Having CCH Injections for Peyronie’s Disease? Don’t Give Up!

Having CCH Injections for Peyronie’s Disease? Don’t Give Up!

CCH injections can be an effective way to treat Peyronie’s disease, but men might not see significant results right away.

What should they do?

Stay patient and continue the full treatment program, scientists say.

Peyronie’s disease is a chronic, often painful condition that causes plaques (areas of hardened scar tissue) to form on the penis, just below the skin’s surface. The plaques make the penis less flexible, and the result is a noticeable curve that can make intercourse difficult.

Treatment for Peyronie’s disease may include medications, injections, traction therapy, and surgery. Some men decide to have injections of collagenase clostridium histolyticum (CCH).  Currently, Xiaflex® is the only CCH treatment  approved in the United States.

CCH therapy takes time. Typically, injections are done in a series.  A man might have two injections a few days apart, then wait six weeks for the next two-injection series. Experts recommend four series overall.

Men who have little progress after two injection series may feel understandably frustrated and question whether they should continue with the full treatment protocol. A recent study offers some hope.

Researchers worked with 203 men with an average age of 56. All of the participants had Peyronie’s disease and underwent CCH injection therapy between January 2014 and February 2019. Men filled out a questionnaire and had their penile curvature assessed at the start of the study (baseline), after two series of injections, and again after four series of injections.

Between baseline and the fourth series, the groups average curvature measurements decreased 21.5 degrees, a 33% improvement. The largest changes were seen between baseline and the second series - an average change of 16.5 degrees, a 22% improvement - compared to the time between the second series and the fourth series, when the average changes was 5.2 degrees (a 7% improvement).  

But that didn’t mean that the men who had smaller changes between baseline and the second series didn’t see improvements later.

In fact, many men whose curvature didn’t improve much over the first two series of injections saw significant improvement between their third and fourth series.

“These data suggest that men who have a poor response to the first two series of CCH should be counseled to complete the full four series,” the authors wrote.

In other words, men shouldn’t give up on CCH if their curvature doesn’t improve after two series.  Sometimes, three to four series are needed before improvements occur.

The findings were presented in October 2019 at the 20th Annual Fall Meeting of the Sexual Medicine Society of North America and published in a January 2020 supplement of the Journal of Sexual Medicine.


The Journal of Sexual Medicine

Alom, M., et al.

“Should Men with Poor Results After Two Series of Collagenase Injections for Peyronie’s Disease Continue Therapy?”

(Abstract. January 2020, Volume 17, Issue 1, Supplement 1, Page S6)


Urology Care Foundation

“What is Peyronie’s disease?”



“Treating your curved erection with XIAFLEX®”