Clinical Experience With Penile Traction Therapy Among Men Undergoing Collagenase Clostridium histolyticum for Peyronie Disease

• Published in: Urology (Ridgewood, N.J.) Vol. 104; pp. 102 - 109
• Main Authors: Ziegelmann, Matthew J, Viers, Boyd R, Montgomery, Brian D, Avant, Ross A, Savage, Joshua B, Trost, Landon W
• Format: Journal Article
• Language: English
• Published: United States 01-06-2017
• Subjects: Aged; Clostridium histolyticum; Cohort Studies; Combined Modality Therapy; Databases, Factual; Humans; Injections, Intralesional; Male; Microbial Collagenase - adverse effects; Microbial Collagenase - therapeutic use; Middle Aged; Patient Satisfaction; Penile Diseases - chemically induced; Penile Diseases - therapy; Penile Induration - therapy; Penis - physiopathology; Prospective Studies; Traction - methods; Treatment Outcome
• ISSN: 1527-9995
• DOI: 10.1016/j.urology.2017.01.054

To evaluate the outcomes in men undergoing collagenase Clostridium histolyticum (CCH) with concurrent penile traction therapy (PTT) for the treatment of Peyronie disease (PD).
We identified patients treated with CCH between March 2014 and July 2016. Patients were recommended to perform modeling and PTT between injection series. A final curve assessment was performed after patients completed CCH. A prospective database was maintained, including patient-reported frequency and duration of PTT. Statistical analysis was performed to evaluate outcomes based on use and duration of PTT.
A total of 51 patients completed CCH and had complete objective data available for analysis. Mean (standard deviation [SD]) baseline curvature was 66.7 (25.0) degrees, and mean (SD) improvement post CCH was 20.9 (17.3) degrees (P < .0001). Thirty-five (69%) men reported daily PTT for a mean (SD) of 9.8 (6.3) hours per week. No significant difference was identified in the degree of curve improvement based on frequency or duration of PTT (P = .40). Similarly, no associations between PTT and functional outcomes including intercourse restoration and surgery prevention were identified. Stretched penile length increased nonsignificantly by a mean (SD) of +0.4 (1.5) cm in the PTT group, compared with -0.35 (1.5) in the non-PTT group (P = .21).
The current series represents a "true-to-life" experience, wherein utilization patterns, attrition, and compliance issues are relevant factors impacting efficacy. PTT use with the Andropenis declined in both frequency and duration with subsequent injection series, and there was no significant difference in curve improvement or stretched penile length with a mean 10 hours of weekly concurrent PTT.