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Peyronie's Disease

 

Xiapex Injection for Peyronie’s Disease

Based on current scientific evidence, Xiapex is the only non-surgical treatment that has a significant impact on the peyronie’s plaque and on average leads to a 35% reduction in penile curvature – however, the results vary significantly from patient to patient with some patients experiencing even greater improvements.

 

How does it work?

The signs and symptoms of Peyronie’s disease are caused by a collagen plaque. Injection of Xiapex into a Peyronie’s plaque, which is comprised mostly of collagen, may result in enzymatic disruption of the plaque. Following this disruption of the plaque, penile curvature deformity and patient bother caused by Peyronie’s disease are reduced.

formation

 

Our doctors have been trained exclusively to administer Xiapex injections and we have integrated this treatment option as a first line of treatment for Peyronie’s disease (learn more about our treatment protocols here).

The results of our patients to date are very encouraging and in our opinion, this treatment option completely changes the landscape of Peyronie’s disease management, allowing patients for the first time to start treating Peyronie’s disease from the onset of the disease.

To find out more about this novel treatment option, then please contact our Patient Co-ordination team on {Telephone Number} or read our Frequently Asked Questions below.

Xiapex Treatment FAQs

 

What results can I expect?

Several clinical studies have established the effectiveness of Xiapex in breaking up the Peyronie’s plaque and reducing penile curvature. Based on the latest studies, on average, the curvature reduction was around 35% – for example, if your curvature was 90 degrees then a 30% reduction would mean that after the treatment the curvature would be less than 60 degrees.

However, these figures are average. Our practical experience suggests that individual results vary significantly. We have seen patients with 60 degrees that had complete curvature correction even after 1 injection, whereas others that after 3 injections saw little improvement.

 

How soon will I see results?

Following a Xiaflex injection, your doctor will instruct you to start mechanical modelling for a month which increases the effectiveness of the injection.

Assuming that you follow the post-injection instructions within a few days from the injection and over the next month you will start noticing a gradual reduction in your curvature.   

 

Am I a good candidate for Xiapex?

During your consultation, your doctor will evaluate whether you are a good candidate for Xiapex treatment. The patients with the following characteristics might not be good candidates:

  • Suffering from severe erectile dysfunction;
  • Curvature is more than 60 degrees;
  • Have a ventral (downward facing) curvature;
  • Their plaque is calcified; and
  • Still experience pain.

Since Xiapex is a novel therapy, the Xiapex treatment protocols and candidate criteria are still being studied and might change in the future. For example, when Xiapex was first evaluated as a treatment option for Peyronie’s it was only tested on patients in the chronic phase of the disease. However, practical experience suggests that patients in the acute phase might actually derive more benefit from the treatment as long as they are appropriate candidates.

 

How many injections do I need?

This is also an evolving research area and the short answer is that the number of injections will depend on the effectiveness and evaluation of the result, post-injection, from your doctor. As mentioned, results vary significantly from patient to patient but your doctor should be able to evaluate whether the treatment is likely to work for you after 2-3 injections.

Our protocol usually involves 3 injections one-month apart each, although some patients might only need only one injection and others more. Initial studies suggest that after 8 injections, it is unlikely to be any further improvement of the curvature.

So in summary, the number of injections will usually be between 3 and 8 for most patients.

What should I do in between injections?

After each injection and for one month (until the next injection) you would need to follow a regime called penis mechanical modelling which will increase the efficacy of the injection. The regime we propose to our patients is the following:

  • Vacuum pump therapy twice daily for 10 min each
  • Gradually pump penis (making sure you don’t over pump once it’s erect)
  • Leave erection on for 30 sec
  • Deflate and start again (5times)

 

  • Penile stretching exercises – each time you go to the toilet, gently and gradually stretch the penis until maximum (10 times). Alternatively, a penile stretching device can be used for 4-8 hours (the longer the better) a day some patients find this difficult.

 

  • Penile modelling – each time you have an erection, gently try to straighten the penis.

Your doctor will show you exactly how to apply mechanical modelling and will instruct you how soon to start after the injection.

 

Who will perform the Xiapex Injection?

Xiapex injections can only be performed by uro-andrologists that have received training specifically for administering and managing Xiapex.

 

Do I need to be hospitalized?

No. The injections take place in a consulting room in an outpatient basis and consist of four steps:

  1. Preparation of the medication
  2. Injection of local anaesthetic and a drug that induces an erection
  3. Injection of Xiapex
  4. Penile modelling from the doctor

 

The whole process is minimally invasive and together with the doctor consultation takes around 45 minutes.

steps

What is the cost of Xiapex?

The cost of each injection is £1450, which includes the consultation cost. Unfortunately, Xiapex as a novel drug is still very expensive but the cost is still significantly less than surgery. Some insurance companies cover the cost of Xiapex and you might be able to get reimbursed. Please also note that Xiapex is only available as a private treatment and not offered in the NHS.

 

Are the results permanent?

Xiapex dissolves the plaque and the results are permanent. In some very rare cases, some patients develop new Peyronie’s plaques, which would also need to be treated.

 

Is the injection itself painful?

The injection is performed under local anaesthesia and hence for most patients it is not painful.

 

Will there be pain after the treatment?

Normal swelling and bruising will develop after the injection and some patients might find this painful.   Pain can be usually treated with standard oral painkillers.

 

How soon after treatment can I have sex again?

Do not have sex or have any other sexual activity for at least 2 weeks after each injection with Xiapex and after any pain and swelling has gone away.

 

What if the treatment doesn’t work?

Most patients should see a significant improvement after a course of Xiapex. However, for some the residual curvature might still impede intercourse or bother them. In such cases, surgical correction of the residual curvature would need to be considered.

 

What are the potential complications of the treatment?

Most adverse reactions are local events of the penis and groin and the majority of these events are of mild or moderate severity, and most resolved within 14 days of the injection. Most frequently reported adverse drug reactions (>25%) during the Xiapex clinical studies were a penile haematoma, penile swelling and penile pain. The most severe complications were one incident of a penile fracture (<1%).

I am suffering from a what I suspect is Peyronies disease, what should I do next?

If you believe you are suffering from Peyronies and it causes you significant concern we advise you to see a specialist urologist/andrologist.


Our doctors have vast experience treating Peyronies and our clinic is an international referral centre for patients suffering from this condition. We would be happy to review your case and treat you in our clinic.

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