What to expect after Xiaflex injections

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Hello All,

I wanted to ask a few questions on what some might have experienced after their procedure. i have had my peyronies for about a year now. I decided with my URO that we would try Xiaflex. I have only maybe a 30-40 degree curve. I am staying very positive about this treatment and hoping it gets me back to a least close to normal. But with any kind of medicine or procedure I know there is patience needed

My first injection 3/13/17
When the getting the injection it was not as bad as i thought it would be. Swelling started almost immediately, saw bruising as soon as i got home. The swelling and bruising lasted about 5 days. I was suppose to get my second injection 3 days later but my URO  decided just to wait a week so that the swelling could come completely down. There was very little pain (probably just the first 2 days where it felt like a stinging feeling)

Second injection 3/20/17
Almost the same thing as the first one. Swelling went away a little quicker though. Still some bruising as of now and still get the occasional small pain when i bend or certain movements when i move around. I feel a little but of bruising/bulge around the bottom area of the penis kind of by the pubic area around the area my URO said i would have to massage after a week.

What I would like to know is how long did it take to start doing their modeling as far as stretching the penis and massaging to break down the plaque. Also if anyone can provide any kind of advice to maybe help make this process a little but more pleasant.

My URO also suggested that i could start using my VED pump after 3 weeks to help with the modeling



What likely happened is your URO nicked a blood vessel and you had a hematoma. You will always have more swelling and bruising if a blood vessel is nicked. The best advice I can give you is to keep your package wrapped with coflex for 3-4 days after each injection. Something I found with my 4th cycle that was very beneficial was having a high strength healing magnet wrapped in the coflex. The magnet I used was the neomax gold. I had absolutely ZERO swelling afterward. The magnet is totally worth the $100.

A couple of things to watch for is discoloration of your penis which is a side effect. I believe using the magnet will prevent this. I always had bruising after each cycle some more than others, but ZERO after the 4th. All further cycles will be with a magnet-wrap. My URO was very conservative and had me waiting two weeks for modeling; however, I always started after 7-10 days and this last time he said start after 3-5 days. I generally pull (i.e. model 4-6 times per day) for about a minute each time and a couple of times a week use VED. Make sure to go very easy with the VED, maybe 50-60% erect until you know your good. The last thing you want to do is get a penile fracture. I though I had one after the 4th cycle when I heard a pop at night when I had an erection and I did the recommended gentle downward press. The pop was the plaque having a minor tear, which is good according to my URO. Large tears, very bad because that would indicate a fracture, but small tears show a breakdown of the plaque.



Thank you. I am going to look into it.

I def think I have hematoma. But like i said its still only been 4 days and I feel i should wait the full 7 days since this is my first cycle and not sure what to expect

I will keep in mind the time tables that you had. I will also probably wait until the 7 days before i start doing any kind of stretching . Did you ever have a ring time buldge around the base area? I feel like it could just be bruising but I have this little bulgy feeling around the base that looks like i need to massage it out but not sure. I guess i will now more after the 7 days.


For what it is worth I will offer my experiences with Xiaflex.  I just finished the second shot of the 4th cycle (last Thursday) so my injections have been completed.  I won't know for at least another 10 days as to final outcome but to this point I have gone from approx 40 degree downward and to the left curve to approx 22-24 degree bend.  This would be about a 40 percent improvement and a bit better than the clinical studies conducted for FDA approval where the average improvement was just over 30 percent.  The biggest challenge I have found with Xiaflex is that there does not seem to be a standard protocol.... some UROs don't recommend a wrap and want you to model immediately. Others suggest a wrap for the 2 days between shoots and 2 days after the second shot.  Modeling suggestions could also be varied... some suggest 10x day for 30 seconds while others may suggest 3x day for 90 seconds.  This creates a bit of a"trial and error" feel to the entire process.  This is just my recommendation.... please research the board for other's thoughts and most importantly get the counsel from a Uro certified on Xiaflex injections.  I would absolutely request the coflex (aka coband) and keep it wrapped for at least 24 hours....although I wouldn't disagree with Quack's counsel on this and leave it on a bit longer if you want to be cautious.  I did not wrap in coflex during my first 3 cycles and had significant swelling and several hematomas.  The significant swelling can interfere with your ability to effectively model which is critical to getting the full effect of the Xiaflex... so better off to do what you can to minimize swelling so you can more aggressively model.  I would model at least 3x day and preferably more if possible.  My Uro did say that it was okay to model more than 3x a day and up to 10x.  The one caveat is at nighttime if you have a nocturnal erection.  Very, Very important to take it easy when gently straightening the curve in an erected state.  The only time you could potentially get a fracture is when in the erected state so take it easy and absolutely no sex for at least 2 weeks after your second shot.  I would also try the magnet that Quack suggests.... I didn't get a chance to but if I were having more injections I would absolutely try it.  I also recommend light traction once the swelling has been reduced and there is not any pain... perhaps the second week after your second shot while the Xiaflex is still active.  I wouldn't push to hard on the traction.  My best results came after my second cycle when I employed traction into the second week but it was more of a consistent stretch vs an aggressive stretch.  Sounds like you will be using a VED which I did not but many others have been using as well. You will most likely get a hematoma (or several) throughout the process and this can be a very painful experience and quite scary when you look down and see your penis completely purple and swelled up.  Not a whole lot you can do for it and is pretty much the downside to this since the penis is such a vascular part of the body.... but see you Uro right away if you are unsure.  It should go away within 2 weeks.  While I did get one this last cycle I do believe the coflex for the first 24 hours greatly reduced the size and pain of the hematoma.... it wasn't nearly as bad as previous cycles and I was able to start modeling 3 days later.  Best of luck and happy to answer any questions
51 yrs old; diagnosed 3.5 yrs ago; 90 degree upward bend
But I had no Erectile Dysfunction
tried all pills, VED, traction, Xiaflex PRP, ESWT, H-100 & stem cells; IF diet. implant surgery with Dr. Eid 3/28/19
to correct deformity - 20 CM Titan 2cm RTE / 1 cm RTE