Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[BadLuck]

Hello, the urologist that I am seeing does not follow the official Xiaflex schedule of two injections one to three days apart. 
His office does one injection followed by a second injection four weeks apart.

How many of the Xiaflex vets here have followed this schedule?

I'm a little worried since this is not the official protocol.

[TonySa]

I’ve heard of various protocols to save expense.  You might try googling it

[BadLuck]

I called US Bioservices and spoke with a pharmacist who said she had never heard of a protocol that was outside the range of 1 to 5 days between first and second injection as stated in the protocol.
Hence my question and concern. 

[TonySa]

I’ve seen alternative protocols here from certain docs.  Maybe search forum tho might be hard to find.  If you don’t trust it maybe go w another doc.  Of give it a try...nay be able to do it twice as long for same price.  Just be SURE To do TRACTION between shots which improved outcomes,

[BadLuck]

I would get another doc, but this urologist is apparently one of the "experts" in the US.  It's taken me years just to get to this point. 

[TonySa]

Are you including traction?

[Shane43]

This is a modified schedule developed a few years ago that had results compared to the FDA approved schedule. This is summarized below from the attached medical journal article that reviewed the procedures. It makes sense to me, though my urologist is following the approved traditional schedule and that seems to be working for me, albeit with more pain etc. than you would have with this shortened schedule. I would not discount your doctor's approach, he may just be more progressive than my (and most) doctors.

"More recently, Abdel Raheem et al [66] evaluated the efficacy and safety of CCH administration using a modified and shortened treatment protocol in 53 patients at a single center. In their shortened protocol, each cycle consists
of only one injection with a larger dose of CCH (0.9 mg; whole vial), rather than two injections of the dose (0.58 mg each) outlined by Gelbard et al [6,59,61,62] in earlier studies (Fig. 1). This method allows higher concentrations
of CCH to be delivered to the plaque while limiting the inflammatory changes that occur with more injections. Furthermore, limiting the frequency of injections in the modified protocol and having patients complete the modeling themselves at home, allows patients to
complete treatment in only four patient visits over a 12-week period (Table 1). This undoubtedly improves compliance and reduces costs associated with CCH treatment. More importantly however, this shortened modified protocol demonstrated a mean curvature reduction
of −17.4° (−31.4%) from baseline. This is comparable to the results obtained in the IMPRESS trials, which yielded mean curvature reduction of −17° (−34%) from baseline [66]. Moreover, there was an improvement in each of the IIEF questionnaire domains, all 3 PDQ domains,
and the global assessment of the PDQ."

The original paper is here, but I do not have a copy of it:
Abdel Raheem A, Capece M, Kalejaiye O, Abdel-Raheem T, Falcone M, Johnson M, et al. Safety and effectiveness of collagenase
clostridium histolyticum in the treatment of Peyronie’s disease using a new modified shortened protocol. BJU Int 2017. doi: 10.1111/bju.13932

[BadLuck]

Shane, thank you very much Shane for posting this information.  What is the consensus as far as traction after the Xiaflex injection?  How soon after the injection and for how long and under what tension should traction be performed?

Thanks again.

[TonySa]

Dr Lue is convinced that adding traction to xiaflex is crucial to maximize improvement.  I’ve forgotten the protocol, but posted it before.  It’s something like waiting about four or five days after the second injection to start traction until the next round and repeat.  Try to search the forum to see the exact protocol.

[BrettC]

I was told not to use traction by my urologist during the Xiaflex treatment.  I would say just be very careful if you do it to avoid any possible injuries or ruptures. 

First injection of xiaflex today.

Started by ziogwe Xiaflex Injections

Weird... Did I Really Get a Xiaflex Injection?

Started by BadCheetah Xiaflex Injections

Work schedule & Xiaflex

Started by Nitrometer2332 Xiaflex Injections