Is Collagenase Clostridium Histolyticum an effective treatment for Peyronie’s disease?

This study looked at how effective Collagenase Clostridium histolyticum (Xiaflex) (CCH) is in the treatment of Peyronie's disease (PD). It compared this treatment to surgical options. It concluded that surgery improved penile curvature more than CCH, but that CCH is effective, safe and a good alternative to surgery to treat PD. 

Peyronie’s disease (PD) is a curvature of the penis when it is erect. The curvature is caused by scar tissue, called a plaque, forming in the penis. Surgery to remove the scar tissue is an option to treat PD, though it can be associated with complications. Tunical plication (TP) and partial plaque excision and grafting (PEG) are two types of PD surgery which involve removing the plaque from the penis and correcting the curvature. 

Collagenase Clostridium histolyticum (CCH) acts to breakdown the plaque with enzymes (a type of protein). CCH has been shown to be safe and effective in other studies. CCH may also prove to be a good option for patients with PD who do not want to have surgery.

57 patients with PD were followed for 1 year after either CCH injection, TP surgery or PEG surgery. CCH was given in two injections, 24-72 hours apart. These injections were given every 6 weeks in a 24 week period. CCH injections were given to 18 patients with PD. TP and PEG were carried out in 39 patients with PD to remove the penile plaques. 

Significant curvature improvement was noted in 67% of the CCH group and 100% of the TP and PEG group. The length of the penis decreased in the CCH and TP groups. Penis length increased slightly in the PEG group. Erectile function significantly increased in the CCH and TP groups. The improvement in erectile function was not as significant in the PEG group. In the CCH group, bruising occurred in some patients. Some of the CCH group also required further treatment and had TP surgery. The TP and the PEG groups had no complications.  

This study concluded that CCH is safe and effective for PD, but surgery can completely correct the penile curvature. CCH injection is a good alternative to surgery in the treatment of PD. 

The authors note that the number of patients with PD in this study are small. This may affect the study's results. 

If you are interested in learning more about CCH injection in the treatment of PD, contact your doctor.