Dr Trost Xiaflex Results

[Sebtp1973]

What do you mean by wrapping while doing traction?

It means, I will be wrapped part time starting today, and when I do traction (Restorex and hand pulling) it should be when the wrap is still on.

The injections punch holes in the penis, and will cause swelling and bleeding. The wrap compresses the penis, preventing blood from leaking and swelling. Without the wrap, because Trost does so many injections (and injects while erect), your penis would turn into a purple swollen eggplant. He said hematomas are extremely painful, and I wouldn't be able to do traction if I got one. Trost's wrappings allows him to go aggressive with injections and traction, without causing hematomas and excessive swelling and bruising.

When doing traction, it disturbs and pulls around the injection site, and could cause reignition of swelling and bleeding. So I am supposed to be wrapped when I do traction for the next three days. After that, it should be sufficiently healed where I no longer need wrapping, even while doing traction.  

[Sebtp1973]

It's been two weeks since my Xiaflex treatment with doctor Trost, and maybe I should wait another two weeks before I give a final assessment, but here is my preliminary assessment.

Before I get there, first some background.

I began Xiaflex treatment with another doctor in summer 2022. This doctor does not induce an erection, he asks his patients to bring in a picture of their erect penis. He looked at my pic for three seconds and said 45 degrees. We got some improvement after the first series, and at the beginning of the second series he estimated the curve was 30 degrees. In total, I did three series with this doctor, with minimal to no improvement after the first series. Then I saw more pics of other people's curves on this forum and elsewhere, and knew my curve was way more than 30 degrees.

I did a free zoom call with Trost in January this year. He said I am eligible to be in a study of peyronies patients who did not get satisfactory results from the old protocols, to see if his protocols would work. He said I'd have to wait six months from my last series. My travel expenses would be covered and they would pay me $150 for my time. I sent Trost an erection pic, and he measured a 55 degree curve.

When I got there in person, he induced an erection and measured my curve with a protractor. This is the most accurate measurement. He said I had a 110 degree composite curve! 75 degrees up, 35 degrees left!

Anyway, what is my curve now, two weeks post Xiaflex treatment with Trost?

Pretty much Zero.

That's right, I'm ramrod straight now.

With a few caveats.

- [ ] There's no precise measuring going on, I'm just looking at it.

- [ ] Trost hasn't seen it yet, so this is my estimate. I see no curve at all.

- [ ] I have some residual swelling, which could be masking a slight curve. But even if that's the case, it would still have to be a very shallow curve. No where near the 75 up, 35 left curve I had pre-Trost.

- [ ] I look ramrod straight when I get erect , stand up, and look in the mirror at both sides, and when I look down.

- [ ] It's possible I'm not 100% erect. It looks like it is, but the residual swelling is giving me a lot of extra girth, making it look fully engorged. Trost says erections sometimes take time to come back fully, as Xiaflex is like "chemical surgery". I think it is fully erect though. I'm hopped up on tadalafil. Even if it is not 100% hard when I look at it, there appears to be a remarkable improvement in the curve.

- [ ] I do have some torque (which I had pre-treatment too), but that's not a big deal.

Other than that, the bruising is finally gone. I have no pain, including at the injection site. Other than some slight swelling, I am feeling fully healed. I'm almost tempted to try intercourse soon, even though I was advised to wait four weeks (two weeks from now).

I sent doctor Trost an email saying I look straight. He said congratulations! But keep doing traction as the body could rescar and sometimes people go 2 steps forward 1 step back.

I do have an indent on the left side, which looks no better or worse than pre treatment (let's see if I feel the same after all the swelling subsides). I'm also around 3/4 inch longer (bone pressed stretched). It looks visibly bigger now, both erect and not erect.

So, preliminarily, I am confident to say I got remarkable improvement from Doctor Trost's aggressive protocols.

My preliminary assessment is that I no longer have any curve, or if I do (see caveats above) it would have to be no more than 10-15 degrees.

I'll provide another update as time goes by, and provide Trost's assessment when I get it. He said I can send a pic in a few weeks or come back for evaluation. I might be in Utah for a business trip this summer, and may stop in his clinic for an in person final assessment.  His in person measurements are more accurate than picture measurements.

Looks like I'm a "one series" guy.

I would say several factors went into my successful outcome, but a major one, something I read was part of his protocol  but I didn't fully grasp the significance of until he did it, is inducing an erection and injecting at the point of maximum curvature. Because of that, he was able to precisely break the plaque apart exactly where it was causing my curve when he pulled on it right after the second injection (with about 20 pounds of force!).

