Just came across this study from earlier this year: https://www.ncbi.nlm.nih.gov/pubmed/31033130
States that Xiaflex with added "percutaneous needle tunnelling" was more effective than Xiaflex alone.
Has anyone tried this? I've had two rounds of Xiaflex with some results but not all the way there, and thinking of asking my urologist about this option.
What is PNT exactly?
"PNT was performed by creating multiple tunnels or holes along the entire plaque using a 25G needle."
25G needle is pretty big, so I imagine this would be somewhat painful but in theory makes sense - manually break up as much plaque as possible before letting the Xiaflex go in and dissolve more of it.
They made a conference presentation showing the technique, but I can't figure out how to access the actual video - https://www.eventscribe.com/2019/AUA2019/fsPopup.asp?Mode=presInfo&PresentationID=535876
I've requested the full text to hopefully get a better idea.
There is a Youtube video of this technique used for Carpal Tunnel Syndrome.
A similar (or same) technique is used for Dupuytren's contracture, sometimes as an alternative to Xiaflex and with good results all by itself. It actually started as a standalone alternative to hand surgery for Dupuytren's contracture.
I imagine that needle tunneling could work for Peyronies, but the amount of pain and risk of injury to healthy tissue would probably be even higher in the penis vs. the hands. Xiaflex alone is rough enough.
Btw, if you are predisposed to getting Peyronies, you have a good chance of also having susceptibility to Dupuytren's, so watch out for that so you can catch it early if so.