{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:41:13Z","timestamp":1762659673122},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Collagenase Clostridium histolyticum (CCH; Xiapex) injections represent the only licensed medical treatment for Peyronie's disease (PD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To evaluate the efficacy and safety of CCH injections in men with stable PD, using a modified treatment protocol and to assess partners' bother improvement in a large cohort of White-European sexually active heterosexual men treated in a single tertiary-referral center.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All the 135 patients enrolled underwent a thorough assessment, which included history taking, physical examination, and pharmacologically induced artificial erection test (intra-cavernous injection) to assess the degree of penile curvature (PC) at baseline and after the completion of the treatment. Patients with calcified plaque and\/or ventral curvature were excluded. All patients underwent a modified treatment protocol, which consisted of 3 intra-lesional injections of 0.9 mg of CCH performed at 4-week intervals at the point of maximum curvature. After each injection, patients were instructed to follow a strict routine involving daily penile stretching in the intervals between injections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>International Index of Erectile Function (IIEF)\u201315, Global Assessment of PD, PD questionnaires (PDQ), and Female Sexual Function Index (FSFI) questionnaire were performed at baseline and at the end of treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 135 patients completed the study protocol. Before treatment, 18 (13.33%) partners showed a degree of sexual dysfunction. Baseline median IIEF\u201315, FSFI, and PDQ scores were, respectively, 59.0, 35.0, and 23.0. Overall, both IIEF\u2013total and all domains significantly improved after treatment (all P &amp;lt; .01). A PC mean change of 19.07 (P\u00a0= .00) was measured. At the univariate linear regression analysis, IIEF\u201315, IIEF\u2013erectile function, IIEF\u2013sexual desire, and IIEF\u2013intercourse satisfaction were positively associated with FSFI (all P \u2264 .03); conversely, PDQ\u2013penile pain, PDQ\u2013symptom bother, and post-treament penile curvature (P \u2264 .04) were associated with a decreased FSFI score. Furthermore, median change of PC was significantly associated with median change of FSFI (r\u00a0=\u00a00.25; 95% CI 0.02\u20130.11; P\u00a0= .004). Global satisfaction after treatment was 89.6% (121\/135).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Translation<\/jats:title>\n                  <jats:p>This modified CCH treatment protocol could improve both patients' and partner's sexual function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strength and limitations<\/jats:title>\n                  <jats:p>This was an open-label, single-arm clinical study, without placebo. where only heterosexual couples in stable relationships were included. Furthermore, no real assessment of female sexual distress was carried out and long-term sexual function in both patients and female partners were not taken into account.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The modified treatment schedule with CCH injections for stable PD has a positive impact on both patients' and partners' sexual function in heterosexual couples with a stable sexual relationship.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2018.03.084","type":"journal-article","created":{"date-parts":[[2018,4,23]],"date-time":"2018-04-23T23:06:16Z","timestamp":1524524776000},"page":"716-721","update-policy":"http:\/\/dx.doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["Predictive Factors of Patients' and Their Partners' Sexual Function Improvement After Collagenase <i>Clostridium Histolyticum<\/i> Injection for Peyronie's Disease: Results From a Multi-Center Single-Arm Study"],"prefix":"10.1093","volume":"15","author":[{"given":"Andrea","family":"Cocci","sequence":"first","affiliation":[{"name":"Department of Urology , Florence, \u00a0 Italy"},{"name":"Careggi Hospital , Florence, \u00a0 Italy"},{"name":"University of Florence , Florence, \u00a0 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio Ivan","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Urology , Catania, \u00a0 Italy"},{"name":"University of Catania , Catania, \u00a0 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Department of Urology , Milano, \u00a0 Italy"},{"name":"San Raffaele Hospital , Milano, \u00a0 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianmartin","family":"Cito","sequence":"additional","affiliation":[{"name":"Department of 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