The following is a summary of “Improved Peyronie’s Disease Curvature Outcomes Using a Novel Collagenase Administration Protocol,” published in the December 2022 issue of Urology by Flores, et al.

For a study, researchers sought to describe the results of a new collagenase injection procedure using Clostridium histolyticum (CCH).

Since 2015, a prospective, sequential database of all Peyronie’s men receiving CCH injections has been kept up to date. Changes to the protocol’s injection approach, timing, aggressive modeling/traction, and wrapping were made. Two definitions were used to compare the results of the “conventional” and “new” techniques: the “most current” evaluation and the final assessments among males who “finished eight (injections) or were satisfied.”

More than one CCH series was performed on 509 males in total (traditional, n = 280; novel, n = 229). The groups’ initial demographic and clinicopathologic traits were comparable. Results showed that the innovative approach considerably increased curve improvements (“most recent” median 30° vs 20° or 46% vs 28%; “completed eight or satisfied” 34° vs 20° or 58% vs 30%). According to the “completed eight or satisfied” criteria, the odds ratios for males in the new cohort were 7.6 for a 20% improvement and 5.0 for a 50% improvement (all P< .0001). For men, the odds ratios were 94% vs. 66% for a 20% improvement and 60% vs. 24% for a 50% improvement. A crucial factor was the International Index of Erectile Function. The subjective erectile function (50% vs 5%, P< .0001) and sensation (17% vs 8% enhanced, P =.01) with the new procedure were both better than they were with the old approach, but the Erectile Function Domain score remained constant. Additionally, the new cohort reported increased incidence of hematomas (56% vs 26%), restored/facilitated the penetration (57% vs 21%), and surgical prevention (53% vs 18%), all of which required modifications to wrapping practices (all P <.0001).

Curvature significantly improved with use of the innovative CCH technique, with no detrimental effects on erectile feeling or performance. Because of its specific nature, low-volume CCH injectors were not advised to use it.