FDA-approved Xiaflex, evidence not hype.

What is Peyronie’s disease?

Peyronie’s disease is a condition where scar tissue (called plaque) forms inside the penis, causing it to curve during erection. This curvature can range from mild to severe and may be accompanied by pain, shortening, or erectile difficulties.

The condition is more common than many men realize, affecting an estimated 1 in 10 men at some point in their lives, but it’s often underdiagnosed because men may be embarrassed to seek help.

If you’ve noticed a curve in your penis that wasn’t there before, or if you’re experiencing pain during erections, you’re not alone, and effective treatment options exist.

Common symptoms

• Curvature of the penis during erection
• A palpable lump or band of hard tissue
• Pain during erections (especially in early disease)
• Shortening of the penis
• Erectile dysfunction
• Difficulty with sexual intercourse due to curvature

How Peyronie’s disease progresses

Understanding the natural progression of Peyronie’s disease is important for making treatment decisions. There are two phases.

Acute / inflammatory phase (6 to 18 months)

Active scar formation, curvature may worsen over time, pain is common during erections, and the plaque is still evolving.

Chronic / stable phase

Scarring has stabilized, curvature is no longer worsening, pain typically resolves, and treatment options may differ based on stability.

Why this matters

Treatment decisions often depend on whether your disease is still actively changing or has stabilized. During your evaluation, we’ll assess which phase you’re in and what that means for your options. In some cases, mild Peyronie’s may improve without treatment. But most cases do not resolve spontaneously, and many worsen over time. If your symptoms are affecting your quality of life or sexual function, it’s worth seeking evaluation.

Comprehensive evaluation

Effective treatment begins with understanding your specific situation. Every case of Peyronie’s disease is different. The best approach depends on factors including the severity of curvature, whether the disease is still progressing, and how your symptoms are affecting you.

Our evaluation includes

1. Detailed history. When your symptoms started, how they’ve progressed, and how they’re affecting your life and relationships.
2. Physical examination. Careful examination to assess the location and extent of plaque formation.
3. Objective curvature assessment. Photographs or other methods to document the degree and direction of curvature. This helps track the disease and measure treatment response.
4. Erectile function assessment. Peyronie’s disease often coexists with erectile dysfunction. Understanding your erectile function is important for treatment planning.
5. Discussion of goals. What are you hoping treatment will accomplish? Understanding your priorities helps us recommend the most appropriate approach.

Xiaflex: the only FDA-approved injection treatment

Xiaflex (collagenase clostridium histolyticum) is the only FDA-approved injection treatment specifically for Peyronie’s disease. It works by breaking down the collagen that forms the plaque, allowing the curvature to improve.

How Xiaflex works

Xiaflex is an enzyme that breaks down the scar tissue causing the curvature. The medication is injected directly into the plaque during an office visit. Between injection cycles, you’ll perform gentle penile modeling exercises at home to help maximize the straightening effect.

Treatment protocol

• Series of injections (typically up to 4 treatment cycles)
• Each cycle consists of 2 injections given a few days apart
• Penile modeling exercises between cycles
• Treatment cycles spaced several weeks apart
• Treatment duration: several months for the full protocol

Who is a candidate for Xiaflex?

Xiaflex is FDA-approved for men with palpable plaque, curvature of at least 30 degrees (measured during erection), and stable disease (curvature not actively worsening).

Expected results

Clinical studies show that Xiaflex can reduce curvature by an average of 34%. While results vary, many men experience meaningful improvement that allows for more comfortable sexual intercourse.

Comprehensive treatment options

Xiaflex is often our primary recommendation for appropriate candidates, but we offer a full range of evidence-based options depending on your situation.

What we don’t offer, and why

You may have seen advertisements for various Peyronie’s “treatments” such as shockwave therapy (acoustic wave therapy), PRP injections, or various supplements. We don’t offer these treatments because the scientific evidence supporting their effectiveness for Peyronie’s disease is limited.

Men with Peyronie’s disease are often searching for solutions, and you deserve honest information about what’s been proven to work and what hasn’t. Our recommendations are based on FDA approval and peer-reviewed evidence, not marketing claims.

If you’ve tried other treatments without success, we’re happy to evaluate you and discuss evidence-based options.

Why choose Sterling Urology for Peyronie’s

One of few Xiaflex providers in the area. Xiaflex requires specific certification and training to administer.

Evidence-based approach. We recommend treatments that have scientific evidence supporting their effectiveness. We don’t offer unproven therapies or devices with limited evidence.

Urological expertise. As a board-certified urologist, Dr. Greene has specialized training in the evaluation and treatment of Peyronie’s disease and related conditions.

Comprehensive care. We address not just the curvature, but also any associated erectile dysfunction or other concerns that may be affecting you.

Insurance-friendly. Xiaflex and other Peyronie’s treatments are often covered by insurance. We work with most major PPO plans and Medicare.