Treatment with collagenase injections (Xiapex)

What is it?

For patients suffering from acquired penile curvature (La Peyronie's disease or Induratio Penis Plastica), a treatment based on the injection of Clostrium histolyticum collagenase (Xiapex®) inside the penile plate responsible for scar retraction and therefore curvature has become available.
Collagenases are enzymes derived from the bacterium Clostridium histolyticum, capable of mechanically breaking down plaque and allowing the penile shaft to significantly reduce the degree of pathological curvature.

Randomized placebo-controlled clinical trials have reported excellent results, showing a high level of patient satisfaction resulting in an average curvature reduction of about 30%.

When is this procedure indicated?

The current indications for intraplate injection therapy with XIAPEX® are:

  • disease in stable phase (absence of curvature changes and/or appearance of erection pain in the last 3 months);
  • dorsal (upward) and/or lateral penile curvature ≥ 30° and ≤ 90°.

How is it performed?

Treatment is performed in a hospital setting on an outpatient basis.

Under local anesthesia practiced at the root of the penis, the drug is injected directly into the plate, perpendicularly, using a sterile syringe. Overall, the procedure lasts about 20 minutes. 

Therapy involves 2 initial injections performed 4-6 weeks apart. Subsequently, additional injections may be necessary depending on the degree of curvature. In the period between one injection and the next one, the patient will have to perform essential rehabilitation exercises to get the best results from the treatmen.

Immediately after the injection, it is necessary to keep the penis facing upward (with the help of briefs sufficiently restrained), abstain from sexual activity for 2 weeks after the injection. At 48 hours after injection, the patient is asked to perform penile manipulation (he should gently straighten the penis manually for about 60 seconds; this maneuver should be performed as many times as possible during the day), exercises with vacuum device in order to promote the best extension of the penis in case of plaque rupture.

Vacuum is a pump instrument capable of inducing a penile erection due to negative pressure that draws blood to the penis. The patient is invited to use the vacuum device in 2 daily sessions with the specific purpose of promoting an extension of the tunica albuginea that surrounds the corpora cavernosa, this procedure should be performed for 5 times in each of the 2 daily sessions.


Recovery after the procedure is very rapid. Local pain associated with the appearance of a small hematoma at the site of injection of the drug are common side effects that in most cases do not involve any limitation to daily activities.

Short-term complications

Local pain, hematoma at injection site.

Are you interested in receiving the treatment?

Contact us and we will take care of you.