The purpose of this study is to compare key clinical outcomes of collagenase clostridium histolyticum injections versus surgery for the management of Peyronie's Disease.
After eligible patients have been informed about the study protocol and risks and consent have been given, men will be randomly assigned into either the collagenase clostridium histolyticum + penile traction therapy (CCH + PTT) group or to the surgery + penile traction therapy (surgery + PTT) group. Those in the CCH + PTT group will receive the full 4 series of 8 Xiaflex injections with 1-3 days between each set of 2 injections and 6 weeks prior to the next series. Patients would then use the RestoreX traction device throughout the series to 3 months post-treatment. Those that were assigned the surgery + PTT treatment protocol would undergo surgery using either penile plication or incision and grafting, depending on the degree of curvature and erectile function. Traction using RestoreX will also be prescribed to these men 2-4 weeks post-operatively until 3 months post-treatment. Key clinical outcomes of both treatment protocols will be compared.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Men in this cohort would receive the full series of 8 Xiaflex injections: 2 injections separated by 1-3 days, repeated 3 additional times with 6 week breaks between treatments.
Men in this cohort would undergo surgery using either penile plication or incision and grafting. The specific surgery would be selected based on commonly used criteria: plication for curvatures \<70 degrees; I\&G used for ≥70 degrees or severe hourglass / hinge deformities. However, the specific surgery (plication vs I\&G) will ultimately be decided based on the primary investigator's clinical judgment.
The Male Fertility and Peyronie's Clinic
Orem, Utah, United States
Overall satisfaction with treatment
Answer to SAPS question #1 (How satisfied are you with the effect of your treatment?) to determine overall satisfaction at all time points
Time frame: 1 year
Subjective reporting of erectile dysfunction post treatment
Comparison of erectile dysfunction complication rates
Time frame: 1 year
Subjective reporting of changes in penile sensation post treatment
Comparison of changes in penile sensation complication rates
Time frame: 1 year
Subjective reporting of changes in penile length post treatment
Comparison of perceived changes in penile length complication rates
Time frame: 1 year
International Index of Erectile Function, Erectile Function Domain (IIEF) Scores
Comparison of IIEF erectile function domain score (Q1-5, 15; min/max 1-30; higher is better)
Time frame: 1 year
Peyronie's Disease Questionnaire (PDQ) Scores
Comparison of PDQ questionnaire scores; Subdomains - psychological and physical (Q1-6; min/max 0-24; lower is better), penile pain (Q7-9; min/max 0-30; lower is better), symptom bother (Q10-15; min/max 0-16; lower is better)
Time frame: 1 year
International Index of Erectile Function (IIEF) Scores
Comparison of IIEF questionnaire scores-all domains except erectile function (which is a primary endpoint); subdomains: orgasmic function (Q9-10; min/max 0-10; higher is better), sexual desire (Q11-12; min/max 2-10; higher is better), intercourse satisfaction (Q6-8; min/max 0-15; higher is better), overall satisfaction (Q13-14; min/max 2-10; higher is better)
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Men in this cohort would undergo surgery using either penile plication or incision and grafting. The specific surgery would be selected based on commonly used criteria: plication for curvatures \<70 degrees; I\&G used for ≥70 degrees or severe hourglass / hinge deformities. However, the specific surgery (plication vs I\&G) will ultimately be decided based on the primary investigator's clinical judgment.
RestoreX is a Class I PTT device developed by PathRight Medical, is registered with the FDA, and has randomized controlled data demonstrating efficacy when used for the treatment of PD.
Time frame: 1 year
Beck's Depression Inventory (BDI) Scores
Comparison of BDI questionnaire scores on depression. 21 items (min/max 0-63, lower is better)
Time frame: 1 year
Penile Curvature
Comparison of changes in penile curvature
Time frame: 1 year
Objective measurements of penile length post treatment (compared to pre-treatment)
Comparison of changes in penile length
Time frame: 1 year
Interventions required
Comparison of subsequent interventions required - surgery or CCH injections
Time frame: 1 year
Hospitalizations
Number of hospitalizations or ER visits resulting from treatment
Time frame: 1 year
Non-standardized questionnaire
Comparison of non-standardized questionnaire responses
Time frame: 1 year