The incidence of surgical intervention in veterans treated with Collagenase clostridium histolyticum

Peyronie's disease (PD) can be managed with surgery or intralesional injections of Collagenase clostridium histolyticum (CCH) however both are associated with side effects and variable results. It is unclear how many patients elect to undergo additional surgical correction after CCH. To answer this, we analyzed the Department of Veterans Affairs Informatics and Computing Infrastructure (VINCI) software. We performed a retrospective analysis over a 5-year period for patients with PD, at least one injection of CCH and surgical CPT codes. In total, 17,646 patients with PD were analyzed with 1541 treated with CCH. Only 51 (3.3%) were treated with secondary surgical intervention after CCH. Three main surgical procedures were performed: penile plication (51%), penile prosthesis (29%) and plaque excision and grafting (20%). Of the 51 men who underwent surgical corrections post CCH, the most common reason was lack of response/residual curvature (62.8%), followed by ED (29.4%). Previous literature shows that CCH was effective for only 60.8% of patients, potentially leaving the remaining in need of additional treatment. Despite this we found that only 3.3% received secondary therapy in the VA medical system, with residual curvature being the most common reason.