Long-Term Satisfaction With Collagenase Clostridium Histolyticum for Peyronie's Disease: Clinical Predictors and Side Effect Profile

Introduction: Collagenase clostridium histolyticum (CCH) therapy for Peyronie's disease (PD) yields satisfaction rates of roughly 50% to 67% within 1 year of treatment completion, but little is known about long-term patient satisfaction. Our study aimed to identify clinical predictors of long-term satisfaction with CCH for PD and the impact of its side effect profile.

Methods: The Treatment Satisfaction Questionnaire for Medication (TSQM) survey was distributed to patients who received CCH for PD at a high-volume men's health academic center from 2009 to 2022. Through retrospective chart review, demographic and clinical data of the disease were collected.

Results: Of 242 eligible patients, 80 (32.9%) responded, with questionnaires completed at a median of 5.1 (interquartile range 2.4-6.7) years after the last CCH injection. Thirty-four (42.5%) respondents reported satisfaction with CCH therapy. Older age was associated with significantly greater side effect domain scores (P < .004 for all). Curvature degree, plaque diameter, and plaque volume before CCH treatment, the mean reduction, and the mean percent reduction in these parameters were not significantly correlated with TSQM totals. Patients with greater final curvature and plaque volume measured after CCH completion had significantly lower TSQM totals (Spearman's ρ = -0.36, -0.32; P < .04 for both). Ten (12.5%) patients with depression and 10 (12.5%) patients who proceeded to surgery exhibited significantly decreased TSQM totals (P < .04 for both).

Conclusions: While a significant proportion of our cohort reported long-term satisfaction with CCH therapy, patient satisfaction with CCH therapy is multifaceted. Our findings can be used to better counsel and manage patient expectations of treatment outcomes before initiating CCH.