Ziegelmann Matthew J, Viers Boyd R, Montgomery Brian D, Avant Ross A, Savage Joshua B, Trost Landon W
Department of Urology, Mayo Clinic, Rochester, MN.
Department of Urology, Mayo Clinic, Rochester, MN.
Urology. 2017 Jun;104:102-109. doi: 10.1016/j.urology.2017.01.054. Epub 2017 Mar 24.
To evaluate the outcomes in men undergoing collagenase Clostridium histolyticum (CCH) with concurrent penile traction therapy (PTT) for the treatment of Peyronie disease (PD).
We identified patients treated with CCH between March 2014 and July 2016. Patients were recommended to perform modeling and PTT between injection series. A final curve assessment was performed after patients completed CCH. A prospective database was maintained, including patient-reported frequency and duration of PTT. Statistical analysis was performed to evaluate outcomes based on use and duration of PTT.
A total of 51 patients completed CCH and had complete objective data available for analysis. Mean (standard deviation [SD]) baseline curvature was 66.7 (25.0) degrees, and mean (SD) improvement post CCH was 20.9 (17.3) degrees (P < .0001). Thirty-five (69%) men reported daily PTT for a mean (SD) of 9.8 (6.3) hours per week. No significant difference was identified in the degree of curve improvement based on frequency or duration of PTT (P = .40). Similarly, no associations between PTT and functional outcomes including intercourse restoration and surgery prevention were identified. Stretched penile length increased nonsignificantly by a mean (SD) of +0.4 (1.5) cm in the PTT group, compared with -0.35 (1.5) in the non-PTT group (P = .21).
The current series represents a "true-to-life" experience, wherein utilization patterns, attrition, and compliance issues are relevant factors impacting efficacy. PTT use with the Andropenis declined in both frequency and duration with subsequent injection series, and there was no significant difference in curve improvement or stretched penile length with a mean 10 hours of weekly concurrent PTT.
评估接受溶组织梭状芽孢杆菌胶原酶(CCH)联合阴茎牵引疗法(PTT)治疗佩罗尼氏病(PD)的男性患者的治疗效果。
我们确定了2014年3月至2016年7月期间接受CCH治疗的患者。建议患者在注射疗程之间进行塑形和PTT。患者完成CCH治疗后进行最终的弯曲度评估。维护了一个前瞻性数据库,包括患者报告的PTT频率和持续时间。进行统计分析以评估基于PTT使用情况和持续时间的治疗效果。
共有51名患者完成了CCH治疗,并拥有可供分析的完整客观数据。平均(标准差[SD])基线弯曲度为66.7(25.0)度,CCH治疗后的平均(SD)改善为20.9(17.3)度(P <.0001)。35名(69%)男性报告每周平均(SD)进行9.8(6.3)小时的每日PTT。基于PTT的频率或持续时间,在弯曲度改善程度方面未发现显著差异(P = 0.40)。同样,未发现PTT与包括恢复性交和预防手术在内的功能结局之间存在关联。PTT组的阴茎拉伸长度平均(SD)非显著增加了+0.4(1.5)厘米,而非PTT组为-0.35(1.5)厘米(P = 0.21)。
本系列代表了一种“真实生活”的经验,其中使用模式、损耗和依从性问题是影响疗效的相关因素。随着后续注射疗程,使用Andropenis进行PTT的频率和持续时间均下降,并且每周平均进行10小时的联合PTT在弯曲度改善或阴茎拉伸长度方面没有显著差异。