May 7, 2026Open Access

Efficacy and safety of collagenase Clostridium histolyticum in men who have sex with men

Key Points

This research aims to evaluate the efficacy and safety of collagenase Clostridium histolyticum in men who have sex with men (MSM) experiencing Peyronie’s disease.
Retrospective analysis of 790 patients receiving CCH injections for PD at 5 academic centers in the U.S.
Assessment of demographic data, sexual orientation, penile curvature characteristics, and treatment outcomes.
Focus on treatment satisfaction, efficacy, and complication rates based on sexual orientation.
Out of 399 included patients, 6.51% identified as MSM.
Median reduction in penile curvature was 15 degrees, with 70% reporting treatment satisfaction.
MSM had higher corporal fracture rates (11.5%) compared to non-MSM (1.36%), but no significant differences in satisfaction or efficacy.

Abstract

Abstract Background While prior studies have demonstrated that men who have sex with men (MSM) may disproportionately experience distress due to Peyronie’s disease (PD), limited evidence exists regarding the outcomes of these men when treated with collagenase Clostridium histolyticum (CCH) injections. Aim To investigate the outcomes of MSM undergoing CCH injections for PD. Methods A retrospective analysis was performed for 790 patients undergoing CCH injections for PD at 5 academic centers within the United States, including data pertaining to demographic information, sexual orientation, penile curvature characteristics, treatment characteristics, and treatment-related outcomes. Outcomes The impact of sexual orientation on treatment-related satisfaction, efficacy, and complication rates. Results Of the 399 patients meeting the final inclusion criteria, 6.51% (N = 26) self-identified as MSM. The median absolute reduction in penile curvature was 15 degrees (interquartile range: 5-20 degrees), with 70.0% (n = 206) reporting feeling satisfied with their treatment. Men who have sex with men patients were noted to have higher rates of corporal fracture following treatment (11.5% vs. 1.36%, P = .011), though sexual orientation was not associated with statistically significant changes in treatment satisfaction, penile curvature reduction, or rates of complications requiring operative intervention. Clinical Implications An improved understanding of the outcomes of MSM receiving CCH injections may improve counseling regarding and management of PD for a vulnerable population of patients. Strengths and Limitations This study offers some of the first data examining outcomes for PD in MSM patients. However, the retrospective and multicohort nature of the study, as well as its small cohort size, may result in impactful bias. Conclusion In our trial, MSM patients receiving CCH were with similar treatment efficacy, treatment satisfaction, and rates of operative complications, suggesting that CCH is an efficacious and safe treatment for MSM patients.

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