He said guys in this study (guys with unsatisfactory results from other doctors using the standard protocols) are doing really well so far. He thinks the other doctor's treatments softened up the plaque a lot. Then he requires six months from the last shot before he does his treatment, and he thinks that healing time helps out a lot. So when he gets a patient like me, the plaque is already softer and loosened up, and responds well to his protocols.

His office is mailing me a check reimbursing my travel expenses plus $150 for my time. Not a bad deal.

 

[richestorags]

That's awesome man, congrats. I sound like a broken record, however, RestoreX use seemed to be a critical factor in my treatment outcome. I still use it 30 minutes a day and what little curve was left after Xiaflex actually seems to be decreasing. This may be a poor analogy, however, as a kid I had braces for two years to correct an underbite and gap teeth. After the braces came off, the orthodontist was adamant about use of a retainer to preserve the correction, otherwise he was concerned that the problems would recur. That's how I'm looking at RestoreX with this situation....continue to use it and no going back to a bent d!ck. Rock on.  

[Sebtp1973]

Doctor Trost responded to my email, and says I should continue doing traction for at least one month after I am completely healed to prevent recontracture. As I feel healed except for some swelling, I suspect I can stop in June, but might keep going to July.

I'm doing 30 minutes a day, straight traction. I graduated to the extension rods (thank you very much) and as documented on here, it is very hard to counterbend with the extension rods, because they get in the way. Further, I don't have a bend (thank you again) to counter. So I will stick with straight traction at least for now.  

[Sebtp1973]

It's been over four weeks since my Xiaflex treatment by Dr Trost. I remain ramrod straight. From 75 degrees upward curve (plus 35 left curve) to a virtually zero curve. From that perspective, a huge success.

Now that the swelling is gone, I see a big dent on the left, and small dent on the right. Dr Trost told me the dents would become more prominent after straightening, and he was right. There's a narrowing I wasn't expecting. Girth is fine coming out of my body to about halfway down my shaft, then there's like a ring around the shaft, then it is narrower. Not sure anything can be done about that. I guess there remains some circumferential plaque.  

Big success, but I wish I had my pre-peyronies penis back.

I had intercourse, and it works. I was getting diamond cutter erections thinking about having sex with my wife when I had to wait the four weeks, but when the actual time came it took a little time to get hard. It's probably mental, worrying about my performance and if everything will work and if she'll like it and all that. I was always a guy that got a boner even before the clothes came off in anticipation of sex. But it did get hard, and intercourse worked, and both me and my wife got our Os. I take daily tadalafil and I get Diamond cutter morning wood, so I guess physically everything works.

Part of me has anxiety about the narrowing, and if that will be a problem over time. I will ask Dr Trost whenever he contacts me about follow up (I'm in a study , so he will need pics or an in-person visit to close the loop). Also, part of me is worried I'll get new plaques from intercourse if I'm not sporting a diamond cutter at all times. Probably all in my head.

Maybe I will post pics here some day.
 

[bent_narsil]

I'd be interested to know if he thinks using RestoreX would help with the indents and narrowing as suggested by some on here and the study.

[Sebtp1973]

Since I had intercourse on May 15, I've had some (very mild) discomfort around my penis head. I'm hoping it's just irritation of the skin from the Restorex clamp. But part of me has anxiety that I have inflammation from the intercourse, and a new plaque will form. It's difficult to really pinpoint where the discomfort is coming from. When I touch it, I can not locate the location of the discomfort. Ugh, this blasted disease!

Part of me wants to take a break from Restorex to see if the irritation goes away. But, if you are developing a new plaque, traction is supposed to help mitigate the effects. So I guess I'll keep doing Restorex.

I remember in early 2022, I had some similar irritation, but no new plaque emerged. When I went for xiaflex six months later, the doctor felt only one plaque (which I got in 2019-2020).

When I first developed peyronies in 2019, I felt a dull pain in the ridge head after ejaculating. I remember googling the symptoms and hearing about peyronies for the first time. I thought it's not what I had, because I did not have a curve. Then one day in early 2020, I developed a curve.

 

[beaulieu1008]

There is a theory on this forum that inflammation leads to nee plaques. Is this true? Is there scientific proof for this?  

[Sebtp1973]

The mental part of this condition can weigh heavily on a person.

I was ecstatic after my Xiaflex treatment from Dr Trost, when I first saw my erection following treatment. From a severe curve, to straight. It was still swollen at that point, so I didn't see the extent of narrowing/hourglassing/dents.

