Xiaflex injection schedule

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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.

Mid 50's
Diagnosed with Peyronies in 2014.
Treatments have included Verapamil injections, Pentox, and Xiaflex.
Currently using RestoreX

TonySa

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

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.  
Mid 50's
Diagnosed with Peyronies in 2014.
Treatments have included Verapamil injections, Pentox, and Xiaflex.
Currently using RestoreX

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,
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.

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.  
Mid 50's
Diagnosed with Peyronies in 2014.
Treatments have included Verapamil injections, Pentox, and Xiaflex.
Currently using RestoreX

TonySa

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.

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
62YO, hourglass indent/hinging at base 30deg bend up 3cmx2cm hard plaque at dorsal base. No ED. 3 rounds Xiaflex decreased plaque/indent/hinge/bend. 1 year later, penis went from 7.5 to 5.5 in, but only 15 degree bend and no hinging.

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.
Mid 50's
Diagnosed with Peyronies in 2014.
Treatments have included Verapamil injections, Pentox, and Xiaflex.
Currently using RestoreX

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.
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.

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.  
52 years old
Diagnosed 5 years ago with an upward curve of 60-65 degrees.
Completed one full round of treatments with Xiaflex (8 injections)  Measured curve 40-45 degrees after that
Using Restorex and took oral medications as well (Pentox Cials)