(038) SATISFACTION AFTER COLLAGENASE <i>CLOSTRIDIUM HISTOLYTICUM</i> MAY BE IMPACTED BY THE ACCURACY OF PATIENT-PREDICTED PENILE CURVATURE

Abstract Introduction Intralesional injection of collagenase clostridium histolyticum (CCH) remains one of the most common, non-surgical, treatment options for Peyronie’s disease (PD). While CCH is often linked to high patient satisfaction rates, discrepancies between a patient’s measured and subjective penile curvature may lead to lower patient satisfaction. Objective To determine the impact of discrepancies between subjective and measured penile curvature and patient satisfaction following CCH. Methods Patients receiving CCH for PD from four Urology clinics were reviewed between 2013 and 2024. Patient charts were reviewed for patient-reported penile curvature prior to treatment, urologist-measured penile curvature before and after CCH, complications during treatment, and patient-reported treatment satisfaction. Patients were deemed over-estimators or under-estimators if their predicted penile curvature was over or under 15 degrees respectively when compared to a urologist’s measurement. Associations between subjective improvement following CCH and accuracy of penile curvature prediction were tested using multiple regression, controlling for age, absolute change in urologist-measured penile curvature before and after treatment, and complications during treatment. Results 221 patients received CCH for PD with an average age of 57 years (range: 23– 79 years). The average penile curvature as measured by a urologist prior to CCH was 45.7 degrees (range 10– 110 degrees). The average penile curvature by patient estimation was 47.9 degrees (range 10– 110 degrees), with 153 patients (69.2%) accurately estimating their penile curvature within 15 degrees. Overall, 38 (17.2%) and 30 patients (13.6%) overestimated and underestimated their penile curvatures by greater than 15 degrees, respectively. Overall, 128 patients (57.9%) noted satisfaction with treatment, with increases in the absolute change of penile curvature being significantly associated with improved satisfaction (p = 0.002). Patients who underestimated their baseline curvature were with higher post treatment satisfaction rates (OR 5.62, p = 0.005) compared to all other patients. Patients who accurately predicted or overestimated their baseline penile curvature were with similar satisfaction rates (p &amp;gt; 0.05). (Table 1). Conclusions In this series, satisfaction with CCH was higher in patients who initially underestimated their penile curvature. While further work is needed to reproduce and further examine these associations, discrepancies between patient and urologist estimates of penile curvature may have important implications in the treatment of PD. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Endo International.