Dr. Harold Reed Blog

Category Archives: Xiapex

More on Xiaflex, Collagenease clostruidiumn histolyticum (CCH)

Xiaflex update appears In Sexual Medical Reviews , Volume 5, Number 4, October 2017.  A review of the literature is reported by 4 authors.   2 authors report conflict of interest in that they are investigators for Auxillium (the maker of Xiaflex in the US) and consultants for Sobi (the makers of Xiapex in Europe).     They conclude the safety and efficacy has been demonstrated in large well-designed clinical trials.

Adverse events were reported by 84% of the intervention group and only by 36% of the control group who were injected with a buffer soltuion not CCH.  The most serious side effect is corporal rupture which could occur if intercourse is initiated within 2 weeks after Xiaflex/Xiapex injection.  The average decrease in curvature was 29% in the CCH group but 11% in the placebo group.  80% in the CCH group has bruising including hematoma vs. 26% in the placebo group. Typical baseline curvature pre-op is about 52%.  At the end of the study curvature persisted in 35%, average curve improvement only 34.2%.

Some improvement but by no means anything close to a cure. Personally I am discouraged with the efficacy of Xiaflex, and what may appear to be a pharmacy driven promotion.

The authors do report while most men have residual curvature, they are happy if their improvement allows penetrable intercourse without surgery.  If surgery is needed, the remedy might be contralateral plication (or penile shortening) as opposed to lysis (cutting) and grafting the plaque which carries a high degree of risk.

Harold M. Reed, M.D.
The Reed Centre for Ambulatory Surgery | Miami

Peyronie’s before and after surgery pictures (dorsal angulation)

Peyronie’s before and after surgery pictures (dorsal angulation)
corrected with plaque lysis and insertion of Tutoplast bovine pericardial graft

Peyronie’s before and after surgery pictures (dorsal angulation)

Peyronie’s before and after surgery pictures (dorsal angulation) corrected with ventral plication