Dr. Harold Reed Blog

Tag Archives: Xiaflex

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

 

Peyronie’s (FAQ) | Treatment | The Reed Centre for Ambulatory Urological Surgery

Dr. Reed, Any specific recommendations for treating Peyronie’s?  Have 60 degree ventral (downward) angulation which makes penetration near impossible.. Neil Der Neil, You have my sympathies. Every year or so the American Urological Association  (AUA) update the guidelines for treating Peyronie’s There are 2 stages.   The first is the active phase which include pain…Continue Reading

Xiaflex for Peyronie’s Disease redux

Xiaflex (collagenase clostridium histolyticum of CCH) has been out since about 2010, 1st for Dupuytren’s contracture (palmar) contracture of the hand.  The FDA approved Xiaflex for the treatment of Peyronie’s disease in December 2013.  My opinion as to the practical value considering the results and cost has not been laudable to say the least.  But…Continue Reading

Peyronie’s with lateral curvature

Dear Dr. Reed,  What approach would you recommend for Peyronie’s with lateral curvature.  Have had the condition for about 3 years, and has not worsened after the initial sexual trauma.  Can feel some plaque on the right, and curves to the right.  Able to have sex in  limited positions with occasional discomfort as noted by…Continue Reading

Peyronie’s surgery | Harold Reed M.D. | Miami

Dear Dr. Reed,  Had female above trauma about 4 years ago resulted in a pop, then bruise, then upward angulation, and loss of length.  Finally my ability to have sex is restored and manageable but at times uncomfortable for both of us.  My spouse remembers and said only once, she liked it better before.  Any…Continue Reading

Peyronie’s disease

Dear Dr. Reed, Had sex with my wife one night. She was on top and my penis slipped out and she came down hard and was told I developed a penile fracture. Did not have surgery. When the bruise went down the length was shorter and now curves to the left. Is this correctable? Ed…Continue Reading

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What to expect with Xiaflex treatment for Peyronie’s

Xiaflex (collagenase) Treatment Schedule for Peyronie’s Disease – Peyronie’s Clinic Xiaflex (collagenase) Treatment Schedule Plan for Peyronie’s Disease What to expect during a doctor visit? The doctor will typically measure the penile curvature after injecting the penis with Trimix or PG1 to induce an erection.  Men with greater than 30 degree curvature are candidates for…Continue Reading

One man’s opinion of Xiaflex for Peyronies, and his statistical analysis

(from http://www.mypeyronies.com/xiaflex-for-peyronies.html) FDA approved Xiaflex for Peyronie’s disease on 6th December 2013. Xiaflex is the first (and currently only) FDA approved treatment proven effective for Peyronie’s disease in men with a palpable plaque and a curvature deformity of 30 degrees or greater at the start of the treatment. This was a big day for men…Continue Reading

Peyronie’s, wife mildly uncomfortable

June 16, 2015 Dr. Reed, I have Peyronies, some bendeing to the left which is mildly uncomfortable for my wife. If my erections were stronger this might be exaggerated, yet I can penetrate. What do you suggest. Yashir Dear Yashir, First I would recommend therapeutic trial of Cialis to see if that makes any difference…Continue Reading