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Personal Experience Of Xiaflex (And Verapamil)


The founder of www.curepeyronies.net has kindly allowed me to share his story with My Peyronie's readers.

Xiaflex story

His story is very interesting as he is one of the few that has personal experience of Xiaflex Peyronie's treatment because he participated in the Xiaflex trials.

But his story began long before that...


John (not his real name) developed Peyronie's in August 2006 when he was 58 years old. Like most of us, he had not heard of this condition before.

John is very proactive person and immediately sought doctors' advice. He saw three urologists and they all told him there was nothing they could do for now - they recommended to 'wait and see'. However, if his condition would become severe then surgery was an option once the disease had stabilized.

He was understandably surprised and discouraged by the lack of satisfactory treatment for Peyronie's disease. Surgery didn't sound good option to him due to the high risk involved, i.e. penile shortening and potential loss of functionality.

John decided not to 'wait and see' and started his Peyronie's treatment with Verapamil injections.

The Experience Of Verapamil Injections

John was advised to start his Verapamil treatment as early as possible and not wait until his condition had stabilized. He was told that the realistic outcome of Verapamil injections was to increase the odds of stabilization of his condition (hence starting the treatment while in the acute phase).

This is how John describes his experience of Verapamil injections (which consisted of 4 - 6 sessions each consisting of a number of injection pass through the plaque):

"My experience with Verapamil injections: The procedure is performed by a physician and a physician‘s assistant (PA). The base of the penis was swabbed with alcohol and for some reasons I found this very creepy. I couldn’t look, but felt a sharp, burning, stinging sensation when the Lidocain (numbing agent) was injected. After that it was not that bad, it’s more unpleasant and uncomfortable than painful. A number of injections were given deep into the penis which was not very pleasant, but bearable. Immediately after the PA applied pressure with his finger to stop any bruising or swelling and wrapped the penis tightly in gauze with instructions to remove it after one hour. After each treatment, the next one was less frightening. One aspect that was particularly unpleasant was to look at your penis after the treatment. My last treatment was a particularly aggressive treatment; my dick looked like a raspberry for a week" (curepeyronies.net/Verapramil.html)

Unfortunately, John condition worsened considerably after the Verapamil treatments. Whether this deterioration was due to the treatment or just a natural progression of the disease no one knows.

Still John says he would do it again, that is as long as there is no better non-surgical treatment option available. He though strongly emphasizes the importance of experienced physician to perform the treatment, someone that performs them on regular basis.

The decision to get the injections was based on his knowledge at the time. Now, he might try Trental (brand names for Pentoxifylline), coq10 (vitamin-like substance, also known as Coenzyme Q10), VED (penis vacuum pump) or stretching devices first.

The Experience Of Xiaflex Injections

John continued to seek treatment for his Peyronie's condition. He decided not to suffer in silence and started his website curepeyronies.net, following closely everything that was going on in the "world of Peyronie's disease".

He managed to get into the phase IIb Xiaflex study but was in the group that received placebo injections (the comparison group).

He was understandably disappointed when he found out but he was offered to participate in the open source clinical trial (everyone receiving Xiaflex injections) that ran essentially concurrently with the last phase III Xiaflex trial.

The treatment protocol consisted of up to 4 cycles (approximately 6 weeks apart), with 2 injections per cycle (1 – 3 days apart). Treatment would be stopped if the curvature reduced to less than 15 degrees.

Xiaflex injection is administered directly into the primary penile plaque. After each injection, pressure is applied to the injection site to minimize any swelling or bruising. Modeling was also part of John's treatment, which meant gentle stretching in the opposite direction of the deformity.

John had his first Xiaflex injection without anesthesia. There was some pain, discomfort and bruising as could be expected. Two days later, he returned for his second injection.

"As soon as the injection was given, I knew there was something very wrong. It didn't feel like the needle went into the right spot. Immediately, there was a great deal of burning sensation, stinging and bruising began" (curepeyronies.net/2013c.html)

John could not be given anything for the pain as it would violate the clinical trial protocol so after the required time he left and went back to his hotel. Over the next few hours his discomfort increased considerable and by 3 am he gave up and had the local police drive him to the emergency room. They couldn't do anything for him, except give him some painkillers and send him back to his urologist when he came to work the following morning.

There he was told that it was nothing to worry about even though his penis looked real bad. It should heal in couple of weeks.

To cut long story short it did not.

The bruising spread to the entire genital area and was blue/black at its worst. The penis contracted and was almost flush with the body. And while the bruising was healing, he noticed large lump on the top of the penis.

