Does Intralesional Injection of Clostridium Histolyticum affect the Treatment Practice of Peyronie’s Disease?

Introduction: Penile curvature and pain during erection present a significant bothersome issue for men with Peyronie’s disease and their partners. Clostridium histolyticum was approved for intralesional-injection in patients with Peyronie’s disease and penile curvature. Aim: We aimed primarily to determine whether the introduction of intralesional-injection of clostridium histolyticum affects the treatment pattern of Peyronie’s disease at a single academic medical center. Material and methods: Medical records of patients evaluated for penile curvature related to Peyronie’s disease were retrospectively reviewed. Patients were allocated into two groups: those who received consultation prior to intralesional-injection availability, and those who received consultation after intralesional-injection availability. Treatment choices were summarized as percentages of each group. Comparison between the groups regarding the proportion of patients who chose to undergo specific treatment was performed using a Chi-square test. Results: Two hundred and twenty-seven patients were evaluated. Fifty-nine were evaluated before the introduction of intralesional-injection of clostridium histolyticum (group A) while 168 patients were evaluated post-introduction of intralesional-injection of clostridium histolyticum (group B). After the first discussion on management, 32 (54.2%) group A and 105 (62.5%) group B patients decided not to pursue treatment nor follow-up. No statistically significant difference in percentage of patients undergoing any treatment was observed between the groups (p>0.05). Of the remaining 27 patients in group A, 10 patients (37.0%) underwent surgery. Of the 63 remaining patients in group B, 14 (22.2%) underwent surgery. No statistically significant difference in percentage of patients undergoing surgery was observed between the 2 groups. Of the remaining patients in group B, only 12 (19.0%) were treated with intralesional-injection of clostridium histolyticum, and the rest, thirty-seven (59%) patients, elected to continue follow-up without treatment. Conclusion: The addition of intralesional-injection of clostridium histolyticum to Peyronie’s disease treatment arsenal did not significantly alter the percentage of patients choosing to undergo surgery.