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Men vary in shape and size, and having a curved erection is common and isn’t necessarily a cause for concern.  However, in some men, Peyronie’s disease causes a significant bend or pain.  This can prevent a man from having intercourse and may make it difficult to get or maintain an erection (erectile dysfunction).

Peyronie’s disease occurs due to a plaque that builds up in a man’s penis.  It typically starts out as a localized inflammation, which then progresses to hardened scar tissue that reduces flexibility and causes a man’s penis to bend during an erection.  Peyronie’s disease can often result from an injury during sex but realistically, anything that causes vascular trauma or injury to the penis, such as athletic activity or an accident, can be the cause as well.

Medications- A number of oral medications have been tried to treat Peyronie’s disease, but they don’t appear to be as effective as surgery.  In some cases, drugs injected directly into the penis may reduce curvature and pain associated with Peyronie’s disease; although evidence on the effectiveness of penile injections is limited.  Medications that are used include:

  • Verapamil- This is a drug normally used to treat high blood pressure.  It appears to disrupt the production of collagen, a protein that appears to be a key factor in the formation of Peyronie’s disease scar tissue
  • Interferon- This is a type of protein that appears to disrupt the production of  fibrous tissue and help break it down.
  • Collagenase- An enzyme that breaks down fibrous tissue scar, is currently being studied for treatment of Peyronie’s disease
  • Surgery- Your doctor may suggest surgery if the deformity of your penis is severe or prevents you from having sex. Surgery usually isn’t recommended until the curvature of your penis stops increasing, and your erections have been pain-free for at least six months.

A new treatment method to alleviate pain is now available–  Xiaflex (collagenase clostridium histolyticum, Auxilium Pharmaceuticals), an enzyme that attacks the plaque and reduces the curvature of the penis.

Researchers ran two clinical trials in which they injected the drug Xiaflex into men’s shafts with the hopes that it would soften scar tissue and reduce curvature.  Approximately after a year of treatment, 67% of the men saw improvement post-Xiaflex.  In fact, in the first trial, the average curvature for men treated with Xiaflex dropped more than 17 degrees in a year.

Xiaflex Dosage/Administration for Peyronie’s Disease

  • XIAFLEX should be administered by a healthcare provider experienced in the treatment of male urological diseases.
  • Reconstitute XIAFLEX lyophilized powder with only the supplied diluent prior to use.
  • A treatment cycle consists of two XIAFLEX injection procedures and a penile modeling procedure.
  • Induce a penile erection. A single intracavernosal injection of 10 or 20 micrograms of alprostadil may be used for this purpose.
  • With the penis in the erect state, identify and mark the target area in the Peyronie’s plaque to be injected.
  • The penis should be in a flaccid state before injecting XIAFLEX.
  • Inject 0.58 mg XIAFLEX into the target plaque of a flaccid penis once on each of two days, 1 to 3 days apart, according to the injection procedure.
  • Perform a penile modeling procedure 1 to 3 days after the second injection of each treatment cycle.
  • For each plaque causing the curvature deformity, up to four treatment cycles may be administered. Each treatment cycle may be repeated at approximately six-week intervals. If the curvature deformity is less than 15 degrees after the first, second or third treatment cycle, or if further treatment is not clinically indicated, then subsequent treatment cycles should not be administered.


For an appointment or consultation with Dr. Gary Bellman,
please contact the office or call 818-912-1899