Curepeyronies website

Ultrasound concluded that this was hematoma (solid swelling of clotted blood within the tissues). Hematoma may be classified as harmless bruising but in John’s case this collection of blood pressed against the penile nerve causing him to lose a great deal of sensation in the penis. It was so bad that for quite some time John could not feel if he was peeing or not.

John found a local urologist that agreed see him, as well as his regular follow up visits to the Xiaflex clinical trial urologist. He also saw local radiologist for periodic penile ultrasounds to follow the progress of the hematoma (surgery would be needed to drain the hematoma if it did not heal on its own).

Fortunately, the ultrasounds showed steady decrease in the size of the hematoma but it took about 15 months for it to be fully resolved. Unfortunately, John has still some loss of sensation as compared to when he first entered the clinical trial. In addition, when he is under stress the skin where the injections were administered becomes hard and leathery, making it hard to urinate.

Still the far biggest disappointment for John was going through all the injections and at best see no change in his condition.

So after his personal experience of Xiaflex, how does John feel about using Xiaflex injections to treat Peyronie's patients?

"If you conclude that an approximately 60% chance of moderate (and I stress moderate) curvature improvement is worth your time, effort, expense and risk, then you should be treated with Xiaflex. At this point, your responsibility is to make sure that the injection is given with the greatest accuracy and that you take steps to minimize the possibility of a serious adverse outcome" (curepeyronies.net/2013h.html)

John goes through his personal experience of Xiaflex injections in great detail on his website, to read the full story visit his website www.curepeyronies.net.

I thank John very much for allowing me to share his Peyronie's story with my readers and for his role in raising the Peyronie's awareness.

Join in and share your experience of Peyronie's. It's easy to do. Simply click here and Share Your Peyronie's Experience with others.

Comments On This Article

  1. Dougk8 April 14th, 2014

    I have many more second thoughts about using this approach. Thank you for your honest and frank story.

    Has anyone tried Neprinol?

    • Birgir April 14th, 2014

      Hi Dougk8

      Thank you for your comment. John was unlucky and had severe side effects from his Xiaflex injections. His experience is fortunately not common. However, Xiaflex is no magical cure. Like any other Peyronie's treatment, it works for some men and not others.

      I have personally not tried Neprinol but I have read both good and bad stories about it. I am not aware of any scientific studies for the efficacy of using Neprinol for treating Peyronie's disease. And I'm not keen on the aggressive way many market it, nor the price. What I have read does not give me much confidence in the product.

      You can search for discussions about Neprinol in the Peyronie's forums. This article provides direct links to the main forums. I recommend reading about the whole article (the pros and cons of forums) prior to visiting them.

      Peyronies Forums

      Best regards,


  2. GAda July 18th, 2017

    2nd round Xiaflex started yesterday. No improvement. So painful. During and after the injection pain is intense. Very bad bruising and swelling and pain.

    • Birgir July 18th, 2017

      Dear GAda

      Thank you for sharing your experience. I believe some pain, bruising and swelling after injections can be expected but sounds really extreme in your case. What does your doctor say?

      I hope this will get easier and that you start to see some improvements soon. I hope you will keep us posted about your progress.

      I wish you all the best with your treatment.

      Best regards,


  3. raja August 9th, 2017

    Just had my second shot of my first series. First shot was extremely painful, as my plaque was at 12'oclock. Doctor injected and my penis swelled up, black and blue and very red. Very painful. After about 5 days, the swelling went away and the bruising as well. I noticed immediately an improvement in my upward curvature.

    Second shot on board yesterday and was extremely painful. To be expected.  Im hoping with stretching exercises to begin in 3-4 days I will see major improvement. Hoping this second shot is enough as I dont want to endure the horrible shots anymore, but if it helps, totally worth it.

    • Birgir August 9th, 2017

      Dear raja

      Thank you for sharing your experience. Sorry to hear abou the pain but it is great that you noticed improvement already after your first injections.

      Everything crossed for on-going success and I hope you will keep us posted about your progress.

      Best regards,


  4. Spencer October 3rd, 2017

    I started having issues with Peyronies at age 17, and kept it to myself all these years.  I am lucky as the curvature is probably 15-20 degrees, so I can't see doing this treatment.  I don't have pain with sex, and while I wish I did not have Peyronies, this treatment seems best for those with severe symptoms.

    I can see how vitamin CoQ10 would help as it improves microcirculation.

    I wish they had some other, better treatment option, and surgery seems like a giant No to me.

    The embarrassment factor of this proc is enough to discourage most people from trying it, but having your penis turn black and blue like it is going to rot away, and then the pain, is not for me.

