Surgical outcomes after collagenase Clostridium histolyticum failure in patients with Peyronie’s disease in a multicenter clinical study.
Resumen: In the present study we aimed to investigate the surgical outcomes of patients with persistent penile
curvature (PC) after Collagenase Clostridium histolyticum (CCH) intraplaque injections. Data from
90 patients with persistent PC after CCH in a multicentre study from 6 andrological centres were
retrospectively reviewed. Three standardized surgical techniques were performed. Group 1: plaque
incision grafting (PIG) with penile prosthesis implant (PPI); Group 2: PIG without PPI; Group 3: Nesbit
technique. Hospital stay, operative time, postoperative complications and PC persistency/recurrence
(> 20°) were evaluated. Overall satisfaction and functional outcomes were assessed through
International Index of Erectile Function-Erectile Function (IIEF-EF), Peyronie’s Disease Questionnaire
(PDQ), Female Sexual Function Index (FSFI) administered pre and 3 months postoperatively. Of all, 25
(27.8%) patients received grafting procedure + PPI (Group 1), 18 (20.0%) patients belonged to Group
2, and 47 (52.2%) to Group 3. Bovine pericardium graft and collagen fleece have been used in in 22
(51.2%) and 21 (48.8%) patients, respectively. Median penile length after surgery was 13.0 cm (IQR
12.0–15.0). After surgery, Group 1 showed higher increase in penile length after surgery and better
improvements in terms of PDQ-PS. In contrast, both IIEF-EF and FSFI scores did not differ among
groups. Overall, 86 (95.6%) did not report any complication. 4 (4.4%) patients had PC recurrence;
of those, 2 (8.0%), 1 (5.6%) and 1 (2.1%) cases were observed in Group 1, Group 2 and Group 3,
respectively. In case of persistent PC after CCH, surgical correction by grafting with or without
concomitant PPI or Nesbit technique emerged as a technically feasible, effective and safe procedure,
with no significant postoperative complications.
Identificador universal: http://hdl.handle.net/10641/2848
Fecha: 2021
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- MEDICINA [819]