Peyronie’s Disease FAQ. Xiaflex treatment

What are the Symptoms?

The three ways if you know you have Peyronie’s disease in the hallmark are:

  • an abnormal plaque or scar tissue,
  • pain with an erection,
  • or deformity or curvature.

Those are the three hallmarks of Peyronie’s disease.

What is a Plaque?

 A plaque is scar tissue; it’s not like the plaque you have in your heart, it’s typically like a scar calcified piece of tissue, which results in an abnormal curvature of the penis when it’s erect.

Can Peyronie’s Disease cause problems with erections?

Peyronie’s disease can actually cause problems with erections. We believe that as men get greater curvature (greater than 60 degrees), it becomes more prohibitive for intercourse, typically when the curvature so severe, men are not able to penetrate. In many times the partners experience pain during intercourse. Also as a penis curves, it makes it more difficult to get blood flow past the distal part of the penis.

Is penile fracture Peyronie’s disease?

Penile fracture occurs during intercourse, where there’s actually a rupture of something called the tunica albuginea. Penile fracture is not Peyronie’s disease, and penile fracture can result in Peyronie’s disease.

What conditions are associated with Peyronie’s disease?

There are many conditions that are associated with Peyronie’s disease. The most common are Dupuytren’s contracture, which is an abnormal scarring of the hand. Studies have shown that up to 20% of men with Peyronie’s disease will have a Dupuytren’s contracture. Others are tympano sclerosis, which is scarring of the ear; we also know that diabetes, beta-blocker use, even now low testosterone usage has been implicated in Peyronie’s disease.

Can Peyronie’s disease turn into cancer?

There’s no data to support that the scar can increase the risk for cancer.

Can Peyronie’s disease cause psychological problems?

Peyronie’s disease can cause significant psychological problems. Studies have shown up to 48% of men who have Peyronie’s disease suffer from some degree of depression. It also can cause a significant impact on the partner as well.

Xiaflex for Peyronie’s disease

Xiaflex is an enzyme derived from a bacteria called Clostridium histolyticum. And it’s a very specific enzyme derived from bacterial species that dissolves collagen, which is the major component of scar tissue, which is to say Peyronie’s plaque. These other medications are taken orally, they go through your digestive system, and there’s no peer review data that shows, they do anything really powerfully against Peyronie’s like certainly nothing even close to Xiaflex accomplishes.

You have to realize that Xiaflexis injected directly into the scar tissue plaques and dissolved it. It sounds really dangerous; the fact is a drug itself is a purified form of that enzyme, so it does not involve the bacteria, it doesn’t spread or causes kind of problems. It does appear to be effective and safe.

Studies on Xiaflex

There is a paper that has already been published electronically. There was clinical trial “Xiaflex versus placebo.” This study Involves 800 men approximately, both in the United States and Australia. And it shows that in terms of correcting curvature and in terms of improving subjective responses on a questionnaire about symptoms, Xiaflex outperformed placebo with statistical significance. So it is effective.


The safety profile in this study was quite acceptable because of black and blue, some bruising, there were some tears of the corpora cavernosa or so-called ruptures; about three cases of that were repaired surgically in this group of 800 patients. A couple of cases of hematoma, where blood accumulated and needed to either be aspirated, one case had to be drained surgically. But for the most part, there were very few complications or problems that didn’t resolve on their own within 14 days. But the important thing is, despite the fact that 90% of patients developed antibodies against this, there was no hypersensitivity allergic reactions, anything of that sort in this group.


In the most current paper, the one that’s published online, it causes on the average something like 34% decrease in penile bending compared to the patients, who got a placebo, where they experienced about an 18% decrease in penile bending. And you have to realize that the placebo group in this clinical trial was actively being treated by stretching or modeling. So it was what we call it “active placebo,” it wasn’t like they got nothing at all, they were getting stretching as well, which probably helped a little bit. But the patients, who got Xiaflex, were getting Xiaflex followed by modeling or stretching of the penis, and they improved considerably more than the patients, who received placebo.