    An odd thing:  my Dad died of cancer in 2001.  He had melanoma and they tried several forms of chemotherapy.  At some point, he was stricken with Peyronies.  I know this only because I found some notes in his wallet after he passed.  I am sure he had no idea what it was before that.

    This leads me to wonder if this is an inherited condition triggered by really stressful events in ones life, much like rheumatoid arthritis is for some people.  I have an older brother and to the best of my knowledge, he does not have Peyronies, as I do and my father did during the last months of his life.

    • Birgir October 3rd, 2017

      Dear Spencer

      Thank you for sharing your experience. It is good to hear that your condition is mild and I agree with you. In those circumstances, learning to live with the Peyronie’s condition may be very good option (or at least avoid the more invasive treatment options, like surgery and yes, injections).

      Please accept my condolences for the loss of your father. There is indeed some indication that there may be a genetic link as Peyronie's is more common in some families than others. It may make men in those families more at risk of developing Peyronie’s. Which actually is a strong argument for discussing Peyronie’s with other male family members, older and younger. But most men find that extremely difficult to do.

      Again, thank you for sharing your thoughts and I wish you all the best in the future.

      Kind regards,


  5. Christopher May, 2018

    I received my first injection 3 weeks ago.  Due to significant swelling and bruising, my urologist recommended waiting for 2 weeks to receive the second injection.  The injection was pretty painful, similar to getting lidocaine with regards to the burning sensation.  However, my urologist advised against numbing as it causes swelling in the penis as well.

    I am 45 and my peyronies presented itself about 5 months ago.  I have a 45 degree bend to the right.  I could feel a pee-sized knot below the head of my penis.  I seem to have also now developed plaque closer to the base on the right side since the first injection.

    A few things I noted was to remove the initial bandage 1 hour and loosely wrap and tape after for 3 days.  I developed a large hematoma that burst a few days later, because I believe I left the original wrapping on for far too long.  The penis needs some room to swell and begin the healing process.

    I appreciate this site and I will update as my treatment progresses.  I wish you all well.  Today is my second injection.

    • Birgir May, 2018

      Thank you very much for sharing your experience and for your kind words, both much appreciated.  The only thing that surprise me a little bit is how quickly you started your Xiaflex treatment, i.e. during your acute phase.

      I wish you all the best with your treatment and would appreciate to follow your progress. I know your experience is of great interest to those interested in trying Xiaflex injections.

      Kind regards,


    Clark May, 2018

    I just finished my fourth injection of Xiaflex yesterday.  No issues like poor John, thank goodness, but the last one was the most painful so far.  No swelling or bruising however, it is just very tender. 

    I am 56 now, and started noticing a 'notch' in my erect penis about 2 years ago, and a noticable pea-sized lump in the middle of my shaft.  I went to my primary care physician and he said 'wait and see' just like John, and that Peyronies was exceedingly rare, so I shouldn't worry, it couldn't possibly be that.  I waited a few months and it got worse, and I switched to another primary care physician.  He gave me a referral to a urologist, who recommended Xiaflex. I started the treatment in March.

    So far there's been no change or not much of one, and the Urologist told me not to have sex/masterbate for two weeks, so I am little paranoid of an erection now.

    A while back, when I first started learning about Peyronie's, I bought an Andropeyronies device.  My question to you, Birgir, is when I can use this again (still a little tender from the last injection, doncha know), in couple days, what is the best way to proceed.  My main issue with these devices is that you can't leave the house with one of these on.  It's a bit bulky.  The literature that came with the device said do not sleep with it on, so that narrows it down to daytime hours.  How long should I wear it for best results in conjuction with Xiaflex. 

    Thank you so much for this site, I have gotten a lot of comfort knowing that I am not alone, and that Peyronie's isn't RARE.


    • Birgir May, 2018

      Dear Clark

      Thank you for sharing your experience and for your kind words, much appreciated.

      You sure ain’t alone… unfortunately! It is always coming clearer and clearer that Peyronie’s disease is much more common than previously thought. Which makes it more and more important to raise the awareness about this condition and what can be done (and how improve penis health and avoid penis injury in the first place).

      I’m glad that your Xiaflex injections have gone well so far and hope you will see some results in due course. I don’t think you have to be overly concerned if you do have an erection for the next couple of weeks. Just obey the doctor and don’t act upon it!

      Regarding when you can start using traction device then I recommend you discuss this with your doctor. As you are having Xiaflex treatments I’m not in a position to advice you here.

      However, regarding how and when to wear Andropeyronie and similar devices. Yes, they are little bit bulky and can restrict certain movement, e.g. not ideal to wear for men doing physical labour or even professional drivers. Many though wear them out and about, e.g. men doing office work. Some find it better when wearing casual clothes, i.e. when they can wear their shirt over their trousers.

