Questions to Ask Uro re: Xiaflex treatment

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metoo2

Hey Guys,

I recently saw a new urologist (for me) and he suggests we go the Xiaflex route for treatment. He recommends adding traction as he's seen better results when they are paired together.

I've read some of the posts on this thread and want to ask for advice: what questions should I ask him before I start the treatment?

He wants to start with an ultrasound and then, if insurance approves, start Xiaflex. He does the injection, then 2 weeks off with no sex/masturbation followed by 4 weeks (6 weeks total) of normal activity between rounds of the xiaflex. I'm not sure how soon after the injection he does the modeling and recommends I do it.

So far, this is what I'm going to ask. But I don't know what I don't know so for those who have gone thru the treatment and know more now, please help me.

Here's my questions so far:

1) Do we need an injection to provide an erection for the ultrasound? Can we do the ultrasound without it?

2) Which kind of anesthetic (injection or cream) is used before the actual xiaflex? If it's an injection, where is the injection? How much? Can we skip the injection?

3) How much time do you advise before "modeling" after the xiaflex injection?

4) How much time do you advise before starting traction after the xiaflex injection?

5) How can we reduce the chances of rupture/side effects?

6) Which kind of bandages/dressing do you recommend after the xiaflex injection?

7) Does he consider his method more aggressive or conservative (I definitely prefer a more conservative approach).

8 ) What are the most common side effects he sees in his patients?

9) What does he recommend as far as pain relief?

That's what I have so far. I'd really appreciate input as to what else to ask. Thank you all.  

james1947

metoo

I think you covered everything :)
Can you tell us what were the answers after your appointment?

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

curved

I will do my best to respond given my experience.... I head into my 4th and final round next week.

1- My uro did not do an ultrasound because the plaque location was obvious from the physical exam; however I don't believe you need to have an erection to locate the plaque via ultrasound.  Definitely have an ultrasound done if the uro can physically locate the plaque and therefore know exactly where to inject xiaflex.  He may want to provide an injection to produce an erection to measure the degree of curvature....this allows him to measure progress.  I supplied several pictures and he was able to estimate off of that.  You need to have at least a 30 degree curvature to qualify for xiaflex treatments

2- You can receive an anesthetic but I was told the anesthetic injection was more painful that the xiaflex because they are delivered in 2 different size needles....the xiaflex is smaller.  So you can skip it. That being said I found it painful so I use a topical cream (lidocaine based) which doesn't help a ton but is better than nothing

3- I was told to model immediately after injection and you uro may want to counsel you on how best to do it in the office after your first shot....there does seem to be some variance based on uro for how often and how long.  I was told 3x day for 90 seconds and gently straighten at night only once if I have a nightime erection

4- I may not be the best to answer on traction but for whatever it is worth I waited until 5 days after my second injection to do traction...primarily do to the bruising from the shots

5- A rupture can only happen if you have an erection so it is critical to avoid sexual activity for the first 2 weeks after your second injection of each cycle. during the trials the only reported ruptures were those that had sex prematurely after the injection.  However a hematoma is very possible.  I have had 2 out of my 6 shots thus far... and they were very painful for me.  I will attempt to mitigate this by having a coflex bandage in place between the two shots are for two days after my second shot which means I will not start modeling immediately.  My understanding is that the hematoma is a bit of a crapshoot.... the penis is a very vascular body part and nicking a blood vessel is a possible consequence.  On both occasions the swelling took approx. 2 weeks to disappear

6- I don't want to speak for QuackAttack but he recommended I use a Coflex bandage which I will next week

7- My uro said his approach was standard.... he did not recommend traction because he had seen a lot of clinical data.  i have reviewed some data and know some of the leading uros are including traction in their protocol.  There are separate threads on traction and the pros and cons

8- Number 1 side effect is swelling.... you will get it but don't be too worried.  Number 2 is a hematoma which can be scary so if it happens get in to see your uro as soon as you can to make sure it is nothing more serious

9- Ibuprofen is what has been recommended....but outside the shot itself and the hematoma the pain wasn't too bad.

Please let me know I can answer anything else.... and again, this has just been my experience.  And for what it is worth I started with a 40degree bend down and to the left and am currently at approx 20 degrees....so really good improvement
51 yrs old; diagnosed 3.5 yrs ago; 90 degree upward bend
But I had no ED
tried all pills, VED, traction, Xiaflex PRP, ESWT, H-100 & stem cells; IF diet. implant surgery with Dr. Eid 3/28/19
to correct deformity - 20 CM Titan 2cm RTE / 1 cm RTE

JohnWright

I didn't see these questions:

How many guys have you personally treated with this therapy?

If the definition of success is a 99% straight dick, can you describe actual results your patients have received?

What have you read recently about results of this therapy?

-------

Important questions, as I didn't encounter any specialists in 2016, among the four I spoke with, who actually believe this therapy delivers results to many men.

QuackAttack

Curved,

I tried something after my 4th cycle injections that were amazingly helpful. I used a very strong 200+ gauss magnet wrapped inside the Coflex for 4 days. There was ZERO, absolutely ZERO swelling or bruising. I got my magnet from Lyon Legacy in Wisconsin. My package will never have another injection without it. Magnets are well known to prevent swelling which is one reason that Copper Fit uses them in their stuff.

curved

QuackAttack--- thanks for the suggestion...will definitely try it!
51 yrs old; diagnosed 3.5 yrs ago; 90 degree upward bend
But I had no ED
tried all pills, VED, traction, Xiaflex PRP, ESWT, H-100 & stem cells; IF diet. implant surgery with Dr. Eid 3/28/19
to correct deformity - 20 CM Titan 2cm RTE / 1 cm RTE

lukewill

Quote from: QuackAttack on March 13, 2017, 08:42:13 PM
Curved,

I tried something after my 4th cycle injections that were amazingly helpful. I used a very strong 200+ gauss magnet wrapped inside the Coflex for 4 days. There was ZERO, absolutely ZERO swelling or bruising. I got my magnet from Lyon Legacy in Wisconsin. My package will never have another injection without it. Magnets are well known to prevent swelling which is one reason that Copper Fit uses them in their stuff.

Hi QA

Do you mean a magnet like this?

Magnet 2500 Gauss. Powerful 2500 Gauss magnets, 10 magnets with plaster. | eBay

or

https://www.amazon.co.uk/RELIEF-XTRA-Magnetic-Therapy-pack/dp/B00GEDNQCQ/ref=pd_sim_60_4/256-4064555-9286507?_encoding=UTF8&psc=1&refRID=C9NC6N0C5KDCEVF3M90E

QuackAttack

Luke,

Here is the exact magnet. I swear by it. Three prior cycles of Xiaflex and always some swelling, more if not wrapped for several days, less if wrapped. This time none. Every time dark purple/blue bruising that has left my penis looking like a brother from another mother because it isn't the same color it started. This time no discoloration.

https://www.lyonlegacy.com/Products/601and5060.aspx

lukewill

Quote removed by moderator. Please read the forum rules. Answer by click on "REPLY and not "Quote" button

Lol brother from another mother ! Thanks for the info. That is crazy fascinating re the use of magnets in healing. Have been reading up on it since your post. I wonder if would aid in peyronies healing in general other than the whole xiaflex bruising swelling thing.