Violent Pain Post Injection

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Shafted

I just had the first shot of round 3 Xiaflex and have severe pain for the second time in a row, results below.

Round 1, shot 1: no pain, minor swelling and bruising.
Round 1, shot 2: no pain, moderate swelling and bruising

Round 2, shot 1: no pain, minor swelling and bruising
Round 2, shot 2: severe pain, severe swelling and bruising. Crotch area was conservatively the size of a softball.  Radiating shooting pain through my penis, pain like I've never felt before and pray to god I never feel again.

Round 3 shot 1, severe pain, minor swelling, no bruising.
Round 3 shot 2: scheduled.

Last night I was jolted awake by a shooting pain and what felt like a pop or click. I immediately noticed I had a nocturnal erection and went into the bathroom thinking I had a corporal rupture, looked at everything and seemed okay.  I thought maybe the plaque broke apart which, from what I've read, is a good thing.

I had almost no swelling today, in fact my first shot of round 3 was yesterday and I went for a long run this evening with no problem.  Tonight I fell asleep on the couch for a bit and woke up in violent pain and an erection.  I immediately and significantly started swelling at the injection site from yesterday.

My question is, has anyone else experienced similar pain with Xiaflex?
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Supermantat

Yes I've had the same excruciating jolt of pain with "morning wood" after 2nd, 3rd and now 4th injection.  I told my doctor it feels a fireball of broken glass and needles randomly exploded.  Doctor says this unfortunately normal and will eventually stop.  Frankly the pain is so exquisite I dread going to bed and am considering alternatives.
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Shafted

I'm pleased to report everything worked out.  While the pain was horrific, the results were worth it.
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jan.schaller1958

Oh my God! I'm going to be having Xiaflex injections myself. I knew the injections were painful, but they give you a numbing agent beforehand (or they better or I'm jumping off the table). But, I didn't know that you could have post-injection pain like that with night erections. That sounds horrible.

,,The pain was horrific, the results were worth it." wow. That doesn't sound good, but at the same time it doesn't sound horrible.  Sort of like, like no pain no gain.  
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Pfract

Hey Shafted. Nice to know it worked out for you, but how where the results you mentioned exactly?

Shafted

Jan - Don't sweat it, not everyone experiences the same side effects.  You could have significant swelling post injection and as you can imagine getting a nocturnal erection with a swollen Johnson is not exactly pleasant.  The plaques breaking apart is a good thing, but it's painful.

Pfract - In terms of results, the large plaques on top of my penis are gone entirely post Xiaflex.  My hour glassing is improved but not gone entirely.  My curvature yo and to the left is now only a few degrees to the point where sex with my wife is largely back to normal.  Erection quality is good for sex and my length and girth have improved.

Full disclosure, I have a plaque coming in near the gland and I will likely go through another round to tackle that fella.
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jan.schaller1958

I asked an internist experienced in Xiaflex and he said that was not true. Xiaflex could be a bit uncomfortable, but you get numbed first, and it doesn't cause all this after the fact pain. He said that was nonsense.  
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Shafted

I wish it were nonsense, but the pain in my case was very real.  Again everybody is different so you may have a different result.  I'm simply sharing my experience for the sake of helping this community.
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bustedchubb

From all the details that I've read here and other places, not to mention what my specialist has said, I would take reports of pain and complications seriously.  They are far more likely than negative side effects from say a cystoscopy.  Tdix on the forums here is the best example.  He had a fracture from his.   Not common, but happens more often than they have in their literature.
45 Yrs old, Peyronies Disease Onset 11/2019, Stabilized 6/2020.

Dent/Hourglassing distal and dorsal side, lost length and girth.

Underwent Plication with Dr. Brian Christine in Birmingham, AL on 6/17/2021. Fully recovered with no complications.

curved

Went through 4 cycles of Xiaflex (8 shots) and can attest that the sharp pain some have experienced is very real.  My urologist said I had 3 hematomas during the course of the shots.  Yes the pain is tough (for me roughly 60 seconds of fall to your knees type of pain), but I did initially get great results to where my severe curvature got back to just about normal.  Ultimately my Peyronies Disease came back and I went the route of an implant. But I would definitely suggest guys consider Xiaflex as long as they are good candidates (eg greater than 30 degree curvature, bend upwards or sideways and not downward, etc.). Most importantly I would make sure your urologist has experience administering the shots.  Don't take their word for it just because they say they are certified (I believe all one needs to do to be certified is to review a video).  I would definitely ask how many times they have administered shots and whether they use dopplar to pinpoint plaque or just by feel.
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

TDix

Yes I can attest this post injection pain is very real.  Don't want to discourage you but after my 3rd injection I ended up in the ER the next day with two huge external hematomas, and the following morning I experienced that morning pain during an erection, but inadvertently tightened my kegel muscles and it fractured.
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

PeyroniKirai

Hi TDix - I'm considering collagenase injections and read your horror story which is quite fear-inspiring.  Can you please explain what a "fracture" is?  What is actually breaking?  Was it that you had blood blisters because the injections caused internal bleeding, and the "fracture" is that the blood blister burst?  Do you have any material on this?  
Also, if you don't mind sharing, did you eventually recover from the "fracture", or not, and that's why your history talks about an implant?

Thanks & stay safe!
Age 64, Peyronie's history 4 years, left side hourglass, 20-degree bend to left, no ED

bustedchubb

45 Yrs old, Peyronies Disease Onset 11/2019, Stabilized 6/2020.

Dent/Hourglassing distal and dorsal side, lost length and girth.

Underwent Plication with Dr. Brian Christine in Birmingham, AL on 6/17/2021. Fully recovered with no complications.

TDix

My fracture was 2 days after my third injection.  I had woken up the day after with excruciating pain and when I unwrapped had two extremely larger hematomas.  I freaked out and went to the ER.  They had to call in my urologist as they had no idea how to deal with them, and he simply drained them and said I was fine.  Rewrappped me and sent me home.  The next morning I woke up in excruciating pain again, but still half asleep I tightened my pelvic muscles and felt a pop in my penis.  Immediate pain, heat, and my penis ballooned to an eggplant.
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

TDix

They did an ultrasound in the ER and said I did not have a fracture but after consulting with my current andrologist I believe I did.  I healed up afterwards, but it took a good 4-5 months before I was semi normal again
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

john.doe.550

"Last night I was jolted awake by a shooting pain and what felt like a pop or click."

I've had this jolting pain during sleep and when awake.  For me, it was only momentary and no lasting harm occurred.
Age: 65. Peyronies Disease in MAR 2019. 90 dgree upward curve.. Immediate &  severe. Xiaflex, APR 2019 to early 2021, slow but minor improvement through 2021. Incisional corporoplasty surgery completed in late 2022.