      But you are right, you cannot sleep with Andropeyronie and similar devices. The only device I’m aware of that you can safely use while sleeping is Phallosan.

      Again, I wish you good luck with your treatment and hopefully you can share your success with us in due course.

      Kind regards,


    Tony December, 2018

    I had my second injection (first round) last week. I woke up at midnight in extreme pain so much so that my wife had to take me to the ER, the swelling was fast and painful. I'm not sure if I will continue to the next round of injections, I can not believe how terrible the pain is at time of the injection. And the pain that followed that night was a new level of hurt for me.

    That said, my erection were very painful, though not as bad, this seems like a no win situation.

    • Birgir December, 2018

      Dear Tony,

      I’m so sorry to hear about your experience. I can only imagine!
      I’m sure you will talk to your doctor before deciding on the next steps.
      I wish you all the best with whatever you decide to do. I sincerely hope it will all work out well for you. Take care and hopefully you will keep us posted about your progress.

      Kind regards,


    Albi March, 2019

    Hi, I just had my first injection of the 4th cycle (injection 7) of Xiaflex. Unfortunately it did not go as well as the others times.

    At the beginning of all this my curve was approx 45 degrees. After the 3rd cycle it was approx 32 degrees so I can say it did work quite well for me but I went ahead with the 4th cycle to see if I can make the curve even less.

    It has been 7 days and it is now that I am noticing the swelling and color starting change and come back to normal. It has been a very scary week for me. Though I'm not in pain, my penis feels tender all over and at the injection site if feels a little hard and a little lumpy (I guess that's where the hematoma is located) not sure though. 

    I am able to urinate normally and even think Iv'e had nightly erection (good sign). The day I was supposed to get the second injection my uro didn't do it and told me to come back in a week after the swelling goes down to evaluate if it is even worth getting the last (8th) injection. I don't think I want to go through with it.  It has been a very tough week.

    From what I have learned as a patient getting Xiaflex, in my opinion if you have hard plaque that is easy to find then I would say get an experienced uro and do it if the PD bothers you a lot, it is impossible or difficult to have sex. But I would say that once you get to the point where you can live with the remaining curve, just leave it as is because as you go through the injections there will be less hard plaque and the possibility of the doc jabbing in there trying to hit the hard plaque could cause the needle to go where it shouldn't and cause a hematoma. 

    Hopefully the uro will not say I need to have it drained and that with a little more time it will heel on it's own. Either way I have to wait at least another 3 full weeks before I can have sex again.

    • Birgir March, 2019

      Thank you very much for sharing your experience of Xiaflex injections. I’m sure men considering this option will find your insight helpful and help them to ask the right questions of their Urologist.

      I hope the swelling will go down on its own and I wish you a good recovery and all the best in the future.

      Kind regards,

    Bri68 March, 2019

    For me I found no improvement at all after 2 cycles of Xiaflex treatment, but what I did experience some 6 weeks after the treatment was a penile rupture, my doctor said it was probably caused by the injections but couldn't confirm 100% that it was definitely the cause.

    So I've now had to be circumcised as part of the procedure to surgically repair the penis, 3 months of recovery and 14-21 days of extremely uncomfortable aftermath immediately after surgery. If had my time again I'd just let nature take its course...

    • Birgir March, 2019

      Thank you for sharing your experience of Xiaflex injections. I’m very sorry to hear it didn’t go as planned.

      I wish you a good recovery and all the best in the future.

      Kind regards,

    Mike123t March, 2019

    It was unpleasant but not painful; two of the shots were followed by painful swelling (and initially pretty scary) that went away after a week; no long term effects.

    I am hesitant to get the last three as I don't believe it is useful or helpful (except for the drug manufacture and the medical staff).

    • Birgir March, 2019

      Thank you for sharing your experience of Xiaflex injections. I’m very sorry to hear it has not worked as you hoped.

      I wish you all the best in the future and hope it will all work out for you, whichever option you go for.

      Kind regards,

    Tomtoes April, 2019

    In 2018 I had a 40 degree upward bend in my penis. I went to my urologist and he recommended Xiaflex.

    After getting the treatment approved by my insurance I had a full round of 12 shots.

    I will tel, you the pain was almost unbearable. The swelling took over a week to subside so I could have the second shot. I realized absolutely zero improvement. In fact my penis is about 1/2 “ shorter than when I started the treatments. I believe it shrunk up due to the ill effects of the shots. My skin on and around my penis is severely discolored.

