For men with Peyronie’s disease, treatment with collagenase clostridium histolyticum (CCH) has become more popular over the years. However, some men respond better to this therapy than others, a situation that prompted a recent Journal of Sexual Medicine study.
One of the most common characteristics of Peyronie’s disease is a distinct curve that develops when the penis is erect. This curve is caused by areas of hardened scar tissue (plaques) that form just beneath the surface of the skin. In some cases, the plaques become calcified, hardening further.
With plaques present, the penis becomes less flexible, forming a curve. For some men, the penis takes on an hourglass shape or a “hinge” effect. Sexual intercourse can become quite difficult, and many men experience pain.
In addition to CCH injection therapy, Peyronie’s disease can be treated in several ways, including medications, traction (a device that straightens the penis), and surgery.
In this study, the researchers looked into some of the reasons men might not have success with CCH.
They analyzed information from 67 men with Peyronie’s disease who were patients at their clinic between October 2014 and October 2019. All of the men had received CCH treatments by other urologists before visiting the study clinic, but were having problems with sexual function.
The men had had Peyronie’s disease for an average of 28 months and their average curvature was 69 degrees. (For over 60%, the curve was greater than 60 degrees.) Over 75% of the men had “indent, narrowing, or hourglass” deformities, and about 39% had a hinge effect or instability. Thirty-nine percent of the men had calcifications.
Almost half of the men went on to have surgery. These patients had a greater average curvature than the rest of the group (83 degrees) and were more likely to have hinge deformities.
Overall, the researchers concluded that “patients presenting with persistent bother after CCH treatment had a relatively severe mean curvature of nearly 70 degrees and high rates of narrowing/indentation deformity and calcification.”
The findings may help doctors who counsel men with Peyronie’s disease who are considering CCH injections, the authors said.
Johns Hopkins School of Medicine
The Journal of Sexual Medicine
Bajic, Petar, MD, et al.
“Characteristics of Men With Peyronie's Disease and Collagenase Clostridium Histolyticum Treatment Failure: Predictors of Surgical Intervention and Outcomes”
(Full-text. Published online: February 29, 2020)