New FDA-approved Treatment for Curvature of the Penis

Until recently, surgery was the only effective treatment for Peyronie’s disease, a condition that causes curvature and shortening of the penis, making intercourse difficult or impossible. Now there is a new option. Xiaflex (collagenase) is the first drug approved by the FDA to treat Peyronie’s disease. “I think the fact that we have an FDA-approved drug is really a breakthrough in this disease,” said Stanton Honig, MD, a Yale urologist who specializes in male reproduction and sexual dysfunction.

Honig’s recent research includes studies on oral testosterone, novel treatments of erectile dysfunction and the effect of high blood pressure medications on male fertility. He also participated in some of the early studies on Cialis (tadalafil) for erectile dysfunction. He participated in the clinical trials that led to the approval of Xiaflex for Peyronie’s disease, which affects between three and eight percent of the population.

The condition is caused by scar tissue that develops in the shaft of the penis, often as a result of injury during sexual intercourse or other traumatic injuries to the penis. It has major impacts not just on sexual function and physical appearance, but also psychologically. “About 50 percent of people with this disease have some level of depression,” said Honig. 

Xiaflex was first approved by the FDA in 2010 for treatment of Dupuytren’s contracture, a disease that affects a person’s ability to straighten and use the fingers. In Peyronie’s disease, it is believed to work by breaking down the scar tissue that causes the curvature. Treatment consists of a series of Xiaflex injections followed by massage to break down the scar tissue.

The newly approved treatment is ideal for someone with mild to moderate curvature of the penis who has significant difficulty with intercourse. Complications are usually limited to bruising and swelling, although there is a rare risk of penile fracture, usually if the patient has intercourse too quickly after treatment. Surgery is recommended for more severe cases, and is highly successful, but poses a small risk of post-operative problems that include shortening of the penis and changes in sensation. 

“I think Xiaflex is a great breakthrough in terms of options,” said Honig. He expects to offer the treatment to patients within the next few months. Click here to read Dr. Honig's article, "Intralesional collagenase in the treatment of Peyronie’s disease", published in Therapeutic Advances in Urology Volume 6 Issue 2, April 2014.