{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:12:17Z","timestamp":1759939937947,"version":"build-2065373602"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the results of intralesional Collagenase <jats:styled-content style=\"fixed-case\"><jats:italic>Clostridium histolyticum<\/jats:italic><\/jats:styled-content> (CCH) treatment in patients with Peyronie's disease (PD) in real\u2010world setting. PD is characterized by curvature of the erect penis caused by fibrotic tissue in the tunica albuginea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Patients with stable PD and curvature of 30\u00b0 to 90\u00b0 were prospectively enrolled. CCH injections were initially given using a scheme of four cycles of two injections within 48\u201372\u2009h every 6\u2009weeks. Later using a modified scheme of three injections every 4\u2009weeks, combined with a vacuum erection device (VED) twice daily. All patients were requested to take pictures of the erect penis prior to and following treatment, from above and laterally. Curvature was measured by three independent researchers based on the provided pictures using a goniometer. Furthermore, patients filled in the Peyronie Disease Questionnaire\u2010NL (PDQ\u2010NL) and Patient Reported Outcome Measurement (PROM).<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>The primary outcome was reduction in curvature and the ability to have penetrating sex again. Secondary outcomes include pain scores during injections, changes in PDQ\u2010NL, PROM and complications of CCH treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010three patients were included, mean age was 56.0\u00a0years (range 39\u201370) and mean reduction in curvature 20.6\u00b0 (SD 10.2, range 5\u201349); 74.5% of the patients were able to have penetrating sex again following treatment, compared with 41.2% prior to treatment. According to the PROM questions, sexual improvement was seen in 66.7% of patients. The satisfaction rate was 6.8 (SD 1.8). All patients save two recommend treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intralesional treatment with CCH in men with PD leads to a mean curvature improvement of 20.6\u00b0. Following treatment, 74.5% of men were able to have sexual intercourse and 54.9% of the couples were satisfied with their sex life. No major complications occurred in the patients treated with CCH. CCH is not available in Europe anymore despite good results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.185","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T01:39:18Z","timestamp":1665625158000},"page":"66-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improvement in the ability to have sex in patients with Peyronie's disease treated with Collagenase <scp><i>Clostridium histolyticum<\/i><\/scp>"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1714-5460","authenticated-orcid":false,"given":"Jeannette P.","family":"Geelhoed","sequence":"first","affiliation":[{"name":"St. Antonius Ziekenhuis  Nieuwegein The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Wegelin","sequence":"additional","affiliation":[{"name":"St. Antonius Ziekenhuis  Nieuwegein The Netherlands"},{"name":"University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Tromp","sequence":"additional","affiliation":[{"name":"St. Antonius Ziekenhuis  Nieuwegein The Netherlands"},{"name":"GGD regio Utrecht  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bert\u2010Jan","family":"de Boer","sequence":"additional","affiliation":[{"name":"Mannen Gezondheid en Zorg de Boer  Bilthoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igle\u2010Jan","family":"de Jong","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Department of Urology University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack J. 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