyticum for the treatment of Peyronie’s disease: A prospective Italian multicentric study. Andrology. 2018;6(4):564–567. doi: 10.1111/andr.12497. - DOI - PubMed

Publication types

Substances

LinkOut - more resources