Traction and Xiaflex

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lmlalo

I have a question for guys on Xiaflex: Do you use traction instead of/in addition to modeling?

I asked my doctor about modeling and he said he didn't think it was necessary as he prescribed traction for two-to-six hours a day once any swelling and pain had subsided, and this could replace the need to do any modeling. I have been doing traction more in the vicinity of two-to-three hours a day, and have had no issues. But curious if other guys are using traction devices while on Xiaflex.

mike1379

My urologist at UCSF directed me to use a traction device from esl40.com rather than the "modeling" which he no longer believes is effective - at least in my case.

lmlalo

Great, thanks. Yeah, I've stuck with traction and managing to squeeze in 5-6 hours a day.

TonySa

Why would plaque softening in the tunica impact the testicles?
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Gutted

I haven't started Xiaflex yet but in my discussions with my Uro, he said he has altered the 'modelling' phase to be more strap based traction. Previously there was more emphasis on VED with him.

I'm not sure whether the 'modelling' program is slightly personalized based on how each individual's symptoms present but my Uro was quite specific about the emphasis on strap based traction now.

He said the prime treatment objective is reduction of curvature. This was said in the context of me asking about the effect of Xiaflex on my other symptoms of hour glassing (multiple) and thinning. Yes. it's bad  :(

So, it could well be that the emphasis on strap based traction is because the treatment objective is specifically curvature reduction. Although we all hope for more than curvature reduction, this is what the clinical treatment amounts to. i.e. when this treatment is available on the UK NHS, each patient will only get a limited number of injections (cost containment) so the bend is the only target as you cannot just keeping taking injections (unless you are paying privately)

I have heard of private patients initially addressing the bend and then continuing to pay for additional injections to attempt to improve the dents ..... does modelling change in this scenario ..... I don't know yet. But intend to cover this in my next meeting

WhatNext81

Modeling for sure and traction unless the dr has a specific reason for you not to. You should be given a xiaflex patient treatment guide with specific instructions on what to do and not do post injections.  
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Gutted

The modelling phase is the attempted reshaping of the plaque post injection after the collagenase has 'weakened' the plaque.

Modelling can consist of : by hand of Uro, VED, Traction and manual stretching yourself.

What has happened over time, is that different Uro's have altered the modelling phase according to their findings/experience, so there isn't a 'standard' approach to modelling anymore. That probably explains the different 'stories' people get.

My Uro, who is luckily the lead Xiaflex consultant in Europe (just under 1000 patients treated) has even changed the injection protocol. He has indicated that he changes the injection and modelling protocol depending on how each individuals symptoms present.

So, LMLALO, my opinion on the answer to your question is that, your Uro's view is that the traction-only he prescribed, is the modelling he thinks is appropriate for your Xiaflex treatment plan / symptoms