Xiaflex (collagenase clostridium histolyticum) is the only FDA approved medical therapy for Peyronie’s disease. The drug is an enzyme that degraded the scar tissue, and has been shown in clinical trials to improve penile curvature in most men who are candidates.

  • A Xiaflex treatment course consists of a maximum of 4 treatment cycles.
  • Each treatment cycle consists of 2 Xiaflex injection procedures. Penile modeling should be included 1-3 days after each injection round.
  • The second Xiaflex injection procedure occurs 1 to 3 days after the first.
  • After the injections of each treatment cycle, the patient performs approximately 6 weeks of daily, at-home penile modeling activities.
  • Penile traction with a traction device: should begin 2 days after second injection 2 hours daily.
  • If prescribed, continue to take pentoxifylline and sildenafil daily.
  • Wait 4 weeks after the second injection of each treatment cycle before resuming sexual activity, provided pain and swelling have subsided.

At-Home Penile Modeling Activities

There are 2 types of at-home penile modeling activities. One is a gentle stretching activity; the other is a gentle straightening activity. You should do these for approximately 6 weeks after each treatment cycle. Please refer to your Xiaflex pamphlet for further instruction.

  • Perform the penis-stretching activity daily, three times per day, with a non-erect penis (Using a traction device will replace this).
  • Perform the penis-straightening activity no more than once per day only if a spontaneous erection occurs. If you do not have a spontaneous erection, you should not attempt the penis straightening.

Modeling: Can be performed daily for 5-6 weeks in addition to traction.

  • 1-3 days after injection, grasp penis by the glans (tip) and stretch out.
  • Using the target plaque as a bending point, bend the penis in the opposite direction of plaque and your curve.
  • Hold this stretch and bend for 30 seconds, then release.
  • Rest 30 seconds, then repeat for a total of three times.

There is a risk of penile fracture and other serious injury to the penis

Your penis may appear bruised and/or swollen

You may have mild-to-moderate penile pain that can be relieved by taking over-the-counter pain medications

Promptly contact us at or go to the nearest emergency department if, at any time, you have any of these symptoms:

  • a popping sound or sensation in an erect penis
  • sudden loss of the ability to maintain an erection
  • difficulty urinating or blood in the urine
  • severe pain in the penis

These symptoms may indicate penile fracture, and may require surgery.

Related Topics