Dr. Trost on injecting CCH at the point of max curve in Peyronie’s disease

In this video, Landon Trost, MD, highlights a key aspect of the study, “Changes in point of maximal curvature during collagenase clostridium histolyticum injections for Peyronie’s disease,” for which he served as the senior author. Trost is the founder and director of the Male Fertility and Peyronie’s Clinic in Orem, Utah.

Video Transcript:

One thing goes along with the study, and it's implicit in the study, but may not be pulled out easily. Over the years, we tried multiple different techniques, everything from feeling the plaque to just measuring the first time, marking with a pen, ultrasound-guided. We tried multiple things. We never published ultrasound-guided one. You’re more accurate in doing your first injection while the person still has the erection. That's controversial, but that's implicit in this study. We always went where the point of max curve was, not necessarily where the plaque was. I found particularly with calcified plaques, your curve often is on the leading edge of that calcified plaque, not within the calcified plaque itself. So, always going where the point of max curve is gives a much better outcome compared to if you're using any other technique. That makes sense surgically too. If you're cutting anything out, tumor or whatever the case, you always go to wherever it's tethered. You're always pulling on the tissue, looking for where it's tethered, and that's where you cut. That's essentially what you're doing if you inject when the person has an erection, and you can see exactly where that point of max curve is. That's going to help achieve better outcomes.

This transcription has been edited for clarity.