V04-07: How to improve your Xiapex results in Peyronie’s disease: The Percutaneous Needle Tunnelling (PNT) technique. Step-by-step surgical video

Video

INTRODUCTION

Intralesional injection of collagenase from Clostridium histolyticum (CCH; Xiapex®) has demonstrated an improvement in curvature in selected patients, sparing many of them from surgery. A combination of two techniques for the treatment of Peyronie’s disease (PD): percutaneous needle tunnelling (PNT) on the plaque and subsequent administration of CCH has been used in our centre since December 2016. We believe this combination could lead to a more cost-effective treatment. In this video we will show how this technique is performed in our centre.

METHODS

Our modified IMPRESS-based protocol consisted of two collagenase injections, at one-week intervals, followed by penile modelling. Patients used penile traction therapy, tadalafil and pentoxifylline for the next two months. Before the injection of Xiapex®, PNT was performed by creating multiple tunnels or holes along the entire plaque using a 25G needle.

RESULTS

Thirty-two patients with stable disease (curvature

CONCLUSION

This novel treatment with CCH using our modified protocol in combination with PNT seems to be safe and effective for treating PD. It provides an alternative approach in the treatment of this disease and may be more cost-effective.

Funding: None