Successful Treatment of Residual Curvature in Peyronie Disease in Men Previously Treated With Intralesional Collagenase Clostridium Histolyticum

Treatment of Peyronie’s disease via preoperative intralesional collagenase clostridium histolyticum followed by placement of an inflatable penile prosthesis: the new standard of care?

“…Mean pre- and post-operative curvatures were 58° and 15° respectively – a very substantial improvement. While the type of implant used was not specified, this early reports confirms the safety of surgery post-CCH ( 8 ). Together, these two small case series suggest that men with residual curvature post-CCH can achieve favorable results with surgery, including IPP insertion.…”

“…Insertion of an IPP post-CCH has also been reported. In their retrospective series, Hellstrom et al ( 8 ) studied 10 men who underwent surgical intervention for persistent curvature via penile plication, plaque incision/grafting, or placement of an IPP. Increased fibrosis was noted in the operative reports of three patients; however this finding did not negatively affect outcomes overall ( 8 ).…”

“…Optimum timing of IPP insertion post-CCH treatment has yet to be determined. Mean time from final CCH injection to surgical intervention was 150.9 days (~5 months) in the Hellstrom ( 8 ) series and 182 days (~6 months) in the Levine series ( 7 ). It is interesting to note that in two of the three cases with increased fibrosis in the Hellstrom series, all were done <100 days from the last CCH injection.…”

“…It is interesting to note that in two of the three cases with increased fibrosis in the Hellstrom series, all were done <100 days from the last CCH injection. Based on these findings alone, a wait time of >6 months post-CCH was proposed ( 8 ).…”

Contemporary surgical and non-surgical management of Peyronie’s disease

“…The authors noted some difficulty with dissection and attributed it to inflammatory effects from CCH, last administered less than 6 months prior. They thus recommended this as a minimum waiting period before pursuing surgery, including IPP implantation, post-CCH ( 80 ).…”