Since the swelling went away, I feel discouraged. The narrowing/hourglass/dent is disconcerting. I don't feel too bad about the aesthetic aspect of it, but worry about function. I did have intercourse since straightening, and it worked. So I think it's mental. And it makes me nervous about future sex, which may affect my erection, and it becomes a self fulfilling prophecy.

Last night, I wanted to test things out by masturbating. I had a semi, and the penis bent easily where the narrowing starts. I thought "oh no, a hinge!" I lost my erection and will to masturbate. I was up late searching "hinge" on this website, and feel exhausted today.

Do I really have a hinge? I don't know. And as I said, intercourse worked since I had my Xiaflex treatment. And the narrowing was probably there pre-treatment too, and intercourse worked then. Trost said the dent and any hourglass becomes more visible post straightening.

Plus, as I state elsewhere, I'm a little freaked out by some minor discomfort in and around my penis head since intercourse.

From ecstatic to anxious. Ugh.  

[Sonic]

I was ecstatic after my Xiaflex treatment from Dr Trost, when I first saw my erection following treatment. From a severe curve, to straight. It was still swollen at that point, so I didn't see the extent of narrowing/hourglassing/dents.

Ask Dr Trost wether you might be a candidate for Extra Tunical grafting. Sorry to hear about your current predicament but remember to take Sildenafil or Tadalafil prior to sex now so that you are assured you have the best possible erections during sex. Weaker erections or hinging will defitnitely make matters worse.

If sex worked, great! That is a positive and nothing you should be anxious about. Just make sure you take oral meds to make sure you have the best erection quality to try avoid further damage. Whatever happens you have possibly the best Peyronies specialist available in the world to visit and do follow ups. He will definitely be sure what your next step would be.

[Sebtp1973]

I read on here that Trost thinks extra tunical grafting is merely cosmetic and offers no structural support.

I don't think I'm to the point of needing surgery or any another procedure. Like I said, a lot of this is mental.

I have to remind myself that sex worked, so calm down. I also read on here that dents/hourglassing/narrowing gets better over time, albeit at a glacier pace. But that means it usually doesn't get worse. So if my penis works now, and it likely won't get worse, even a little better, maybe there's nothing to worry about.  

[Sonic]

Yes, this is the right attitude to have. The truth is sometimes it's even out of our control if it gets worse or not some men abstain from any sexual activity but end up worse so when things are working we should always be happy and try to relax. If I am not wrong the xiaflex at least significantly lowered your curve and that is a big plus.

[Sebtp1973]

Dr Trost responded to my email, and I feel better. First, he highly doubts I am developing a new plaque, it's fairly rare and when it does occur it usually takes years.

He said rigidity and stability will improve over time as the penis further heals. He did say narrowing is due to lost tissue from Peyronies Disease and that's not coming back. He said if it's bothersome , I could get the extra tunical grafting, which is a minor procedure, but it's mostly cosmetic and doesn't restore lost erectile tissue.

That's ok, as long as my penis is functional, which it has been and sounds like it will continue to improve further. Intercourse with my wife felt damn good for me and for her.

The aesthetic aspect is less of an issue. It doesn't look too bad, and my wife doesn't study my penis, she just wants it in her. I've had girlfriends in the past who were "penis centric" who'd look a lot at my penis and enjoy the aesthetics, but my wife is not that way.
 

[richestorags]

Interesting information....I too was concerned about plaque recurrence and it's a relief that Dr. Trost finds that circumstance rare. Same thing about rigidity....I've got some hourglassing and my unit doesn't get as as hard as it used to. Wonder if it's now safe to being using a VED for rigidity purposes?

[danh]

I too have some hourglassing after getting straightend.  Not too bad. Hardly notice it. But, it's there. It doesn't interfere with intercourse. I don't feel it's a weak spot either.
I will say one thing. It sure is a LOT better going "straight" in, rather than angling myself to enter her. And I don't have the worry of hinging like I did when I was bent. Much, much better sexwise. Physically and mentally.

[Sebtp1973]

It's been two weeks since my Xiaflex treatment with doctor Trost, and maybe I should wait another two weeks before I give a final assessment, but here is my preliminary assessment.

Dr Trost asked me to send pics to follow up my case, a pic from each side and from the top.

He replied with his measurements. He said zero degrees from one side, and 10 degrees up from the other side, and he measures 10 degrees left from the top pic. I think that curve is from the dent on my left side where the plaque was.

