Penile Modeling for Peyronies Disease
Penile Modeling Procedure
This section outlines the in-office penile modeling procedure, which in conjunction with Xiaflex helps relieve the curvature deformity and straighten the penile shaft. At a follow-up visit 1 to 3 days after the second injection of each treatment cycle, perform a penile modeling procedure (as described below) on the flaccid penis to stretch and elongate the treated plaque.
This section also outlines instructions to give to patients on how to perform daily, at home penile modeling activities for 5 to 6 weeks following each treatment cycle.
NOTE: Prior to administering Xiaflex and as part of every treatment- related visit, use the Patient Counseling tool, What You Need to Know About Xiaflex Treatment for Peyronie’s Disease to discuss important information with each patient.
In-Office Penile Modeling Procedure
- Administer suitable local anesthetic, if desired.
- Wearing gloves, grasp the plaque or indurated portion of the flaccid penis about 1 cm proximal and distal to the injection site. Avoid direct pressure on the injection site.
- Using the target plaque as a fulcrum point, use both hands to apply firm, steady pressure to elongate and stretch the plaque. The goal is to gradually create bending opposite to the patient’s penile curvature, with stretching to the point of moderate resistance.
- Hold pressure for 30 seconds, then release.
- After a 30 second rest period, repeat the modeling attempts at 30 seconds for each attempt.
At-Home Penile Modeling Activities
There are 2 types of at-home modeling activities. One is a gentle stretching activity; the other is a gentile straightening activity. Discuss with patients the best time to perform these activities. Patients will do these approximately 6 weeks after each treatment cycle.
Patients should perform the penis-stretching activity daily, three times per day, with a non-erect penis.
For the stretching activity, instruct the patient to:
- Grasp the tip of the penis with the fingers of one hand and hold the base of the penis with the fingers of the other.
- Gently pull the penis away from the body to its full length.
- Hold the stretch for 30 seconds.
- Let go and allow the penis to return to normal, unstretched length.
Patients should perform the penis straightening activity no more than once per day only if a spontaneous erection occurs. If the patient does not have a spontaneous erection, he should not attempt the penis straightening.
For the straightening activity, instruct the patient to:
- Gently attempt to bend the shaft of the erect penis in the opposite direction of the curve, but not so forcefully as to produce significant pain or discomfort.
- Hold the penis in this more straightened position for 30 seconds, then let it go.
- Perform this no more than once per day, if a spontaneous erection unrelated to sexual activity occurs.
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