Systematic Reviews
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Nov 24, 2014; 3(3): 364-369
Published online Nov 24, 2014. doi: 10.5410/wjcu.v3.i3.364
Use of intralesional collagenase in the treatment of peyronie’s disease: A review
Daniel Marchalik, Henry Wright, Frank Hill, Anup Vora
Daniel Marchalik, Henry Wright, Frank Hill, Department of Urology, Georgetown University Hospital, Washington, DC 20007, United States
Anup Vora, Department of Urology, 2950 Cleveland Clinic Boulevard, Cleveland Clinic Florida, Weston, FL 33331, United States
Author contributions: All authors contributed to the research, writing, formatting, and revisions of this work.
Correspondence to: Anup Vora, MD, Department of Urology, 2950 Cleveland Clinic Boulevard, Cleveland Clinic Florida, Cleveland Clinic Blvd, Weston, FL 33331, United States. anupvora@gmail.com
Telephone: +1-954-6595188 Fax: +1-954-6595189
Received: April 5, 2014
Revised: May 16, 2014
Accepted: July 15, 2014
Published online: November 24, 2014
Processing time: 227 Days and 21.1 Hours
Abstract

AIM: To review the relevant literature in an effort to examine the body of evidence available to date.

METHODS: Ovid MEDLINE search database was queried using MeSH terms “penile induration”, “peyronie’s disease”, “Collagenases” and “Collagenase” using various permutations. No temporal parameters were employed.

RESULTS: In all, 5 relevant clinical trials were isolated from 34 results. These trials were analyzed using the Oxford Centre for Evidence-Based Medicine criteria. They were further examined based on study design and methods; the primary and secondary outcomes were reviewed for treatment efficacy and collagenase-related side effects.

CONCLUSION: Intralesional collagenase appears to be safe and effective in the non-surgical treatment of Peyronie’s disease. However, the data remains limited and further inquiries into the safety of collagenase, treatment standardization and standardized outcomes reporting remain necessary. Furthermore, studies comparing intralesional collagenase to alternative medical and surgical therapy will be important in guiding the future treatment decision process.

Keywords: Peyronie’s disease; Collagenase; Reconstructive urology; Plaque; Intralesional injection

Core tip: In December of 2013, the United States Food and Drug Administration approved the use of collagenase clostridium histolyticum (CCH) for the treatment of Peyronie’s disease (PD). In all, 5 relevant clinical trials were isolated from 34 results. With limited data on medical PD treatments, the studies to date appear to support CCH as a reasonably safe and well-tolerated non-surgical intervention. However, because no studies compared CCH to other medical interventions and no trials have been conducted to assess the ultimate need for surgical intervention, further comparative investigations are necessary to determine the ultimate role that the intralesional collagenase may play in the treatment of PD.