He called it a vast improvement from his pretreatment when I was 75 degrees up and 35 degrees left, and we are done.

[Sonic]

That is indeed a remarkable improvement. Probably one of the most successful stories on xiaflex on this board.

[Sebtp1973]

So, I flew into Salt Lake City arriving around noon Monday. Rented a car and drove to Orem, which takes about 40 minutes. My appointment was at three, so had time to kill and checked into hotel. Then drove to the clinic. Nice facilities in a nice setting.

Day one summary:

*Injected numbing agent.
*Took length measurements with ruler.  
*Teaches wrapping and traction methods. Will reiterate on Day 2.
*Always leave wrapping on, except once a day quickly replace it. Said penis can blow up in front of your eyes, so move fast when replacing. Says he'll replace day one wrapping for me tomorrow.
*Says all you have to do tonight is straighten your erection if you get one.
*Says urine leak age will be a problem, advises getting padding. I swallowed my pride and bought incontinence diapers after the appointment.
*Induced an erection with an injection. Measured the curve with a protractor.
*Located the point of maximum curvature. My curve goes up and to the left. Asked me which curve I would like to reduce the most. The upward is sharper and more noticeable, but I said the left one is uncomfortable for my wife. He said yes, the vagina does not expand as much left and right as it does up. Anyway, both curves will be addressed.
*injected the Xiaflex.
*Day one appointment lasted 45 minutes.

After I went to the store to get diapers. The erection medicine really kicked in by then. I was able to pull my shirt out in front to cover my "circus tent".

I went back to the hotel, and really needed to pee. After I was done and put my penis back in my pants, well...I wet my pants really good. It looked like I peed my pants. I brought some gym shorts, put a diaper on then the shorts, and washed my jeans in the laundry room at the hotel. Learned my lesson, I wear the diaper all the time as long as I am wrapped. The compression from the wrapping makes it feels like you are done, but there is still pee in your uretha that comes out when you put your penis away.

No discomfort or pain that night. Had some boners that I straightened out.

Day two.

*My appointment is at 12:20.
*Trosts assistant gives me laughing gas and numbs my penis.
*No erection on day 2. Trost comes in, takes the wrapping off, and finds the location using a ruler and measurements he took day one.
*He injects the Xiaflex.
*He grabs the head of the penis and pulls HARD (grabs it with the sheet so it doesn't slip out of his gloved hands). He pulls straight out and up and to the right. This is going on for awhile. We are talking, although he is pulling so hard at some points he is not talking and almost grunting like someone lifting weights at the gym. Then suddenly, "riiiipp". The plaque is torn apart.
*Both me and Trost are very happy. He says something like "you might be a one series guy". He says it's like how glass is cut, you score it first then break it. The Xiaflex at the point of maximum curvature is weakened there, then when he pulls, that's were it rips. His techniques are making more sense to me now.
*He said if I wasn't numbed up, that rip would have caused excruciating pain. I felt nothing, other than the sensation of it tearing.
*He said my job now is to make sure the tear doesn't heal. If it heals, it will contract. You disturb the healing process by using using a Restorex and hand modeling once a day.
*I need to keep it fully wrapped for three days (quickly changing the wrap once a day). Then for three nights after that, wrap at night while sleeping and in the morning while doing traction.

I went back to Utah for a one year follow up with Dr Trost. I am participating in a study (I believe funded by Endo, the maker of Xiaflex)so I get free medical care, all my travel expenses reimbursed, and $150 for my time.

In this visit, Dr Trost assistant measured my flaccid penis at 20 cm, and he said last year it was 17.75 cm. So, I think I gained about an inch. Then the assistant gave me a shot to make me erect.

Dr Trost then came in and measured the curve. There was no or minimal curve from some angles. The largest curve he could measure was 17 degrees left, which is well within normal range. I wasn't fully erect, and he said it'd be even straighter if more hard. I always had a left curve , so back to normal.

He said my hourglassing and denting is minimal. He said last year it was moderate. So that improved in the past year. He said he wouldn't recommend extra tunica grafting because the dent is mild.

He said the study is showing that the optimal protocol is what I went through. A couple rounds of Xiaflex with gentle modeling, then wait a year of healing, then do another round with Trost style aggressive modeling. He said the median curve improvement in the study is 99%. So, pretty much full eradication of curves for at least half the men. He said he's getting better results in this study than when he does aggressive protocols in the first round. He thinks the softening up in the first couple rounds and the year of healing, sets you up for a big fix once you resume with aggressive protocols.