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We offer our most sincere condolences to Old Man who lost his wife of 59 years on Monday night to Pancreatic Cancer.   
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Author Topic: Modeling after Xiaflex  (Read 26204 times)

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Shane43

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Re: Modeling after Xiaflex
« Reply #50 on: November 19, 2020, 06:13:19 AM »

Jan is simply summarizing what the medical evidence supports. The clinical studies on Peyronies Disease are few and not that well done, not the fault of the researchers so much as limited number of participants and inability to control all of the possible confounding factors. If you look at the reviews of possible treatments and international guidelines for treatments, there is some variation in recommendations but most are similar to the review cited below. I provide the conclusions section and attach the paper. Oral treatments like vitamin E and Co-Q10 are not harmful, and may even have other health benefits, so I take them as well. But there is only anecdotal evidence of their benefits.

Medical Management of Peyronie’s Disease: Review of the Clinical Evidence
Patrick Teloken and Darren Katz

"A great number of medical treatments have been suggested and utilized in Peyronies Disease. Evidence from randomized controlled trial with regards to improvement in curvature exists for intralesional (with CCH and interferon alpha-2b) and traction therapy. Oral therapy has not proven to be effective and due to potential side-effects and costs, is not currently recommended. Topical verapamil with or without EMDA is not recommended and novel topical agents need further studies prior to routine use. An optimal treatment algorithm applying a multimodal approach is yet to be defined. With advances in the comprehension of the mechanisms of inflammation and scarring and the development of new agents, it is expected that more effective treatments for Peyronies Disease will become available."

These two papers (also attached) are a little less enthusiastic about Xiaflex, but seem to simply be noting the uncertainty of how it will work for every patient.

Contemporary surgical and non-surgical management of Peyronie’s disease
Recent advances in managing Peyronie’s disease

This last paper "Minimally invasive therapies for Peyronie’s disease: the current state of the art" (also attached), concludes:

"The optimal minimally invasive therapy for Peyronies Disease likely involves a combination of non-surgical therapies. Further investigation into particular combination therapies, including oral anti-inflammatory agents, CCH, and PTT,
may reveal a synergistic therapeutic effect. Nonetheless, surgery offers the highest success rates for men with chronic-phase Peyronies Disease who desire rapid return of a functionally straight erection."

All of these papers were published in the last 2 years and are from highly qualified medical researchers at very good medical schools. None of them note any conflict of interest with manufactures of Xiaflex, traction/VED, or any other therapies.

They are not saying that the many therapies discussed in this forum do not or cannot help, but that there is no good evidence that they work. I realize that not everyone has access to Xiaflex or is a good candidate for this drug, but it does appear to be the best non-invasive treatment (with reasonably good controlled clinical studies to support it) used alone or in combination with traction.

And from my personal experience, after three series of injections, it has made a very big improvement of my hourglass indentation and penis stability, albeit with some pretty bad bruising and pain, but well worth it.


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60YO, hourglass indent/hinging at base 30deg bend up 3cmx2cm hard plaque at dorsal base. No Erectile Dysfunction. 3 rounds Xiaflex decreased plaque/indent/hinge/bend by ~50%. Can now have careful sex, but now getting worse. Saw Dr. Levine, will start PMP for 6 months

Shane43

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Re: Modeling after Xiaflex
« Reply #51 on: November 19, 2020, 06:19:59 AM »

Sorry that my above message is a bit out of place on this topic of "modeling", but I thought I would write a more complete response.
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60YO, hourglass indent/hinging at base 30deg bend up 3cmx2cm hard plaque at dorsal base. No Erectile Dysfunction. 3 rounds Xiaflex decreased plaque/indent/hinge/bend by ~50%. Can now have careful sex, but now getting worse. Saw Dr. Levine, will start PMP for 6 months

MFPC Trost

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Re: Modeling after Xiaflex
« Reply #52 on: August 24, 2021, 09:17:06 AM »

Going back to the original post, modeling is absolutely critical to getting a good outcome.  In the original phase IIb study, men who didn't model had no improvement, while those who did experienced benefits.  We have been adjusting our modeling technique over time, and our median improvements with Xiaflex have almost doubled from when we first started.  There are a lot of considerations with Xiaflex injections though to optimize outcomes and minimize complications.  We put together a video on this to highlight many of the things that we've learned since first doing these injections in early 2014. 
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nemo

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Re: Modeling after Xiaflex
« Reply #53 on: August 24, 2021, 10:10:11 AM »

Dr. Trost, welcome to the Forum, we're pleased to have you join us!

Regards,
Nemo
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50 yrs. old, multiple auto-immune conditions. First episode of Peyronies Disease in 2002. Recurred in 2013. Have now begun a third episode in 2021. Over the years I have tried Topical Verapamil, Iontophoresis, all the supps and Cialis + Pentoxifylline.

GaussRifle

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Re: Modeling after Xiaflex
« Reply #54 on: August 24, 2021, 11:27:36 PM »

We are very pleased to have Dr. Trost with us indeed !

As far as modeling after Xiaflex is concerned, I typically feel scared doing modeling with hand because it’s tough to maintain pressure and apply the right force. Is it reasonable to skip hand modeling as long as you are daily doing modeling with RestoreX twice a day and expect curve improvement  ?
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26 year old
45-50 degree downward curve with an indentation on one side when erect.
Using RestoreX and Xiaflex injections
Taking coq10 with daily Cialis 5mg.
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