What is Xiaflex?
Xiaflex (clostridium collagenase) is a medication that breaks down collagen, the major component of scar tissue. It is delivered in a local injection directly into scar tissue or plaques and when used appropriately can significantly relax plaques.
Why might I need Xiaflex therapy?
Xiaflex is approved for treatment of Peyronie’s disease, a disorder in which scar tissue forms within the penis and causes curvature and difficulty with erections. To be eligible for Xiaflex you must have:
- An erect curvature between 30 and 90 degrees
- Stable disease – no pain or change in curvature for at least 3 months
- Adequate erections for intercourse, either with or without medical help
Prior to your first series of injections your doctor will perform an in-office erection assessment. This is essential to determining if this treatment is appropriate for you.
Preparing for your Xiaflex injection:
Xiaflex is injected in a series of office visits. No special preparation is required prior to these visits. You can eat normally, and take all of your medication unless otherwise instructed.
What happens during a Xiaflex injection?
If you do not have a palpable plaque (a plaque that can be felt on exam), at your first injection session an artificial erection will be caused with injection of a mixture of medications into the penis, using a very thin needle. Most patients have a palpable plaque and only require this test once, prior to initiating Xiaflex therapy.
- The penis will be cleaned with alcohol in the area of the plaque.
- A thin needle will then be inserted into the plaque itself, and the medication slowly injected to allow it to spread through the scar tissue.
- The needle is removed
- A small dressing it placed over the site
This process is repeated two days later in a slightly different location. On the third appointment, your doctor will demonstrate manual modeling (stretching) of the penis, which you will continue at home for 6 weeks.
Some patients may choose to purchase a penile traction device. Some penile traction devices have been shown to improve results with Xiaflex therapy. Your doctor can recommend brands. Insurance often does not reimburse the cost of these devices, but they can usually be purchased using HSA funds.
What can I expect after my Xiaflex injection?
Immediately after your injection you may have a small amount of discomfort or bruising at the site. The bruising can worsen over several days, but it usually not uncomfortable.
During manual modeling of the penis, you should not experience pain, but instead a “stretching sensation”. If you are feeling pain you are stretching too hard.
Do not have sex or masturbate for at least 4 weeks after the 2nd injection of the cycle.This can cause injury to the penis, potentially requiring emergency surgery.
What are the risks of Xiaflex injection?
The most common issue after Xiaflex therapy is bruising and discomfort at the site of injection. While rare, penile fracture, a breakage of the tubes that allow the penis to fill with blood, can occur. If this occurs, you will require an urgent surgical procedure to repair the injury. Approximately 1 in 100 patients experience this during their therapy.
