Safety and Efficacy of Collagenase Clostridium Histolyticum After Prior Intralesional PRP for Peyronie's Disease

This study evaluates the effectiveness of collagenase clostridium histolyticum (CCH, brand name Xiaflex) — an injectable enzyme that breaks down abnormal collagen tissue — in men with Peyronie's Disease who have already received intralesional platelet-rich plasma (PRP) injections. Peyronie's Disease is a condition where scar tissue (plaque) forms inside the penis, causing painful or curved erections that can make sexual intercourse difficult or impossible. PRP has been used as a first-line regenerative treatment to try to soften the plaque, and this study asks whether CCH injections afterward provide additional benefit. Adult men aged 18–75 who have confirmed stable Peyronie's Disease, a palpable penile plaque, penile curvature between 30 and 90 degrees, and have received PRP injections within the past 18 months are eligible. Previous CCH treatment more than 6 months ago is permitted. Men who have had penile surgery (other than circumcision), had a penile fracture or priapism, have ventral (downward-curving) plaque, have severe erectile dysfunction (IIEF score at or below 12), or have an hourglass deformity are excluded. Participants receive CCH injections with standardized follow-up measuring penile curvature, plaque characteristics, and patient-reported outcomes including sexual function. Peyronie's Disease is significantly underdiagnosed and undertreated despite affecting an estimated 1–9% of men — research into sequential treatment approaches helps define the best management pathway for this condition that profoundly affects men's physical and psychological wellbeing.