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Posted by on Feb 21, 2021 in Erectile dysfunction | 0 comments

In a nutshell

This study investigated the effects of surgery in patients with Peyronie's disease previously treated with Collagenase Clostridium histolyticum (CCH; Xiaflex). The main finding was that surgical treatments may improve persistent penis curvature (PC) in these patients.

Some background

Peyronie's disease is caused by the formation of scar tissue, called plaques, inside the penis. This leads to PC and painful erections and impaired sexual intercourse. CCH injections into the penis plaques are often used to break down the plaques causing by Peyronie's disease.

However, sometimes PC does not improve after CCH treatment. For these patients, surgery is required to further remove plaques and straighten the penis. The outcomes of surgical procedures in men with persistent PC after CCH treatment are still unknown. 

Methods & findings

90 patients with persisten PC who had previously received CCH treatment for Peyronie's disease were included in this study. 3 standard surgical procedures were performed in an attempt to improve the PC. Those in group 1 (25 patients) received plaque incision grafting (PIG) with penile prosthesis implant (PPI). This means a graft of either bovine tissue or collagen along with an implant was attached inside the penis opposite the plaques, where it was most curved. Those in group 2 (18 patients) received PIG without PPI. This means no implant was used and only the bovine tissue or collagen was grafted inside the penis. Those in group 3 (47 patients) underwent Nesbit’s technique. This involved the stitching together of the patient’s erectile tissue opposite the plaque.

Hospital stay, the time the operation took, any side effects following the operation, and the effect on the surgery on PC were evaluated. Overall sexual satisfaction and the function of the penis after treatment were measured.

The average penile length following treatment was 13 cm. After surgery, those in Group 1 showed the greatest improvement in penile length (+2 cm) and in the symptoms associated with Peyronie’s disease. Group 2 had a 1 cm improvement in penile length while those in group 3 lost 2 cm in penile length. 

Overall, there was no difference in sexual satisfaction between the groups following surgery. 95.6% of participants did not report any surgical complications. 4 patients had PC which came back after treatment (2 in group 1 and 1 in group 2 and group 3).

The bottom line

This study suggested that surgical treatment may improve PC following treatment with CCH with PIG with PPI being the most effective therapy assessed.

The fine print

This study included only 90 patients. Also, the data came from medical records. Some information may not have been complete. Further studies are needed to also assess outcomes of these patients in the long-term.

What’s next?

If you have questions about the treatment of Peyronie's disease, please ask your doctor. 

Published By :

Scientific reports

Date :

Jan 08, 2021

Original Title :

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

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