Abstract Introduction Penile deformity, pain, and erectile dysfunction from Peyronie's disease (PD) impact patient quality of life. Collagenase Clostridium Histolyticum (CCH) treatment protocols have evolved, with contemporary refinements aiming to enhance efficacy. We analyzed longitudinal trends in treatment outcomes at our institution, correlating them with the adoption of modified CCH protocols. Objective analyze and present real-world outcomes of CCH with a contemporary protocol Methods We retrospectively reviewed all patients receiving CCH for PD. Patients were cohort-stratified by treatment initiation year. The primary endpoint was the change in penile curvature, measured as absolute (degrees) and percentage improvement. Data are presented as means +/- SD, medians IQR, and proportions where appropriate. Results The analysis included 58 patients initiating CCH between 2022 and 2025. Mean percentage curve improvement was 27.3% (±35.7) for the 2023 cohort, 37.0% (±32.9) for the 2024 cohort, and 69.1% (±13.2) for the 2025 cohort. The overall ANOVA comparing all groups was not significant (p=0.18). However, a t-test comparing the 2023 and 2025 cohorts revealed a statistically significant greater improvement in the 2025 group (p=0.0197). Conclusions These preliminary findings suggest significantly improved CCH outcomes for the 2025 cohort versus 2023, though this must be interpreted with caution due to small sample sizes. The evolution of our protocol (adding concurrent tadalafil, universal traction, high-force modeling, erect penis injections, and shortened intervals) correlates with this change in efficacy. While isolating the impact of any single modification is difficult, the overall trend is toward enhanced curvature correction. This suggests contemporary CCH protocols may yield results superior to the landmark IMPRESS trials. These real-world data aid patient counseling for modern CCH therapy. Multi-center validation is warranted. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast, Endo Pharmaceuticals
Bole et al. (Mon,) studied this question.
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