Disclosure: Work supported by industry: yes, by Endo Pharmaceuticals. A consultant, employee (part time or full time) or shareholder is among the authors (Endo). 109 PENILE PLICATION FOR SEVERE PEYRONIE’S DEFORMITIES HAS SIMILAR PATIENT REPORTED OUTCOMES TO MILD CASES Reddy, R. 1 ; McKibben, M. 1 ; Shakir, N. 1 ; Liu, J. 1 ; Davenport, M. 1 ; Morey, A. 1 1 University of Texas Southwestern Medical Center Introduction: Penile plication (PP) is proven to be an effective and common treatment for mild to moderate Peyronie’s Disease (PD), but scant data exists on outcomes of PP for men with severe or complex deformities. We compared long-term outcomes following PP among severe and mild PD patients in our large single surgeon cohort. Objective: To evaluate long-term outcomes among men undergoing penile plication for Peyronie’s disease, comparing severe with mild to moderate penile deformities. Methods: We performed a retrospective review of patients who un- derwent PP for PD between 2009-2017. All patients underwent multiple parallel tunical plication without degloving via a longitudinal penile incision regardless of degree of curvature. Severe PD was defined as either curvature 60 degrees, bi-planar curvature 35 degrees, or hourglass deformity. Patient demographics and surgical outcomes were analyzed. A modified Peyronie’s Disease Questionnaire (PDQ) and International Index of Erectile Function (IIEF-5) were administered by telephone. Results: Of 327 PP patients, 102 (31%) responded to the telephone survey at a median 59.5 months (IQR 28.3-84) since surgery. Patients were equally distributed into severe (n¼51) and mild/moderate groups (n¼51). Despite a greater mean degree of curvature in severe compared to mild/moderate patients (71.6 degrees vs. 37.7 degrees, respectively, p<0.001), correction of penile curvature was achieved in nearly all, with a mean change of 60.7 degrees in severe cases compared to 31.4 degrees in mild/moderate cases (p<0.001). Equal numbers of patients in severe and mild/moderate groups reported improvement of penile curvature (74.5% vs. 74.5%, p¼1.0) and sexual function (51.0% vs. 49.0%, p¼0.84). PDQ metrics were likewise similar between severe and mild/ moderate patients (p>0.1), as were subjective penile shortening (62.7% vs. 62.7%, p¼1.0) and IIEF-5, both preoperatively (19.5 vs. 19.7, p¼0.9) and postoperatively (19.4 vs. 17.6, respectively, p¼0.15). On multivariate logistic regression, worsening sexual function was significantly associated with increased age (OR 0.94, p¼0.028) and time since the surgery (OR 0.97, p¼0.009). Conclusion: PP is an effective surgical correction of severe PD, with similar PROs compared to patients with milder curvature. Similarities between PDQ and IIEF in simple and complex cases supports a broader application of PP beyond mild disease. Disclosure: Work supported by industry: no. 110 SAFETY AND EFFICACY OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM IN PEYRONIE’S DISEASE MEN WITH VENTRAL CURVATURES Alom, M. 1 ; Meng, Y. 2 ; Savage, J. 1 ; Kohler, T. 1 ; Trost, L. 1 1 Mayo Clinic; 2 Washington University in St. Louis Introduction: Prior studies evaluating the impact of collagenase clos- tridium histolyticum (CCH) on Peyronie’s disease (PD) have excluded men with ventral curvatures. However, as ventral curvatures had his- torically been treated with other intralesional therapies without higher rates of complications, we began offering CCH to men regardless of direction of curvature. Given the absence of data on ventral curvatures, we sought to review our CCH outcomes stratified by direction of curvature. Objective: To report outcomes of men undergoing CCH injections for PD based on initial direction of curvature, including absolute and percent improvement in curvature, adverse events (AE), and other subjective outcomes. Methods: A prospective registry has been maintained of all men undergoing CCH injections at our institution. All men underwent curvature assessments and subjective questioning at the time of initial evaluation and following 2 and 4 series of injections. Injections were performed based on the original phase III CCH trial protocols with minor modifications (patient-performed modeling, injection performed on erect penis). To review outcomes, clini- copathologic data were abstracted from the registry and medical record to including relevant history, exam, and data obtained at the time of penile ultrasound and curvature assessment. Curvature data are reported as end- point measures (defined as either the interval or final curvatures, whichever is most recent). Results: A total of 228 patients (mean age 57.2 years) were identified from March 2014 through December 2017 and comprise our study cohort. Baseline PD factors included disease duration (mean 24.3 months), primary curvature (mean 52.9 degrees), secondary curvature (mean 11.4 degrees), and direction of curvature (dorsal component 83%, lateral 50%, and ventral 11%). Overall, men with ventral and lateral curvatures experienced greater relative improvements in curvature compared to dorsal (ventral 29.5 degrees [49%], lateral 11.4 [38%], dorsal 15.0 [25%], p<0.05). Ventral and lateral also experienced higher rates of more significant improvements (see Figure 1 for breakdown of likelihood of percentage improvement in curvature based Figure. Patient reported outcomes of penile plication for peyro- nie’ s Disease comparing severe and mild cases (n ¼ 84). Figure 1. Relative improvements in penile curvature based on direction of curvature. E.g. 31% of men with ventral curvature experienced 75% or more improvement in curvature compared to <5% of men with dorsal (red arrows). J Sex Med 2019;16:S1eS143 S56 19th Annual Fall Scientific Meeting of SMSNA