    I have a hard time believing the rare review that says it worked well or even perfectly, If I had it to do over, I would have had the surgery to remove the plaque.

    • Birgir April, 2019

      Thank you for sharing your experience of Xiaflex. I’m very sorry that you didn’t seen any improvements. From what I have seen, now few years since Xiaflex became approved Peyronie’s treatment, the results have not been as good as hoped in the beginning. Don’t get me wrong, some men have seen improvements, but many have not. And many complain about how painful this treatment has been for them.

      Not heard about penis shortening before though. Traction therapy will help you to gain back lost length, that’s just how traction works (think of the long-necked ladies in Burma). It has also helped many to reduce their curvature.

      Kind regards,

    65 degrees November, 2019

    1st November 2019

    Before starting xiaflex, I found the very best urologist specializing in Peyronie and Xiaflex injections. I had a 65+degree upward curvature as well as a left handed twist at the head. The first course targeted the penis head. At the end of first course the head was completely straight.No problems! The second course concentrated on the 65 degree upward bend. At the end of second course, the bend was reduced to 30 degrees. No problems! I have just finished my third course with great optimism. He does use a block, no pain, hematomas or any other ill effects during or after injections. Bottom line, research, research, research. Find the VERY BEST Urologist that specializes in Peyronies/Xiaflex treatment. A good sign is an unusually long time for an appointment opening initially.  Best of luck to all!

    4th November 2019

    I am shocked at the volume of negative reports on xiaflex treatments. My urologist is in practice with three other urologists. He is the sole Dr. in his practice that performs xiaflex injections. He starts each course with a block and an injection to cause erection, followed by another block before all injections, two xiaflex injections over following 2 days. two days after 2nd injection another block followed by penis modelling. No pain and minimal bruising before and after treatment! Before starting treatments, my penis had a mid-shaft 65% upward curve with a left sharp twist/bend just below the penal head. After 2 full courses (4 shots) the penis head is straight and the mid shaft 65% bend upward was reduced to 30%. I have just completed 3rd course and am experiencing no negative effects. My spontaneous erections appear to have significantly reduced to about 15%. People needing xiaflex injection treatment travel hundreds of miles to seek xiaflex treatment from this urologist. He,s considered a rock star by his treated patient! All urologists are not created equal, do your back ground home work on the Dr. that's holding the needle. Best of luck to all of you, don't give up on this treatment as a possible option.

    • Birgir November, 2019

      Thank you for sharing your experience of Xiaflex with My Peyronie’s readers. I’m really glad it worked so well for you. There is no question that Xiaflex has helped many men with their penis curvature and I’m sure many men will find your experience very inspiring and helpful.

      Regarding negative reports on Xiaflex treatments then can think of few reasons. First, we human beings seem to be more likely to share negative experiences than positive ones. Secondly, before / when Xiaflex first came available it was kind of introduced as “the solution”, “magic” and “cure”. Many men may have had too high hopes and therefore feel more let down when it’s not working for them. Finally, when things go wrong / do not work with Xiaflex, it can be more severe / painful than when some other treatments go wrong / do not work.

      For me personally, I consider Xiaflex one option that can work for some men but not all. I fully agree with you about “research, research, research. Find the VERY BEST Urologist that specializes in Peyronies/Xiaflex treatment”.

      Again, I’m very glad that Xiaflex worked so well for you and congratulate you on your success. And I’m sure your experience will help and inspire others. Thank you.

      All the best in the future.


  6. Frisco February, 2021

    About 3 years ago I developed a slight 30 degree bend upwards towards the front of my penis.  Naturally I was horrified, upset, embarrassed, and bewildered by what was happening to my penis.  Today, 02/011/2021 around 8:30AM I had my first injection of Xiaflex and will receive the second injection in 7 days later.  My urologist is not much of a hand holder, so to speak, so my experience was frightening and very stressful(I’m a big baby).  The numbing injection was somewhat uncomfortable but not as bad as I imagined. To my surprise my penis never became completely numb, something they neglected to mention during the consultation.  The Xiaflex inject itself was moderately bearable and reality quick with some discomfort.  The doctor wrapped my penis in a bandage and instructed me to remove it in a couple of hours.  By early afternoon my penis was very swollen and bruised - about double it’s normal size.  I have experienced an aching discomfort on/off most of the time after the injection.  I am applying ice packs on and off coupled with the counter medications. 

    • Birgir February, 2021

      Thank you for sharing your experience. We wish you all the best with the rest of your treatment and we hope you will keep us posted about your results.

      Kind regards,

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Hello, I'm Birgir

This website is based on my experience of Peyronie's disease