New bump after first Xiaflex shot?

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shrugs

Has anyone developed a new bump/plaque after a Xiaflex shot?

Had my first shot a week ago and it was more uncomfortable than I expected. The shot itself wasn't too bad but after I removed the bandage, I developed major swelling and bruising... The swelling subsided after three or four days but I'm still a bit bruised up, sore, and swollen a week later.

I wouldn't be so concerned but there's a new bump where I don't remember one before, and it's more prominent than the plaques I had before beginning Xiaflex. It's also painful to the touch and I'm constantly in a low level of soreness throughout the day depending on how much pressure is on it. I was able to have a few nocturnal erections over the past week so I know things are still somewhat functional.

I saw the urologist for my second injection today and after an exam he actually put off the next injection for three more days for the swelling and tenderness to go down. So it'll be ten days between shots.

My uro said the new bump was a fracture in the plaque and that's it's a good thing overall for the plaque to be breaking up.

I have to admit I had second thoughts about continuing treatment and was concerned the bump could be a tunica rupture or other adverse reaction... I don't remember having a prominent bump of plaque where this is.

Last thing I want is for Xiaflex to make my condition worse, but maybe it's doing what it's supposed to in breaking up the plaque?
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.

johndoe

@shrugs,

Wow I'm in the exact same boat as you.

Just finished my second shot (1st round) two weeks ago. My first shot was painless and only mild swelling occurred after. After the second shot a few days later however, I had significant pain (sharp pains felt throughout the penis), major swelling and bruising that last days and as you have experienced also a new bump, soreness and now painful erections which weren't painful before.

I had about a 30-40 degree curvature exactly mid shaft to the left and some slight hourglassing due to the peyronies. I was able to have full erections without pain and intercourse no problem and opted for treatment which admittedly was more so for cosmetic reasons only after reading all the outcomes posted here.

I'm starting to worry that the xiaflex may have made my condition worse as I now have painful erections. As of now the curvature hasn't improved nor gotten worse so I'm thankful for that.

I'm hoping more forum veterans can chime in on this thread and shed some light on what's going on.
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shrugs

Johndoe, well, it's reassuring that perhaps this is a common occurrence in the first round! But yes, more input from veterans would be great... I'm trying to decide what to do next.

I also only had about a 30ish curve up/left too and could have intercourse prior to Xiaflex (though the intercourse had to be somewhat "careful" to be honest), so I've been debating whether to even go forward with the second shot of round one after such a rough last week. Been a lot of handwringing lately over whether I could have tried traction and daily PDE's for longer before resorting to this.

However, now I have this painful bump and figure the rest of the injections will probably be focused on it, trying to get it to reduce in size, which I realize is now my main goal. I did some self-exams today and have come to the conclusion that my doc is probably right, what happened was a thin plaque spread across the top of my shaft may have "snapped" after Xiaflex did its thing and could be bunched up on one side. Which is... good? Maybe. Haven't really been able to judge my erections in my state.

I've resolved to proceed but will have a word with my uro before the shot, confirming if the injection will be at the site of the plaque/bump and stressing that my side effect profile was intense last time... I will mention that I'm less about going for the best possible outcome and more about avoiding the worst possible outcome. Moderate to slight improvement is fine by me.

Also, I don't mind if he doesn't use every last drop in the syringe and will tell him so. In my opinion, it's possible that the volume of Xiaflex routinely injected is more than enough for the intended effect and may even be excessive for me judging by how widely it spread bruising. I'm going to ask him to take it easy.

I'm not sure of the protocol but I've seen in other posts on this forum that uro's like Dr. Lue have given less volume of a shot when a patient has encountered severe swelling and bruising.
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.

TDix

47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

samsung

Johndoe and shrugs, in exact same boat. My pain is constant. Painful erections. Flaccid constant pain. Sometimes worse, sharper than others. Can't do traction or modeling at all. Next shot coming up in 2 weeks. Don't even see the point of it if can't do traction and causing more pain.

Shrugs, your bump seems like might just be injection site swelling/hematoma like tdix says.
45 y.o. Single. Onset of symptoms (pain-stinging like a wasp) @ 6/2018. No sudden injury. Curve developed slowly. 40 deg. dorsal. Hourglassing. Torsion to left flaccid. 4 rounds xiaflex. Restorex, DMSO+, heat, arginine, cialis, lipoic acid, vit. K2

johndoe

This is good stuff fellas. We need more vets to chime in and continue to share our experiences.

I to am also debating whether or not I should go for my third and fourth shot (2nd round) in a couple of weeks.

The good news in my case is that every day things get better and better. The bad news however is that I don't know what the xiaflex is doing in my case.

Prior to xiaflex it felt like I had a hard patch of cartilage directly mid shaft on the left side of the penis. Xiaflex was injected right into that "cartilage" and that hard patch now feels like a very hardened putty if that makes sense.

