A modified technique for intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease results in reduced procedural morbidity using a standardized hematoma classification rubric

Purpose Early clinical trials of injectable collagenase Clostridium histolyticum (CCh) for Peyronie’s disease (PD) demonstrated safety and efficacy. Since then, modified injection protocols have been proposed. Adverse events—such as bruising, swelling, hematoma, and corporal rupture—exceed 50% in many studies, but lack of standardization of hematoma severity limits conclusions about the relative safety of protocols. We propose a modification of the standard injection technique that aims to decrease the rates of adverse events. We further describe a hematoma classification rubric that may standardize safety assessment.