RAG rating
Document type
Clinical policy
Hertfordshire and West Essex ICB
Output type
Clinical Policies & Evidence-based Interventions

Peyronie’s Disease

July 2022 v1.1
Peyronie’s Disease is a benign penile condition characterized by curvature of the penile shaft secondary to the formation of fibrous tissue plaques within the tunica albuginea.


The HWE ICB do not routinely fund treatment for Peyronie’s disease. If there is no functional impairment that prevents intercourse then it is primarily considered to be cosmetic condition and is therefore low priority.
Funding for surgical will be assessed on an individual basis where the following criteria apply:
  • The disease is in the stable phase
  • Conservative measures have failed or are not possible due to clinical reasons.
  • Severe disease that makes intercourse not possible

Extracorporeal Shockwave Therapy will not be funded due to inadequate evidence of efficacy. Collegenase clostridium histolyticum is no longer available in the UK.

Patients who are not eligible for treatment under this policy may be considered on an individual basis where their GP or consultant believes exceptional circumstances exist that warrant deviation from the rule of this policy. Individual cases will be reviewed as per the ICB policy.

1.Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. The Journal of urology. 2006; 175(6):2115–2118
2.European Association of UrologistsK Hatzimouratidis (Chair), I. Eardley, F. Giuliano,I. Moncada, A. Salonia. Guidelines on Penile Curvature Eur Urol 2012 Sep;62(3):543-52.
3.NICE. Extracorporeal shockwave therapy for Peyronie's disease. 2003. Interventional procedure guidance 29. https://www.nice.org.uk/guidance/ipg29/chapter/5-Aboutthis-guidance London Medicines Evaluation Network. Collagenase Clostridium histolyticum (XiapexTM) for Peyronie’s disease – July 2015 https://www.sps.nhs.uk/wp-content/uploads/2015/08/LMEN__Xiapex_Peyronies_July15.pdf
4.Gelbard M, Goldstein I, Hellstrom W.J.G et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of Peyronies disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol 2013; 190(1):199-207.
5.Levine LA, Cuzin B, Mark S, et al. Clinical safety and effectiveness of collagenase clostridium histolyticum injection in patients with Peyronie’s disease: a phase 3 openlabel study. The journal of sexual medicine. 2015; 12(1):248–258.
6.Levine LA, Cuzin B, Stephen M et al. Clinical safety and effectiveness of collagenase clostridium histolyticum injection in patients with Peyronie's disease; a phase 3 open label study. The Journal of Sexual Medicine 2015; 12(1):248-258.
7.Yang, Kevin K. et al. Peyronie's Disease and Injectable Collagenase Clostridium histolyticum: Safety,  efficacy, and Improvements in Subjective Symptoms. Urology Volume 94 , 143 - 147 https://www.ncbi.nlm.nih.gov/pubmed/27211926 
8.Ziegelmann M, Viers B, McAlvany K et al. Restoration of Penile Function and Patient Satisfaction with Intralesional Collagenase Clostridium Histolytic Injection for Peyronie’s Disease. Journal of Urology. 195(4):1051-1056. 
9.Anaissie, J., Yafi, F. A., Traore, E. J., Sikka, S. C. and Hellstrom, W. J. G. (2017), Survey of patient and partner satisfaction following collagenase Clostridium histolyticum treatment for Peyronie's disease. Andrology, 5: 274–277. doi:10.1111/andr.12302
10.Coyne KS, Currie BM, Thompson CL, and Smith TM. Responsiveness of the Peyronie's Disease Questionnaire (PDQ). J Sex Med 2015;12:1072–1079.
11.Thoma, C. CCH injections reader effective by men with Peyronie’s disease. Nature Reviews Urology 2015;12:654 https://www.ncbi.nlm.nih.gov/pubmed/26526755 
12.Abdel Raheem, A., Capece, M., Kalejaiye, O., Abdel-Raheem, T., Falcone, M., Johnson, M., Ralph, O. G., Garaffa, G., Christopher, A. N. and Ralph, D. J. (2017), Safety and effectiveness of collagenase clostridium histolyticum in the treatment of Peyronie's disease using a new modified shortened protocol. BJU Int, 120: 717–723. doi:10.1111/bju.13932
13.Carson, C. C., Sadeghi-Nejad, H., Tursi, J. P., Smith, T. M., Kaufman, G. J., Gilbert, K. and Honig, S. C. (2015), Analysis of the clinical safety of intralesional injection of collagenase Clostridium histolyticum (CCH) for adults with Peyronie's disease (PD). BJU Int, 116: 815–822. doi:10.1111/bju.13120
14.Yafi, Faysal A. et al. Results of SMSNA Survey Regarding Complications Following Intralesional Injection Therapy With Collagenase Clostridium Histolyticum for Peyronie’s Disease The Journal of Sexual Medicine , Volume 13 , Issue 4 , 684 -689 
15.Yafi,Faysal A.et al Multi-institutional Prospective Analysis of Intralesional Injection of Collagenase Clostridium Histolyticum, Tunical Plication, and Partial Plaque Excision and Grafting for the Management of Peyronie's Disease Urology , Volume 120 , 138 -142
16.Surgical Treatment of Peyronie’s Disease: A Critical Analysis Kadioglu, Ates et al. European Urology , Volume 50 , Issue 2 , 235 – 248
17.Nehra, Ajay et al. "Peyronie's Disease: AUA Guideline” Journal of urology vol. 194,3 (2015): 745-53 
18.National Institute for Health and Care Excellence.: https://www.nice.org.uk/Media/Default/About/what-wedo/NICE-guidance/NICEtechnology-appraisals/Block-scoping-reports/Batch-43-block-scoping-reportnoCIC.pdf