Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

The incidence of surgical intervention in veterans treated with Collagenase clostridium histolyticum

International Journal of Impotence Research volume 36, pages 223–225 (2024)Cite this article

Subjects

Abstract

Peyronie’s disease (PD) can be managed with surgery or intralesional injections of Collagenase clostridium histolyticum (CCH) however both are associated with side effects and variable results. It is unclear how many patients elect to undergo additional surgical correction after CCH. To answer this, we analyzed the Department of Veterans Affairs Informatics and Computing Infrastructure (VINCI) software. We performed a retrospective analysis over a 5-year period for patients with PD, at least one injection of CCH and surgical CPT codes. In total, 17,646 patients with PD were analyzed with 1541 treated with CCH. Only 51 (3.3%) were treated with secondary surgical intervention after CCH. Three main surgical procedures were performed: penile plication (51%), penile prosthesis (29%) and plaque excision and grafting (20%). Of the 51 men who underwent surgical corrections post CCH, the most common reason was lack of response/residual curvature (62.8%), followed by ED (29.4%). Previous literature shows that CCH was effective for only 60.8% of patients, potentially leaving the remaining in need of additional treatment. Despite this we found that only 3.3% received secondary therapy in the VA medical system, with residual curvature being the most common reason.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Bjekic MD, Vlajinac HD, Sipetic SB, Marinkovic JM. Risk factors for Peyronie’s disease: a case-control study. BJU Int. 2006;97:570–4.

    Article  PubMed  Google Scholar 

  2. Gelbard M. Myofibroblasts and mechanotransduction: do forces in the tunica albuginea contribute to Peyronie’s disease? J Sex Med. 2008;5:2974–6.

    Article  PubMed  Google Scholar 

  3. Terrier JE, Nelson CJ. Psychological aspects of Peyronie’s disease. Transl Androl Urol. 2016;5:290–5.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194:745–53.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie’s disease: a prospective, single-center, non-placebo-controlled study. J Sex Med. 2008;5:180–7.

    Article  PubMed  Google Scholar 

  6. Gelbard M, Goldstein I, Hellstrom WJ, McMahon CG, Smith T, Tursi J, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190:199–207.

    Article  CAS  PubMed  Google Scholar 

  7. Cocci A, Russo GI, Briganti A, Salonia A, Cacciamani G, Capece M, et al. Predictors of treatment success after collagenase Clostridium histolyticum injection for Peyronie’s disease: development of a nomogram from a multicentre single-arm, non-placebo controlled clinical study. BJU Int. 2018;122:680–7.

    Article  CAS  PubMed  Google Scholar 

  8. Wymer K, Ziegelmann M, Savage J, Kohler T, Trost L. Plaque Calcification: an important predictor of collagenase clostridium histolyticum treatment outcomes for men with Peyronie’s disease. Urology 2018;119:109–14.

    Article  PubMed  Google Scholar 

  9. Hellstrom WJG, Tue Nguyen HM, Alzweri L, Chung A, Virasoro R, Tapscott A, et al. Intralesional collagenase clostridium histolyticum causes meaningful improvement in men with Peyronie’s disease: results of a multi-institutional analysis. J Urol. 2019;201:777–82.

    Article  PubMed  Google Scholar 

  10. Affairs USDoV. VA Informatics and Computing Infrastructure (VINCI): Office of research & development. Available from: https://www.research.va.gov/programs/vinci/default.cfm.

  11. Levine LA, Larsen SM. Surgical correction of persistent Peyronie’s disease following collagenase clostridium histolyticum treatment. J Sex Med. 2015;12:259–64.

    Article  PubMed  Google Scholar 

  12. DeLay K, Diao L, Nguyen HMT, Zurawin J, Libby R, Yafi F, et al. Successful treatment of residual curvature in peyronie disease in men previously treated with intralesional collagenase clostridium histolyticum. Urology 2017;110:110–3.

    Article  PubMed  Google Scholar 

  13. Ziegelmann MJ, Viers BR, McAlvany KL, Bailey GC, Savage JB, Trost LW. Restoration of penile function and patient satisfaction with intralesional collagenase clostridium histolyticum injection for Peyronieʼs disease. J Urol. 2016;195:1051–6.

    Article  PubMed  Google Scholar 

  14. Bajic P, Wiggins AB, Ziegelmann MJ, Levine LA. Characteristics of men with peyronie’s disease and collagenase clostridium histolyticum treatment failure: predictors of surgical intervention and outcomes. J Sex Med. 2020;17:1005–11.

    Article  PubMed  Google Scholar 

  15. Nguyen HMT, Anaissie J, DeLay KJ, Yafi FA, Sikka SC, Hellstrom WJG. Safety and efficacy of collagenase clostridium histolyticum in the treatment of acute-phase Peyronie’s disease. J Sex Med. 2017;14:1220–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA

    Isaac J. Zucker & Thomas A. Masterson

  2. Herbert Wertheim School of Medicine, Florida International University, Miami, FL, USA

    Isaac J. Zucker

  3. Miller School of Medicine, University of Miami, Miami, FL, USA

    Sirpi Nackeeran

  4. Department of Urology, UC San Diego School of Medicine, San Diego, CA, USA

    Sirpi Nackeeran

  5. Department of Urology, Bruce W. Carter VA Medical Center, Miami, FL, USA

    Thomas A. Masterson

Authors
  1. Isaac J. Zucker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sirpi Nackeeran
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas A. Masterson
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

IZ was responsible for project conception/design; literature review; manuscript drafting/revisions. SN was responsible for project conception/design; literature review; statistical analysis; manuscript drafting/revisions; tabulation of data. TM was responsible for project conception/design; manuscript drafting/revisions.

Corresponding author

Correspondence to Thomas A. Masterson.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zucker, I.J., Nackeeran, S. & Masterson, T.A. The incidence of surgical intervention in veterans treated with Collagenase clostridium histolyticum. Int J Impot Res 36, 223–225 (2024). https://doi.org/10.1038/s41443-022-00658-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-022-00658-1

Search

Advanced search

Quick links