UP-161 Treatment of Peyronie’s disease patients with Collagenase clostridium histolyticum: Clinical Significance and Outcomes
Thursday June 27, 2019 from
TBD
Award Winner
Raidh R Talib, Qatar has been granted the
Presenter

Raidh R Talib, Qatar

Sr consultant

Urology

HMC

Abstract

Treatment of Peyronie’s disease patients with Collagenase clostridium histolyticum: Clinical significance and outcomes

Raidh Talib1, Mohamed Abdelkareem1, Mustafa Alwani1,2, Ahmad Al-Qudimat1, Sarra Karbech1, Mohamed Rejeb1, Faowaz abdelwahab1, Khalid Alkubaisi1, Abdulla Alansari1.

1Surgery, Hamad Medical Corporation, Doha, Qatar; 2School of Medicine , Jordan University of Science and Technology , Irbed, Jordan

Introduction: Peyronie’s disease (PD) is an inflammatory fibrosis of the penile tunica albuginea results in penile curvature and may cause sexual dysfunction. In this overview we evaluate the treatment outcomes in symptoms and signs settings.

Methods: A prospective observational data registry study was recorded for PD patients who underwent Collagenase Clostridium Histolyticum (CCH) treatment. Inclusion Criteria were any Peyronie’s disease patient with penile curvature >30o and <90o. Exclusion criteria were any ventral curvature and calcified plaque. Data registered through follow up to 2 years using history, physical Exam, International Index of Erectile Function (IIEF), and Penile ultrasound with induced erection for plaque size and curvature determination pre and post treatment. A Pearson Chi-Square and T-test (P<0.05) was used to figure out the statistical significance.

Results: A sample size of 99 patients suffer from PD underwent CCH injections, the age of the participants was (mean± Standard Deviation) 55.5 ± 9.8 years. Baseline mean curvature degree 49o ± 20.44o. Regarding the curvature direction 73% dorsal, 11% lateral and 16% were in mixed direction. More than 90% of plaques were <2 cm in size (mean size 1.71+6.6 cm). Duration of follow-up took up to > 6 months after treatment. Forty-nine percent have 8 injections at all while the remaining took between 4 to 6 injections. Our course was 1 injection per month. The mean change in degree after treatment was 25.77o ± 11.05o (p<0.001), almost 87% have more than or equal to 20% reduction in curvature. A mean improvement in IIEF score after treatment by 2.27 points (P<.001). In total of 100, 23 patients developed complications after taking the injection, most of them were hematoma and transient chest pain, back pain, and lower limb pain (similar to sciatica). All complications were treated conservatively. For the treatment of erectile dysfunction (ED), all the patients were given vacuum devices in addition to medical therapy Tadalafil 5 mg for daily use.

Conclusion: PD treatment with CCH has a good outcome even with comorbid diseases, with about 87% of our patients improved with a low rate of complications. Erectile dysfunction and curvature degree improved significantly. We urged our patient to use vacuum, phosphodiesterase type 5 inhibitor, and patient stretching daily to improve the ED. We also strongly recommend this method of combined treatment for ED in Peyronie’s disease patients.

 


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