{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:19:47Z","timestamp":1788826787120,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,9]],"date-time":"2019-06-09T00:00:00Z","timestamp":1560038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To compare the efficacy and safety of a combined treatment of percutaneous needle tunnelling (\n                      <jats:styled-content style=\"fixed-case\">PNT<\/jats:styled-content>\n                      ) and a modified collagenase\n                      <jats:italic>Clostridium histolyticum<\/jats:italic>\n                      (\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      ) protocol (PNT\/CCH) vs the modified protocol alone (\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      ) in the treatment of Peyronie's disease (PD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      A prospective registry of patients treated with a modified\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      protocol was maintained between June 2014 and February 2018. The last 50 patients received\n                      <jats:styled-content style=\"fixed-case\">PNT<\/jats:styled-content>\n                      as an adjuvant therapy (\n                      <jats:styled-content style=\"fixed-case\">PNT<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      ), and their data were compared with those of the other 94 patients treated previously (\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      ).\n                      <jats:styled-content style=\"fixed-case\">PNT<\/jats:styled-content>\n                      involves the creation of multiple holes made percutaneously in the plaque before each injection. The modified protocol consisted of two collagenase injections, at 1\u2010week intervals, followed by penile modelling. Patients used penile traction therapy, tadalafil and pentoxifylline for the next 2\u00a0months and were followed up for 6\u00a0months. The main outcome was improvement of curvature. Secondary outcomes were improvements in erectile function, PD symptoms, stretched penile length and satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Improvement in curvature was greater in patients in the\n                      <jats:styled-content style=\"fixed-case\">PNT<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      group than in the\n                      <jats:styled-content style=\"fixed-case\">CCH<\/jats:styled-content>\n                      group (mean \u00b1\n                      <jats:sc>sd<\/jats:sc>\n                      19.2 \u00b1 6.1\u00b0 vs 12.7 \u00b1 5.0\u00b0;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001 [36.2 \u00b1 12.5% vs 28.1 \u00b1 14.5%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001]). Compared with baseline, both interventions were associated with significant improvement in secondary outcomes. The main complications were ecchymosis, bruising and penile pain, with no significant differences between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Treatment of PD with CCH using our modified protocol in combination with PNT is safe and more effective than the modified protocol alone, with the potential for improved cost\u2010effectiveness\n                      <jats:bold>.<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.14784","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T05:48:45Z","timestamp":1556516925000},"page":"1055-1062","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Optimizing collagenase\n                    <i>Clostridium histolyticum<\/i>\n                    therapy for Peyronie\u2019s disease using a novel approach with percutaneous needle tunnelling"],"prefix":"10.1111","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2602-2617","authenticated-orcid":false,"given":"Esa\u00fa","family":"Fern\u00e1ndez\u2010Pascual","sequence":"first","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta de Hierro\u2010Majadahonda Universidad Aut\u00f3noma de Madrid Madrid Spain"},{"name":"Lyx Institute of Urology Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6567-962X","authenticated-orcid":false,"given":"Francisco Javier","family":"Gonz\u00e1lez\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Lyx Institute of Urology Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3789-9465","authenticated-orcid":false,"given":"Javier","family":"Angulo","sequence":"additional","affiliation":[{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Cerezo","sequence":"additional","affiliation":[{"name":"Lyx Institute of Urology Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Quintana","sequence":"additional","affiliation":[{"name":"Lyx Institute of Urology Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Turo","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta de Hierro\u2010Majadahonda Universidad Aut\u00f3noma de Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Mart\u00ednez\u2010Ballesteros","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta de Hierro\u2010Majadahonda Universidad Aut\u00f3noma de Madrid Madrid Spain"},{"name":"Lyx Institute of Urology Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Carballido","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta de Hierro\u2010Majadahonda Universidad Aut\u00f3noma de Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5586-6838","authenticated-orcid":false,"given":"Juan Ignacio","family":"Mart\u00ednez\u2010Salamanca","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Puerta de Hierro\u2010Majadahonda Universidad Aut\u00f3noma de Madrid Madrid Spain"},{"name":"Lyx Institute of Urology Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2016.04.062"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2006.05969.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aju.2013.06.006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)39746-X"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.05.098"},{"key":"e_1_2_7_7_1","unstructured":"HatzimouratidisK GiulianoF MoncadaIet\u00a0al.EAU Guidelines on Male Sexual Dysfunction. 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