Treatment Schedule: Xiaflex (collagenase) for Peyronie’s Disease

By Dr. Alex Shteynshlyuger M.D.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4050


Xiaflex is an FDA approved biological medication for treatment of Peyronie’s disease.

Based on randomized controlled studies, Xiaflex is indicated for men with Peyronie’s disease typically classified as moderate to severe Peyronie’s disease.  Read more about patient selection for Xiaflex administration in men with Peyronie’s disease.

Initial Evaluation of Men with Peyronie’s Disease

Initial evaluation of men with Peyronie’s disease typically requires 1-2 visits to determine the extent of the disease and what treatment options are appropriate for each individual men. A Peyronie’s specific questionnaire will be filled out and can be downloaded from our Forms section of the website.

Peyronie'sCosts and Insurance Coverage

For those men who are good candidates for Xiaflex and who wish to undergo treatment with Xiaflex, we will work with insurance companies as well as charitable organizations to determine insurance coverage and out-of-pocket costs through the Xiaflex Experience service.  Discounts may be available to self-pay patients.  Insurance coverage may be available for international patients through their insurance policies.

What to expect during a doctor visit?

The doctor will typically measure the penile curvature after injecting the penis with Trimix or prostaglandin to induce an erection.  Men with curvature greater than 30 degrees are candidates for Xiaflex. Penile ultrasound may be performed to document plaque.

Treatment Schedule: Xiaflex for Peyronie’s disease

Initial 1-3 Appointments: 

Comprehensive history will be obtained and a physical exam will be performed.  An artificial erection will be induced to evaluate the extent of Peyronie’s disease and to measure the curvature as well as to evaluate the Peyronie’s plaque.  If the patient is a good candidate for Xiaflex and chooses to proceed with Xiaflex treatment, an informed consent will be obtained; the risks and benefits of Xiaflex will be discussed.   Xiaflex is usually available within 1-2 days for self-pay patients. Insurance authorization typically takes 2-3 weeks.

Week 1

Xiaflex Cycle 1:

  • Day 1 Cycle 1: One Injection of Xiaflex 0.58 mg into the plaque that causes curvature (Injection #1)
  • Day 2-4 Cycle 1: One Injection of Xiaflex 0.58 mg into the plaque that causes curvature (Injection #2)
  • Day 6-8 Cycle 1: Penile remodeling by the  urologist – the patient will be taught how to perform it at home
  • Weeks 2-7:  Patient does penile remodeling by himself three times daily at home. No office visits necessary unless questions or problems arise.
  • If the curvature becomes <15 degrees, no further treatment with Xiaflex is needed.

Xiaflex Cycle 2:

Week 8:     Start of Xiaflex Cycle #2: same as cycle 1 above.

If at any point, penile curvature becomes <15 degrees, Xiaflex treatment will be stopped as it is considered a successful response; most men with a curvature of fewer than 15 degrees are minimally symptomatic.

Xiaflex Cycle 3:

Week 15

Xiaflex Cycle 3: same as cycle 1 above.

If at any point, penile curvature becomes <15 degrees, Xiaflex treatment will be stopped as it is considered a successful response; most men with a curvature of fewer than 15 degrees are minimally symptomatic.

Xiaflex Cycle 4:

Week 22

Xiaflex Cycle 4: same as cycle 1 above.

If at any point, penile curvature becomes <15 degrees, Xiaflex treatment will be stopped as it is considered a successful response; most men with a curvature of fewer than 15 degrees are minimally symptomatic.

What to Expect:

In studies of men with Peyronie’s disease treated with Xiaflex, 60% of men experienced improvement. Please read more about expectations and success rates of Xiaflex in the treatment of Peyronie’s disease.

If no improvement after 4th cycle, further cycles are currently not considered to be beneficial, except for men who have multiple plaques.  Treatment of other plaques may be attempted.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4050

Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men with Peyronie’s disease.


 

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