Xiaflex is an FDA‑approved, non‑surgical injection therapy used to treat Peyronie’s disease in men who have significant penile curvature caused by collagen plaques. This therapy uses collagenase clostridium histolyticum, an enzyme that breaks down excess collagen within the plaque, helping reduce curvature and improve sexual function.
Table of Contents
- What Is Xiaflex for Peyronie’s Disease?
- Quick Facts About Xiaflex Peyronie’s Treatment
- How Xiaflex Injection Therapy Works
- Why Xiaflex Matters for Men’s Health
- Benefits of Xiaflex for Penile Curvature
- Potential Risks and Side Effects
- Consent, Communication, and Expectations
- Xiaflex and Other Medical Conditions
- When to Seek Professional Help
- Frequently Asked Questions About Xiaflex Peyronie’s Disease
- References and Further Reading
- Disclaimer
What Is Xiaflex for Peyronie’s Disease?
Xiaflex for Peyronie’s disease is an injectable medication containing collagenase clostridium histolyticum, an enzyme that breaks down the collagen-rich scar tissue (plaque) responsible for penile curvature. Peyronie’s disease occurs when fibrous plaques form inside the tunica albuginea, often leading to curvature, pain, and difficulty with sexual activity.
Xiaflex is currently the only FDA-approved non‑surgical treatment specifically designed to address Peyronie’s plaques. Treatment involves a series of injections directly into the plaque, followed by physician‑guided penile modeling and at‑home stretching exercises.
Key Takeaways
- Xiaflex Peyronie’s treatment is FDA‑approved for men with significant penile curvature.
- It reduces curvature by breaking down collagen within Peyronie’s plaques.
- Treatment involves several in-office injections plus penile modeling.
- It is most appropriate for stable Peyronie’s disease—not active inflammation.
- Many men experience meaningful curvature reduction and improved sexual function.
- Side effects are generally mild but may include bruising, swelling, or temporary pain.
- Severe complications, including corporal rupture, are rare but possible.
- Xiaflex does not work for all men and is not recommended for minor curvature.
- It is also used for Dupuytren’s contracture in the hands.
Quick Facts About Xiaflex Peyronie’s Treatment
| Category | Summary |
|---|---|
| Medication Name | Xiaflex (collagenase clostridium histolyticum) |
| Approved Use | Peyronie’s disease with palpable plaque and curvature >30 degrees |
| Other Uses | Dupuytren’s contracture |
| Treatment Type | Non‑surgical injectable therapy |
| Goal | Reduce curvature and improve sexual function |
| Typical Protocol | Up to 4 treatment cycles, 2 injections per cycle |
| Best For | Stable plaques and significant curvature |
| Common Side Effects | Bruising, swelling, tenderness |
| Serious Risks | Penile injury or corporal rupture (rare) |
How Xiaflex Injection Therapy Works
Xiaflex breaks down collagen in Peyronie’s plaques, allowing the hardened tissue to soften and remodel. The therapy is designed for men with stable disease, meaning curvature has not changed for several months. Treatment occurs in cycles, each involving two injections into the plaque and a penile modeling session by the physician.
How Treatment Typically Progresses
- A doctor identifies the plaque and injection site.
- Xiaflex is administered using very small needles.
- Men return 24–72 hours later for the second injection.
- Several days later, the doctor performs penile modeling.
- At-home stretching is performed according to provided instructions.
This process may be repeated up to four times depending on results.
Why Xiaflex Matters for Men’s Health
Peyronie’s disease can affect a man’s physical comfort, sexual performance, and emotional wellbeing. Many men experience anxiety, shame, or reduced confidence because of penile curvature or difficulty with intercourse.
Xiaflex offers a non‑surgical option that avoids the risks of invasive procedures such as penile shortening, grafting, or implant surgery. For many men, it provides a middle-ground solution that improves function and comfort without requiring major medical intervention.
Benefits of Xiaflex for Penile Curvature
Men who undergo Xiaflex treatment often report:
- Reduced penile curvature
- Improved penetration comfort
- Greater sexual confidence
- Less emotional stress related to Peyronie’s disease
- Avoidance of surgery and its risks
Not every man responds fully, but studies and clinical experience show many benefit significantly from gradual plaque remodeling.
Potential Risks and Side Effects
Xiaflex is generally safe but carries risks. Most side effects are temporary and occur near the injection site.