So on one hand I can feel it doing something to the plaque but on the other I'm getting the swelling, bruising, soreness, painful erections and of course no visible improvement in the curvature.

Modeling is possible but it was very painful at first but getting less and less painful every day. The pain level was at about a 9 couple of days post 2nd injection with some really painful nocturnal erections that would wake me up in the middle of the night and not allow me to go back to sleep. Everyday since has gone done one level: 8, 7, 6, 5, 4, 3 (current pain level).

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melting

I wonder why there's no additional treatment for the side effects of the XIAFLEX inejections. This comes up frequently.
Seems to me that the XIAFLEX itself does great stuff but the way it's administered creates possibly more problems.

Logically if someone has underlying problems with inflammation and reacts bad to penis injuries/manipulation this can create new faulty tissue.  

Do we know how long the Xiaflex is staying in place, doing it's magic, it's half life? If it's short people should think, IMO, about treating the side effects/hematoma etc. with transdermal anti-inflammatories.(if they don't interfer with Xiaflex doing it's magic)  
Daily Transdermals and Traction/VED solved my Peyronies Disease https://www.peyroniesforum.net/index.php/topic,12587.0.html (DMSO+X)

samsung

My pain is doing the opposite of yours Johnd. It goes up a level every day. And I can't take any drugs to relieve it. I am going insane with pain. Like someone sticking a red hot scalpel in it.
45 y.o. Single. Onset of symptoms (pain-stinging like a wasp) @ 6/2018. No sudden injury. Curve developed slowly. 40 deg. dorsal. Hourglassing. Torsion to left flaccid. 4 rounds xiaflex. Restorex, DMSO+, heat, arginine, cialis, lipoic acid, vit. K2

TDix

I had the same feelings Samsung.  Again, sounds like an internal hematoma, which are very painful.  Trust me I know.  I had internal and external after my shots
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

samsung

Thanks tdix. I'm really hoping it is something like an internal hematoma. Can that occur weeks later, after the 2nd shot though?

I hope it isn't some kind of inflammation flare up that lasts a long time. Some people on here in pain for years. I was never in pain prior to the xiaflex. Well, for a few days I was but then it subsided. This has been lasting and getting worse.
45 y.o. Single. Onset of symptoms (pain-stinging like a wasp) @ 6/2018. No sudden injury. Curve developed slowly. 40 deg. dorsal. Hourglassing. Torsion to left flaccid. 4 rounds xiaflex. Restorex, DMSO+, heat, arginine, cialis, lipoic acid, vit. K2

shrugs

Thanks for the feedback, guys. If that bump is an internal hematoma, I hope my doc doesn't try to inject right into it!

He seemed to think it was a piece of plaque during the exam when he put off the second shot.

It does seem to be going down a bit now that I'm ten days after the first shot. The main thing I'm worried about is where he's going to inject #2. I can't feel much distinct plaque besides that bump, but I know there's still some in there...

For me, the pain is steadily improving since the injection so I guess I'm fortunate in that. And prior to starting Xiaflex, I did have some pain with erections so it isn't like things were all rosy beforehand...

I was able to do traction after 48 hours even with swelling and discomfort, but I was pretty gentle to start out. Oddly, at first I felt tension in areas during modeling but that's largely gone now, so maybe I stretched something loose though I don't remember an event.

My flaccid state is also bigger since the injection, but I'm not sure if that's because Xiaflex loosened the plaque or because I still have some swelling.

Metling, it's true that the side effects of Xiaflex are considerable and the most my doctor recommended was ibuprofen... Wish there were some better remedies for the discomfort!
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.

shrugs

Had my second shot of round one today... The doc examined the bump and said it's a fractured piece of plaque with likely an internal hematoma beneath. I asked if the injection would be at that spot and he said unfortunately yes, it's the biggest plaque and the one to target.  :o

He gave me the option of putting it off another week. After considering it, I decided to go ahead. The bump had gone down a little so I figured might as well go for it.

The injection itself hurt about the same as the first, but the side effects were worse this time. Less swelling so far, but a stronger burning pain developed after a couple hours that radiated down to my feet at times. I went back to work after the shot, which is probably something I wouldn't do again.

I also got chills later in the afternoon and come home to take my temperature and find out I have a low fever?  

Only a couple reports of fever on this board, but the official patient instructions say it could be a sign of infection and to call the doc. I didn't find out about my fever until into the evening, so I'm not sure whether I should call tonight or see if it subsides in the morning.

Definitely an Advil PM night!
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.

melting

Well, theoretically a fewer is a good reaction if there's anything to combat within your body.
Makes all sense that the area is acting up due to the shot and due to the plaque breaking up. You can imagine the tissue around it isn't happy for now and has to deal with the new circumstances.

