Authors Justin Y.H. Chan Division of Urology, Department of Surgery, University of Toronto https://orcid.org/0000-0001-7952-9123 Abdullah Alhamam Department of Urology, Imam Abdulrahman Bin Faisal University Luke Witherspoon Division of Urology and Men’s Health Centre, The Ottawa Hospital (Civic Campus) Ottawa, Canada Jason K. Rivers Department of Dermatology and Skin Science, University of British Columbia Ryan K. Flannigan Department of Urologic Sciences, University of British Columbia DOI: https://doi.org/10.5489/cuaj.8852 Keywords: Peyronie's Disease, Penile Curvature, Erectile Dysfunction, Penile Induration, Laser Therapy Abstract

INTRODUCTION: Fractional CO2 laser therapy is used to treat fibrosing conditions similar to Peyronie’s disease (PD). The aim of the study was to evaluate the safety and efficacy of using a fractional CO2 laser in the management of chronic phase PD.

METHODS: This was a single-site, non-randomized, open-label study using a fractional CO2 laser. Subjects underwent three treatment sessions every six weeks with a fractional CO2 device. Topical triamcinolone was applied immediately after each treatment. Between treatments, patients performed penile modeling three times daily. Penile curvature assessments, self-reported questionnaires, and adverse event screenings were completed at baseline, 24 weeks, and 52 weeks.

RESULTS: Five patients were included in the study. The median baseline penile curvature was 37.0° (interquartile range [IQR] 33.0°, 53.0°), and at 52 weeks, this had reduced to a median curvature of 28.0° (IQR 17.50°, 44.0°, p=0.03), representing a median reduction in penile curvature by 24.3% (IQR 17.0%, 47.5%). The International Index of Erectile Function Overall scores were comparable at baseline and at 52 weeks (median 59.0, IQR 42.5, 66.5 vs. median 60.0, IQR 53.5, 70.0 respectively, p=0.81). Patients did report significant improvement in overall Peyronies’ Disease Questionnaire scores from baseline to 52 weeks after laser treatment (median 26.0, IQR15.0, 29.5, vs. median 14.0, IQR 7.0, 22.50, respectively, p=0.03). Four patients reported self-limiting side effects immediately after laser therapy that resolved spontaneously within two weeks.

CONCLUSIONS: With encouraging results at 52 weeks, fractional CO2 laser therapy may serve as a well-tolerated and minimally invasive therapy for PD in the future.

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Chan, J. Y., Alhamam, A. ., Witherspoon, L., Rivers, J. K., & Flannigan, R. K. . (2024). Fractional CO2 laser for the treatment of Peyronie’s disease: A pilot clinical trial. Canadian Urological Association Journal, 19(2), 25–31. https://doi.org/10.5489/cuaj.8852

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