Xiapex Injection for Peyronie’s Disease
Based on current scientific evidence, Xiapex is the only non-surgical treatment that has been proved to have 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 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 results in enzymatic disruption of the plaque. Following this disruption of the plaque, penile curvature deformity and patient suffering caused by Peyronie’s disease is reduced.
Our doctors have been trained exclusively to administer Xiapex injections and we have integrated this treatment option as a first stage 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 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 treatment, please contact our Patient Co-ordination team on 02031312933 or read our Frequently Asked Questions below.
Xiapex Treatment FAQs
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, the curvature reduction was around 35%(on average) – for example if your curvature is 90 degrees then a 30% reduction would mean that after the treatment the curvature would be less than 60 degrees.
These figures are estimates and our practical medical experience suggests that individual results vary significantly. We have seen patients with 60 degree curvature that achieved complete correction after 1 injection, whereas others that after 3 injections saw little improvement.
Following a Xiapex injection your doctor will instruct you to start mechanical modelling over a month, increasing the effectiveness of the treatment.
Assuming that you follow the post-injection instructions within a few days and over the next month, you will start noticing a gradual reduction in your curvature.
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 as good candidates:
- Suffering from severe erectile dysfunction;
- Curvature is over 30 degrees;
- Have ventral (downward facing) curvature;
- Their plaque is calcified
- Still experience pain.
Since Xiapex is a new therapy, the Xiapex treatment procedure and candidate criteria are still being studied and may 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 our doctors experience suggests that patients in the acute phase might actually derive more benefit from the treatment as long as they are appropriate candidates.
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, by our doctor. 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 or even less.
Our protocol usually involves 3 injections, one-month apart each although some patients might only need only one injection or others more. Initial studies suggest that after 8 injections, it is unlikely to be any further improvement of the curvature.
An average estimate is a treatment plan of between 3 and 8 injections for most patients.
After each injection and over one month (until the next injection) you will 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 on erection for 30 sec
- Deflate and start again (5times)
- Penile stretching exercises – each time you go to the toilet, gently and gradually stretch the penis till at maximum length (10 times). Alternatively, a penile stretching device can be used for 4-8 hours (the longer the better) a day although some patients may find this difficult.
- Penile self modelling – each time you have an erection, gently try to straighten your penis.
Your doctor will show you exactly how to apply mechanical self modelling and will instruct you on how soon to begin after the injection.
Xiapex injections can only be performed by uro-andrologists that have received specialist training specifically for administering and managing Xiapex.
No. The injections take place in a consulting room in an outpatient basis and consist of four steps:
- Preparation of the medication
- Injection of local anaesthetic and a drug that induces an erection
- Injection of Xiapex into the plaque affected areas
- Penile modelling instruction from the doctor
The whole process is minimally invasive and together with the doctor, consultation takes around 45 minutes.
The cost of each injection is £1950, which includes the consultation cost. Unfortunately Xiapex as a new drug is still very expensive but the cost is still significantly less than surgery. Some insurance companies cover the cost of Xiapex. Please also note that Xiapex is only available as a private treatment and not offered by the NHS.
Xiapex dissolves the plaque and the results are permanent. In some very rare cases, some patients develop new Peyronie’s plaques which will also need to be treated.
The injection is performed under local anaesthesia and is not painful.
Normal swelling and bruising will develop after the injection and some patients might find this painful. Pain can be usually treated with standard oral over the counter pain killers.
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.
Most patients should see a significant improvement after a course of Xiapex. However for some the residual curvature might still impede intercourse or cause concern. In such cases, surgical correction of the residual curvature would need to be considered.
Most adverse reactions are local minor, mild complications to the penis and groin area and most are resolved within 14 days of the injection. The most frequently reported adverse drug reactions (>25%) during the Xiapex clinical studies reported were penile haematoma, penile swelling and penile pain. The most severe complication was 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.