Treatment-related Outcomes for Patients With Atypical Peyronie's Disease Using Xiaflex Injections

Urology. 2020 Sep:143:153-158. doi: 10.1016/j.urology.2020.05.076. Epub 2020 Jun 24.


Objective: To evaluate the efficacy and safety of collagenase Clostridium histolyticum (CCH) for the management of penile deformities in patients presenting with different categories of atypical Peyronie's disease (PD).

Methods: We conducted a retrospective review of charts of patients who presented to a men's health clinic with atypical PD between October 2016 and June 2019. We included patients in the stable phase of the disease, had completed a penile duplex Doppler ultrasound before any intervention, and proceeded with CCH treatment. Gathered data included patient demographics, treatment details, outcomes, and complications. Outcomes collected were both quantitative (curvature assessments) and qualitative using the symptom bother domain (last 6 questions; Q10 to Q15) of the Peyronie's Disease Questionnaire.

Results: Twenty-one men with stable PD underwent CCH inject therapy after penile duplex Doppler ultrasound. The mean number of injections was 8.4 (standard deviation [SD] = 3.3), and the mean follow-up was 20.5 months (SD = 5.9). The overall mean change in penile curvature was -19.2° ± 8.3°, which corresponded to a -39% ± 13% improvement in curvature (P = .0079). In men who presented with an indentation or hourglass deformity, 11 of 17 (64%) were satisfied and reported subjective improvement in narrowing/indentation after receiving CCH injections. The average composite symptom bother domain of the Peyronie's Disease Questionnaire decreased by 6.7 (P = .0029).

Conclusion: Our results suggest that CCH appears to be safe and provide significant clinical improvements in men presenting with atypical PD.

MeSH terms

  • Aged
  • Drug Administration Schedule
  • Humans
  • Injections, Intralesional
  • Male
  • Microbial Collagenase / administration & dosage*
  • Microbial Collagenase / adverse effects
  • Middle Aged
  • Penile Induration / diagnosis
  • Penile Induration / drug therapy*
  • Penis / diagnostic imaging
  • Penis / drug effects
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex


  • Microbial Collagenase