NHS (UK). Injections. Is there someone better than Prof David Ralph

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Hi guys,
I am based in the UK and have an NHS appointment to see Prof David Ralph in the UCLH (London).

However, I am concerned that reports on his personality (here), and his primary focus on 'implants', may actually mean he is not the best consultant to see on the NHS.

My condition is not as severe as many, there is no serious bend, just the hard plaque that has reduced length (1 inch) and reduced hardness of erections. Therefore I am looking for Verapamil (or Xiapex / Xiaflex) injections instead.

I now have chronic phase peyronies, 15 months since it happened.

Please can anyone recommend another NHS Urologist (for injections) that may be more suitable than Ralph? ... Perhaps another specialist in the UCLH: https://www.uclh.nhs.uk/our-services/find-service/urology/andrology

... or perhaps another hospital altogether.

Any feedback would be most welcome.

Thank you

Peyronies onset #1: AUG-2021: Upward bend 1 inch below glans. Corrected after approx 6 months of VED.

Peyronies onset #2: NOV/DEC-2022: Downward & right bend 1 inch above base. Not corrected by VED.



I went to see Dr Ralph about 4 months ago for lifelong ED and I was also concerned with report of poor bedside manner. I was therefore surprised to find him really approachable, very friendly. I had many, many question on implants - I think he was a bit surprised by number and depth I wanted to ask but I wanted to get my monies worth. He was fantastic.

So I went there to sort out implant surgery and we talked about that a lot but he said if you've not tried injections then lets do one now. So without expecting it I injected myself with Alprostadil 10mcg under his instruction.  I expected it not to work but it did give me some hope.

Unfortunately, the Injections with Alprostadil need higher and higher doses over the four months Ive been using it, and the alprostadil pain is getting quite unpleasant. I've moved to Invicorp which has been amazing but again the amount I am having to use to get the same results is advancing at an alarming rate to the point I realize that the implant is back on the cards.

So in brief, Dr Ralp is THE guy I would go to for implants, he doesnt push it at all. In fact he really wanted me to exhaust everything before I got to that stage, he was an engaging, easy to approach man. Like all of us maybe the others who thought he was abrupt had just caught him on a bad day?

BTW - Anyone who goes to Sheffield Urology - they were so bad at prognosis (that I had pyronies when I did not) providing just outdated and poor information on injections and implants - Do NOT go there. They will break your heart.  
Age 47
Had ED all my life, tried all the meds
Dupuytren's with mild peyronies


Xiaflex injections on the NHS? I thought they were only available through a select few private providers at like £2500 per injection here?

If you can get them on the NHS for free I wouldn't care if it was Hitler doing the injections providing he was qualified so I wouldn't read too much into bedside manner in this instance  
32 yo UK
Engaged with two young children
Injured 2017, healed
RE injured Sept 2022
Chronic flaccid pain since 2nd injury
Starting 5mg cialis daily, trying to obtain pentox online

Possible hard flaccid, possible Peyronie's, possible nerve damage


I know this is not answering your question, but Dr Ralph never suggested an implant to me; he proposed plication. I found him to be friendly and reasonable.

Regarding alternatives: There is a chap in Birmingham, Chris Anderson I think, with a good reputation. Not sure if he is NHS though and not sure if he does injections. For a second opinion though, he might be worth a try.
Late 50s
Nesbit Procedure July 2023 which was successful
Official diagnosis 12/2021: Bend at the end @70 degrees upwards/@35 left



As far as I know, neither Verapamil nor Xiaflex is available through the NHS. Last thing I heard (Aug 2022) is that Xiaflex is currently only available at an extremely high cost, around £7,000 per injection. Verapamil is available for £3,000/6 sessions but I do noit think you can get that through the NHS.

I had Verapamil injections through London Andrology and I can recommend them, but you will have to pay for it as you would for private healthcare. I saw DR Minhas and Yap, both very good.

My only contact with the NHS has involved urologists recommending Penimaster or the like, or surgery.
Early 30s, diagnosed with Peyronies in 2017 after trauma during sex. ca 15 degrees upward curvature. Restorex, VED, 5mg Cialis, Pentox, L-arginine, Coq10, Propolis, Vitamin E. Underwent 12 rounds of Verapamil injections 2021-22


I suffer from Peyronie's disease, and I also suffer from Erectile dysfunction. I understand that there is a process of taking blood and injecting into the penis that can help some people. Has anyone tried this? Does it work?   Different suppliers seem to use different names. Is it the same process?
Diagnosed with Mild Peyronies disease