{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:29:36Z","timestamp":1787617776557,"version":"build-2736575974"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T00:00:00Z","timestamp":1624752000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T00:00:00Z","timestamp":1624752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Urol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Collagenase Clostridium histolyticum (CCH), also know as Xiaflex, with penile modeling is considered to be the gold standard non-surgical option for management of Peyronie\u2019s disease and is known to be safe and efficacious. Corporal rupture is a rare but known adverse event of CCH treatment, however there are limited studies describing corporal herniation without rupture. Here we present a patient who experienced a rare complication following CCH injections for Peyronie\u2019s disease: lateral herniation of the tunica albuginea in the setting of a dorsal penile plaque.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 58-year-old male presented to our clinic seeking treatment for Peyronie\u2019s disease. On exam, he was found to have a palpable dorsal plaque and &gt;\u200930 degrees leftward curvature of the penis. He was deemed an appropriate candidate for and patient decided to proceed with CCH and modeling. He received 2 cycles of CCH injections (4 total CCH injections) with in-office and at-home penile modeling, per manufacturer\u2019s protocol. Two weeks following in-office modeling during his second CCH cycle, the patient reported a painless, soft swelling involving the left side of his penile shaft only occurring with erection. Exam and history were suggestive of lateral herniation rather than corporal rupture. CCH was discontinued. Patient declined further evaluation with penile ultrasound.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is the first case report detailing lateral herniation with CCH injections. Symptoms and exam that should raise suspicion of corporal herniation are a soft, painless mass with erection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12894-021-00858-9","type":"journal-article","created":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T17:02:43Z","timestamp":1624813363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lateral herniation during treatment with collagenase Clostridium histolyticum (Xiaflex) for Peyronie\u2019s disease"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3557-6902","authenticated-orcid":false,"given":"Margaret K.","family":"Gannon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M.","family":"Pearlman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,27]]},"reference":[{"issue":"3","key":"858_CR1","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.euf.2018.08.021","volume":"4","author":"D Shin","year":"2018","unstructured":"Shin D, Shah T, Sadeghi-Nejad H. Xiaflex for treatment of Peyronie\u2019s disease. Eur Urol Focus. 2018;4(3):302\u20133.","journal-title":"Eur Urol Focus"},{"key":"858_CR2","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/S0022-5347(01)65359-X","volume":"157","author":"G Brock","year":"1997","unstructured":"Brock G, Hsu GL, Nunes L, et al. The anatomy of the tunica albuginea in the normal penis and Peyronie\u2019s disease. J Urol. 1997;157:276\u201381.","journal-title":"J Urol"},{"key":"858_CR3","doi-asserted-by":"crossref","unstructured":"Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol 2006;175:2115\u20138; discussion 8.","DOI":"10.1016\/S0022-5347(06)00270-9"},{"key":"858_CR4","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.juro.2013.01.087","volume":"190","author":"M Gelbard","year":"2013","unstructured":"Gelbard M, Goldstein I, Hellstrom WJ, et al. Clinical efficacy, safety and tolerability of collagenase Clostridium histolyticum for the treatment of Peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190:199\u2013207.","journal-title":"J Urol"},{"issue":"5","key":"858_CR5","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1111\/bju.13120","volume":"116","author":"CC Carson 3rd","year":"2015","unstructured":"Carson CC 3rd, Sadeghi-Nejad H, Tursi JP, Smith TM, Kaufman GJ, Gilbert K, Honig SC. Analysis of the clinical safety of intralesional injection of collagenase Clostridium histolyticum (CCH) for adults with Peyronie\u2019s disease (PD). BJU Int. 2015;116(5):815\u201322.","journal-title":"BJU Int"},{"issue":"4","key":"858_CR6","doi-asserted-by":"publisher","first-page":"380","DOI":"10.23736\/S0393-2249.18.03118-1","volume":"70","author":"A Abdel Raheem","year":"2018","unstructured":"Abdel Raheem A, Johnson M, Ralph D, Garaffa G. Collagenase clostridium histolyticum: a novel medical treatment for Peyronie\u2019s disease. Minerva Urol Nefrol. 2018;70(4):380\u20135.","journal-title":"Minerva Urol Nefrol"},{"issue":"4","key":"858_CR7","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1016\/j.jsxm.2016.02.105","volume":"13","author":"FA Yafi","year":"2016","unstructured":"Yafi FA, Anaissie J, Zurawin J, Sikka SC, Hellstrom WJ. Results of SMSNA survey regarding complications following intralesional injection therapy with collagenase Clostridium histolyticum for Peyronie\u2019s disease. J Sex Med. 2016;13(4):684\u20139.","journal-title":"J Sex Med"},{"issue":"3 Pt 1","key":"858_CR8","first-page":"737","volume":"153","author":"DL Watson","year":"1995","unstructured":"Watson DL, Morgentaler A. Spontaneous corporeal herniation of the penis: a new abnormality of the tunica albuginea? J Urol. 1995;153(3 Pt 1):737\u201340.","journal-title":"J Urol"},{"issue":"4","key":"858_CR9","first-page":"474","volume":"4","author":"WO Brant","year":"2015","unstructured":"Brant WO, Reed-Maldonado A, Lue TF. Injection therapy for Peyronie\u2019s disease: pearls of wisdom. Transl Androl Urol. 2015;4(4):474\u20137.","journal-title":"Transl Androl Urol"},{"issue":"5","key":"858_CR10","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1016\/S0022-5347(17)35214-X","volume":"151","author":"GL Hsu","year":"1994","unstructured":"Hsu GL, Brock G, Mart\u00ednez-Pi\u00f1eiro L, von Heyden B, Lue TF, Tanagho EA. Anatomy and strength of the tunica albuginea: its relevance to penile prosthesis extrusion. J Urol. 1994;151(5):1205\u20138.","journal-title":"J Urol"}],"container-title":["BMC Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-021-00858-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12894-021-00858-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12894-021-00858-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T17:02:52Z","timestamp":1624813372000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcurol.biomedcentral.com\/articles\/10.1186\/s12894-021-00858-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,27]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["858"],"URL":"https:\/\/doi.org\/10.1186\/s12894-021-00858-9","relation":{},"ISSN":["1471-2490"],"issn-type":[{"value":"1471-2490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,27]]},"assertion":[{"value":"30 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient completed written consent for his pictures and clinical course to be published without any patient identifiers.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Amy Pearlman is a consultant for Endo Pharmaceuticals.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"94"}}