Common, Mild Side Effects
- Bruising
- Swelling
- Pain or tenderness
- Temporary lumps
- Mild skin discoloration
Less Common but More Serious Risks
- Penile hematoma
- Bleeding or prolonged swelling
- Allergic reactions
Rare but Serious Complications
- Corporal rupture (penile fracture)
- Significant penile injury
Risk Reduction Strategies
| Risk | Prevention Strategy |
|---|---|
| Excess Bruising | Follow post‑treatment instructions carefully |
| Injury During Sex | Avoid sexual activity until cleared by a doctor |
| Modeling Injury | Only perform stretching exactly as instructed |
| Rupture | Report sudden pain, popping sensations, or deformity immediately |
Consent, Communication, and Expectations
Men are encouraged to discuss treatment goals, expected outcomes, and concerns with their partners and healthcare providers. Since Peyronie’s disease can create relational anxiety, open communication often reduces stress.
Key Considerations
- Set realistic expectations: Xiaflex reduces curvature but rarely eliminates it completely.
- Discuss emotional impacts: Many men feel uncertainty or fear around treatment.
- Address timing: Sexual activity restrictions may temporarily affect relationships.
- Share information: Partners often feel reassured when they understand the process.
Xiaflex and Other Medical Conditions
Men with certain medical issues may require additional discussion before treatment.
Conditions That May Affect Xiaflex Treatment
- Active Peyronie’s disease (inflammatory stage)
- Erectile dysfunction
- Bleeding disorders
- Anticoagulant medication use
- History of penile surgery
- Severe plaque calcification
Xiaflex may still be appropriate in some cases, but treatment plans must be individualized.
When to Seek Professional Help
Men should consult a urologist—ideally one who specializes in sexual medicine—if they experience:
- Difficulty with penetration due to curvature
- Painful erections lasting months
- Emotional distress or relationship problems linked to Peyronie’s
- Sudden worsening of curvature
- A popping sensation, severe bruising, or rapid swelling during treatment
Professional support ensures safe treatment and helps men work through physical and emotional challenges.
Frequently Asked Questions About Xiaflex Peyronie’s Disease
What does Xiaflex do for Peyronie’s disease?
Xiaflex breaks down collagen in Peyronie’s plaques, reducing curvature and improving sexual function.
The enzymes soften hardened tissue over time, especially when combined with physician-guided modeling. Many men experience meaningful improvements after several cycles.
Is Xiaflex safe for men?
Yes, Xiaflex is FDA‑approved and considered safe for most men with stable Peyronie’s disease.
Mild side effects are common; serious complications are rare. An experienced urologist helps minimize risks.
How effective is Xiaflex for penile curvature?
Xiaflex often reduces curvature by 20–40 percent.
Some men experience greater improvements, while others see smaller changes. Even partial correction can significantly improve sexual comfort.
Does Xiaflex cure Peyronie’s disease?
No, Xiaflex does not cure Peyronie’s disease but helps manage curvature.
The plaque remains but becomes softer and less restrictive. Most men still have some degree of curvature after treatment.
When is Xiaflex not recommended?
Xiaflex is not recommended for active, painful Peyronie’s disease.
It is also inappropriate for men with mild curvature, unstable erections, or certain medical conditions that raise risk.
Can Xiaflex help with erectile dysfunction?
Xiaflex is not an ED medication.
However, reducing curvature often improves sexual confidence and functional performance, indirectly benefiting erections.
How long does treatment take?
A typical Xiaflex course lasts several months.
Most men undergo up to four treatment cycles spaced weeks apart.
Does Xiaflex hurt?
Men may feel temporary stinging or pressure.
Bruising or tenderness afterward is common but usually mild.
When can I resume sexual activity after Xiaflex?
Doctors generally recommend avoiding sexual activity for several weeks.
Resuming too soon increases risk of injury.
Can I combine Xiaflex with traction therapy?
Some urologists recommend traction therapy to enhance results.
Always follow your doctor’s specific guidance before starting traction.
Will insurance cover Xiaflex for Peyronie’s disease?
Many insurance plans cover Xiaflex.
Coverage varies, so checking beforehand is important.
What if my curvature is too severe for Xiaflex?
Men with very severe curvature may require surgical options.
Your doctor will discuss the best approach based on anatomy and goals.
How do I know if Xiaflex is working?
Curvature may gradually reduce over weeks or months.
Your doctor will assess progress during follow-up visits.
What are the risks of Xiaflex injections for Peyronie’s disease?
Risks include bruising and swelling; serious complications are rare.
Prompt reporting of unexpected symptoms prevents complications.
Can Xiaflex be repeated in the future?
Some men may undergo additional cycles if medically appropriate.
Discuss long‑term planning with your healthcare provider.
References and Further Reading
- Major urology association educational materials on Peyronie’s disease
- National health service overviews of collagenase therapy
- Men’s sexual health foundations focusing on Peyronie’s disease research
- Peer‑reviewed articles on non‑surgical plaque treatment and collagenase therapy
- Sexual medicine guidelines from recognized professional organizations
Disclaimer
This article is for informational and educational purposes only and does not constitute medical or mental health advice. It is not a substitute for speaking with a qualified healthcare provider, licensed therapist, or other professional who can consider your individual situation.
