A new medical protocol to treat the Peyronie disease was developed based on the clinical study published in Journal of Sexual Medicine, May-2019, The use of a penile traction device reduces the need of cycles of collagenase in patients with Peyronie disease, by Dr. García Gómez, Dr. Romero-Otero et al..
The objective of this study is to show the experience of Urology Department of the University Hospitals in Madrid (Spain) with the use of collagenase of the Clostridium Histolyticum (CCH) plus a penile traction device (PTD) in the treatment of Peyronie disease (PD). The used methods were the collection of all patients diagnosed with Peyronie disease and treated with these both therapies (collagenase plus traction device) in two healthcare centers. The criteria to include the patients were: age older of 18 years, palpable plaque of fibrosis, penile curvature bigger than 30º, adequate previous manipulation of a penile traction device, and an important disturbance of sexual intercourse. The doctors collected all demographic data, IIEF-5 and PDQ scores, comorbidities, time since onset of symptoms, and assessed the penile curvature with a Kelami test. The doctors excluded patients with severe calcification of the fibrosis plaque.
In the clinical study, the patients received a maximum of 4 cycles, each one consisting on 2 injections of collagenase in 24-72 hours, and followed by 6 weeks of manual modelling and a minimum of 4 hours of daily use of a penile traction device. The doctors stopped the protocol if no improvement was observed after the cycle, or continued it until the curvature was lower than 30º or the patient managed with the residual one.
The results of the clinical study was: 63 patients were available at the time of the analysis of the data. 4 were lost to follow, so 59 patients received 1 cycle, 41 received 2 cycles, 15 received 3 cycles, and 4 received 4 cycles. Mean curvature at the end of the treatment was 36º with a reduction of -24º (-40%). 15 patients required additional surgical treatment (7 grafting and 8 plication). The mean number of cycles was 2.
The conclusion of the clinical study was the combination of the use of a penile traction device with collagenase is useful to reduce the number of cycles of collagenase to treat the Peyronie disease, achieving similar results to those in the literature, and improving the cost-efficiency of the treatment.
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