Now theoretically the Xiaflex would also prevent new calcification to come up. I still think docs should add something to the treatment that calms the area of injection and plaque break up. At least ramp up possible oral treatments. The simple Vitamin C(ascorbic acid) is needed to create healthy collagen(take in many small doses orally cause of short half life). MSM supplement can help too.  
(I would go for some transdermals but that's an alternative treatment and DIY)
Daily Transdermals and Traction/VED solved my Peyronies Disease https://www.peyroniesforum.net/index.php/topic,12587.0.html (DMSO+X)

shrugs

Fever broke overnight but still felt a bit under the weather today...

I will say there was a lot less bruising/swelling on the second shot.
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.

P47D

Howdy SHRUGS,
I also had a developed lump/hematoma associated with some extreme pain during the second round of Xiaflex shots.  I think that since my primary Dr. was out, and the APRN did the injection, he may have pulled the needle out a bit too far during the injection and some of the Xiaflex got into the right cavernosum chamber during the second injection of the second cycle.  The following morning when I removed the coflex tape and gauze to change it the right side of my penis bulged out and began to inflate with excruciating pain!  The bulge started adjacent to the injection site and expanded as it moved down the shaft towards my pelvis - it felt like a red hot fireplace poker was being slowly pushed into the right cavernosum!!!  This may have been the worst pain I have ever experienced in my life...I was standing in the bathroom, frozen in my tracks, shaking with pain, and unable to move...terrible.  After a few minutes I was able to slowly grab some gauze and gingerly wrap the entire length of the shaft from base to glans - that hurt too.  I just held it gently and after about 10 minutes the pain was down enough to wrap it with coflex stretch tape - gently - and let it compress back down.  From that day forward there was a long firm mass running through the center of the right corpus cavernosum chamber and it was very sensitive.  This mass stabilized and became rather firm and along its length there were large diameter spots and small diameter spots.  Imaging a long tube sock with several balls of decreasing size spaced slightly apart...that's what it resembled.  Over the next few months it SLOWLY went away.  In the final phases it was just a few small BB sized had nodules centered in the right corpus cavernosum chamber.  My impression is that the Xiaflex did some damage to the soft tissues since it is not supposed to be in that area, only supposed to be directly into the plaque.  Clinical warnings say this and my symptoms seem to match up with the warnings.  Although this bumpy mass is gone, the right side cavernosum is to this day slightly more "puffy" when the penis is flaccid and I can feel a slight difference in the structure of the right side Dartos Fascia and Buck's Fascia when I gently pinch the side of the shaft.  All in all, although noticeable it is quite inconsequential.  And since the plication surgery fixed all the dorsal bending issues, I am happy and do not worry about it.

If you have severe pain, rapid and progressive bulging/swelling, and this hematoma it may be from misplaced Xiaflex or leakage out of the plaque.  I can only suggest a proper full wrap with the coflex stretch tape IMMEDIATELY AFTER EACH INJECTION and keep it on for at least 36 hours...then change it quickly...then check every 24 hours until the swelling and pain subside.  Good luck...I feel for you!

-P47D
Trauma induced 74 degree vertical dorsal curve in OCT 1916 - after 3 years, success with plication.

shrugs

Thanks for that detailed response, P47D, that's helpful and sounds like a likely explanation for what happened during my first injection.

Both times I left the coflex wrap on for about 12 hours--even though my uro's protocol is 4 hours max to prevent any swelling around the edges of the bandage. So I'm not sure if it was the wrapping procedure as much as the placement of that first shot. Something definitely went amiss with the first injection, the bruising and swelling were severe and the second shot wasn't nearly as bad.

Almost three weeks later, there's still a firm bump on the right side that's painful when I apply pressure. If I examine it, it's sensitive enough that it'll be mildly sore for hours afterwards. I think it's gotten slightly smaller and less sensitive but it's tough to say for sure.  Whether it's an internal hematoma, a fractured piece of plaque, soft tissue damage in the corpus Cavernosum, I don't know but it wasn't there prior to the shot.

I really wish it would resolve because it's the only adverse effect left from my first round at this point. It's too early for intercourse, but I know it would be a complicating factor the way it is currently. Your time table of a few months to go away is the longest I've heard but lines up with how slowly any progress is happening for me. As long as the bump clears, I'll be happy but I'd like it to clear up ASAP.

All in all, these side effects have put me off on continuing Xiaflex treatment. My second round doesn't begin for three weeks but as of now I'm leaning towards calling it off...
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.

shrugs

Just wanted to update, now around 5 or 6 weeks since my first shot that caused the "bump" AKA hematoma and it's nearly gone, though still a little tender on that spot.

So if you find yourself with something similar, don't panic, any new lumps will hopefully go away with time!

Of course just in time for me to begin round two next week...
Early 40's. Completed 4 rounds (8 shots) of Xiaflex in early 2020. Using low-dose Cialis and Citrulline to maintain decent results.