Adding A Penile Traction Device To A Classic Scheme Of Treatment With Collagenase Of The Clostridium Histolyticum Helps Reduce The Number Of Cylces Needed And Lenghten The Penis

Treatment with collagenase from Clostridium Histolyticum (CCH) together with penile modeling has been established as an effective therapeutic alternative for Peyronie's disease (PD). The use of a penile traction device (PTD) in this pathology seems to have positive results in different stages of the disease. We present our results with the "protocol i+e" (IMPRESS + extender) in patients with PD. Prospective, descriptive, observational, non-randomized study. Patients with PD treated with CCH from October 2015 to August 2019 are included. The inclusion criteria are the existence of a palpable plaque, not intensely calcified, a curvature ≥ 30º and a good management with a PTD for at least 4 hours a day. After each cycle, the penile curvature is evaluated by the Kelami test. Mean pretreatment basal curvature of 57.43º (30-100). 87 patients available for the analysis in which a first cycle has been administered. The mean of cycles administered is 1,92. The final average curvature after treatment is 33.82º, being the difference with respect to the baseline of -23.49º (-41%). Average length of the penis pretreatment is 14.55 centimeters, reaching 15.01 cm after treatment (p = 0.01). Analyzing the difference of means in terms of the degrees of curvature after each cycle, we found statistically significant differences in all the groups (p = 0), except in the group that analyzes the curvature after the fourth cycle. Statistical significance is also found when comparing the initial and final curvature after the complete treatment.