For Patients · University Urology, PC
Xiaflex Injection — Preparation & Recovery
What to expect during your Xiaflex treatment cycle for Peyronie’s disease, including pre-injection preparation and post-injection care.
Understanding Your Treatment
How Xiaflex Treatment Works
Xiaflex is an FDA-approved injectable enzyme that breaks down the collagen scar tissue causing penile curvature in Peyronie’s disease. Treatment consists of up to 4 cycles, each with two injections given 1–3 days apart, followed by a modeling procedure.
Day 1 of cycle
First injection into the plaque. Mild swelling and bruising begin.
Day 2–3 of cycle
Second injection into the same plaque site. Swelling typically more pronounced after the second injection.
Day 3–7 of cycle
Modeling procedure: your provider manually stretches the treated area. You will also perform daily home modeling exercises for 6 weeks.
Before Each Injection
Preparation
No fasting required
You may eat and drink normally before your injection appointments.
Avoid sexual activity 24 hours before
Abstain from sexual activity or erection-stimulating medications for 24 hours before each injection to reduce bruising and swelling risk.
Understand the modeling exercise
After the in-office modeling procedure, you will perform daily penile stretching exercises at home for 6 weeks. Your provider will demonstrate the technique at your modeling appointment.
Blood Thinner / Anticoagulation Medications
Contact your prescribing physician before stopping any blood thinner or anticoagulant. Do not stop these medications without medical guidance, particularly if you are on anticoagulation for a high-risk condition such as atrial fibrillation, a mechanical heart valve, or a recent blood clot.
- Aspirin — hold 7 days
- Clopidogrel (Plavix) — hold 5–7 days
- Apixaban (Eliquis) — hold 48 hours
- Rivaroxaban (Xarelto) — hold 48 hours
- Warfarin (Coumadin) — contact prescribing physician for INR guidance
After Each Injection
Recovery & Post-Injection Care
Normal after Xiaflex injection
No sexual activity for 4 weeks after modeling
Avoid sexual activity and erections for 4 weeks after the modeling procedure in each cycle to allow the plaque to remodel and reduce fracture risk.
Call us immediately if you experience:
Call (865) 305-9254. For suspected penile fracture, go to the ER immediately.
Common Questions
Frequently Asked Questions
How much improvement can I expect?
Clinical studies show an average curvature reduction of approximately 30–35% with a full course. Results vary by patient, plaque location, and degree of curvature. Xiaflex is most effective for curvatures between 30 and 90 degrees.
How many cycles will I need?
Up to 4 cycles are FDA-approved. Your provider will assess response after each cycle and recommend whether to continue.
Is significant bruising normal?
Yes. Swelling and bruising are expected and typically more pronounced after the second injection in each cycle. Ice and elevation help with comfort during the first few days.
Questions Before Your Xiaflex Injection?
Send a Klara message or call us. Our team is happy to walk you through what to expect.